Is Cannabis the Solution to the Chronic Pain Crisis?

A new study has found that medicinal cannabis may be able to reduce the intensity of chronic pain in patients by as much as 30%.

A new study conducted by Southern Cannabis Holdings (SCH) has found that medicinal cannabis may be a highly effective treatment option for patients suffering from chronic pain.

The study was carried out by Applied Cannabis Research—which is a division of SCH—in partnership with Little Green Pharma (LGP), the first Australian producer of locally-grown and GMP-manufactured cannabis products.

This is in keeping with LGP's ongoing business strategy, which centres on improving patient access through education and supporting the market with cannabis grown at the company's secure facility in Western Australia.

Applied Cannabis Research chose to focus on chronic pain patients who have exhausted conventional forms of therapy for the study, which is currently recruiting an additional 300 patients over the age of 25 via the Cannabis Access Clinics' healthcare network.

Initial findings from the study—which makes uses of Little Green Pharma products—have demonstrated a trend in patients towards improvements in pain, anxiety, sleep disturbance, depression, and other quality of life measures.

LGP and Cannabis Access Clinics have chosen an observational study to provide Australian doctors with timely access to real-world results in preference to a placebo controlled clinical trial which frequently take several years before data can be made available to practitioners. Managing Director of Little Green Pharma, Fleta Solomon

This could potentially be huge news, as chronic pain currently affects up to 1 in 5 Australians. In fact, the total number of people living with chronic pain in this country is expected to increase to 5.23 million by 2050.

According to the Medical Director of Cannabis Access Clinics, Dr Sanjay Nijhawan, after four months into the study, "initial findings suggest that for some patients there are positive improvements in quality-of-life measures including pain, anxiety, sleep disturbance and depression."

"There is a growing body of evidence supporting the use of medicinal cannabis as an adjunct therapy to reduce dependence on opioids, resulting in improved patient pain control and side effect profile," Dr Nijhawan said.

The ethics-approved research protocol for the study was also specifically developed by Applied Cannabis Research to be aligned with best practices in Europe and North America, significantly widening the potential application of any positive findings.

Improving Patient Outcomes

Although the trial is still underway, LGP's medicinal cannabis products have already begun delivering measurable quality of life improvements for the participating patients.

One of these patients is Lorna Joyce, a 55-year-old woman from Brisbane who has been taking prescribed medicinal cannabis for approximately 4 months. Lorna has suffered from chronic pain for over 20 years, and during this time has also had to undergo more than 20 surgeries to divide adhesions on her small bowel.

During this period her level of pain was so intense that she often had to be hospitalised, while also requiring daily pain relief injections that were administered by her GP.

Medicinal cannabis has a legitimate role in treating certain conditions in certain people. It is important patients seek advice from their doctor who can provide more information about qualifying conditions for medicinal cannabis treatments, and products legally available for prescription. Medical Advisor to Little Green Pharma, Dr Joe Kosterich

However, within just a few weeks of commencing treatment, Lorna was already beginning to see a positive difference.

She initially began by taking cannabis oil, but once she was accepted into the study Lorna was put onto Little Green Pharma THC 10:10 medicinal cannabis. And while she was originally approved for 6ml per day, she currently only needs to take 2ml—split between two doses in the morning and evening—to effectively manage her pain.

According to Lorna, she is now pain free and no longer has "to visit my doctor every day to have an injection to manage my pain."

"Since I started my medicinal cannabis treatment I haven't been hospitalised at all and this is the longest I have been out of hospital in 10 years. I am absolutely thrilled and my GP is so happy with the results also!"

"This is the first holiday where I haven't had to worry about needing access to a hospital or doctors."

"I feel like I have my life back," she said.

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These sentiments were also echoed by another participant in the study, Dave, a 35-year-old former chef from Penrith, Sydney. Dave was diagnosed with epilepsy during his youth—which has necessitated a lifetime of medication—and suffers from a number of other health challenges, including Meniere's disease.

Unfortunately, Dave also developed arthritis throughout the right side of his body due to a serious car accident and was eventually forced to use a wheelchair when he started losing his mobility.

Compounding this was another accident that took place in 2015, when Dave suffered a seizure and fell down a flight of concrete stairs. Scans revealed that the incident caused Dave to develop multiple protruding disks in his spine. However, specialists informed him that they were inoperable because of his pre-existing health conditions.

As a result, Dave found himself taking up to 16 different pain and anti-inflammatory medications per day, although he claims they had little effect on his quality of life.

"The pain was excruciating and I got to a point where I just wasn't living," he said.

"I was a juggling act of so many medications that really didn't control my pain and I spent weeks on end on the couch. I tried every treatment the doctors could think of."

While things seemed increasingly bleak for Dave, his situation turned a corner 6 months ago, when he was prescribed medicinal cannabis.

Within a week and a half of commencing treatment he was already recording positive improvements in his quality of sleep and is now even able to spend time outside of his wheelchair on a regular basis.

Aside from the substantial improvements in mobility and pain management, Dave says that the greatest benefit is his renewed sense of autonomy and personal agency. He is now even considering going back to TAFE for training so he can re-enter the workforce, after being forced to abandon his career as a chef due to chronic pain. 

"I just wanted to do some of the most simplest things on my own without having to ask people for help. I wanted to take my dog for a walk again. Being able to sit through a whole movie, go to the shops on my own."

"I am getting my life back," Dave said.

Give and Toke

The principal research investigator who worked on the study, Dr John Barlow, recently sat down for an interview with The Green Fund, where he explained that the trial will run for approximately 4 years, with an observational period for individual patients of 12 months.

And while the study is currently recruiting an initial 300 participants, Dr Barlow said that this number will eventually increase to approximately 3,000 patients, which are expected to accrue over a 3-year period.

Applied Cannabis Research also chose to make the trial an observational study rather than a clinical one, as it will allow them to draw from a large cross-section of patients—suffering from a variety of different conditions—who are already undergoing treatment with medicinal cannabis.

The data has given us a suggestion that the intensity of pain that our patients are feeling can be reduced by upwards of 30%. Applied Cannabis Research principal research investigator, Dr John Barlow

This will allow them to generate a considerably broader pool of data concerning the "efficacy of the drug", rather than conducting a clinical trial for a specific disease or condition.

"We chose an observational study because of several things. First, it's less expensive than a full-blown clinical trial, which is a tick. Second, patients will be treated with medicinal cannabis, regardless of whether they're on a trial or not. And we can then obtain some results which indicate what's the best direction to go to conduct a full-blown clinical trial," Dr Barlow said.

"At this stage if we said, 'Oh, well let's conduct a clinical trial,' we might actually choose the wrong formulation to test for a particular condition. But if we do an observational study in the first instance, we're just observing the effect that the drug has on patients."

"So, the patients are being treated. If it works, we'll see an effect of the treatment in an observational sense, and then that can provide direction for a full blown clinical trial."

In fact, Southern Cannabis Holdings have already confirmed that they intend to partner with product companies to execute further clinical trials if the study is successful.

Have you ever wondered why cannabis has such an effect on us? Well, thank the Endocannabinoid system.

But, while the initial findings from the study are already highly promising, Dr Barlow explained that medicinal cannabis—or other products derived from the drug—are unlikely to be a magic bullet solution to the opioid crisis.

However, the study's findings do indicate that cannabis may be able to reduce chronic pain sufferer's overall dependency on opioid drugs.

"It would be nice if any of the various cannabis derivatives could replace opioids, because there are always problems with all of the medications that are available for treatment of pain. If a cannabis derived drug could relieve the effect of intractable pain without having the unwanted side effects, that would be terrific."

"But that's probably not going to be the case. However, if some cannabis derivative—whether it's THC or CBD or any of the others—is able to reduce people's dependence on opioids, then that would be a terrific thing," Dr Barlow said.

The trial is currently expected to conclude at some point during the 2023-2024 period, and will analyse the clinical results of patient's ongoing medicinal cannabis treatment.

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Hugo Gray
Hugo Gray

Hugo Gray is a Melbourne-based journalist with a body of work that covers a diverse range of topics, including immigration law, sex technology, and now the rapidly expanding cannabis industry.

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