Medical

Controversial Australian study finds no evidence that cannabis helps chronic pain

Controversial Australian study...
A new Australian study is casting doubt over the efficacy of cannabis as a tool to treat chronic pain despite prior studies suggesting the contrary
A new Australian study is casting doubt over the efficacy of cannabis as a tool to treat chronic pain despite prior studies suggesting the contrary
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A new Australian study is casting doubt over the efficacy of cannabis as a tool to treat chronic pain despite prior studies suggesting the contrary
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A new Australian study is casting doubt over the efficacy of cannabis as a tool to treat chronic pain despite prior studies suggesting the contrary
A new Australian study is casting doubt over the efficacy of cannabis as a tool to treat chronic pain despite prior studies suggesting the contrary
2/2
A new Australian study is casting doubt over the efficacy of cannabis as a tool to treat chronic pain despite prior studies suggesting the contrary

The results of one of the world's longest in-depth studies examining the relationship between cannabis use and chronic pain is raising doubts over whether cannabis reduces either pain severity or opioid use. The study, recently published in Lancet Public Health, is proving controversial as its findings contradict a growing body of research suggesting exactly the opposite.

The new Australian research, from the National Drug & Alcohol Research Center at UNSW Sydney, tracked over 1,500 subjects for four years. Participants suffered from chronic, non-cancer pain, and were all currently prescribed opioids as their primary pain management tool. Following a baseline interview and a three-month follow up, the subjects were reinterviewed every year for the following four years.

Using questionnaires and interviews all subjects self-reported their pain severity, mental well-being, and opioid and cannabis use. The results found no evidence that cannabis use reduces pain severity, in fact, the study reported that those using cannabis reported higher levels of both pain and anxiety compared to those not using the drug.

"At each assessment, participants who were using cannabis reported greater pain and anxiety, were coping less well with their pain, and reported that pain was interfering more in their life, compared to those not using cannabis," says Gabrielle Campbell, lead author on the study. "There was no clear evidence that cannabis led to reduced pain severity or pain interference or led participants to reduce their opioid use or dose."

The study is proving reasonably controversial in the field of medical marijuana research for its seemingly contradictory results when compared to other recent similar studies. While studies on the effects of cannabis for chronic pain have historically presented rather mixed results this seems to be due to the lack of specificity in many of these studies, as well as an inability to objectively determine a metric for pain severity.

Other research into more specific dosages and administrations of cannabis in relation to the drug's analgesic effects have found that low versus high dosing can make a key difference in the efficacy of its pain-modulating effects.

Another anachronistic element of this new study is the fact that while adjusted longitudinal analyses found no difference in pain severity between cannabis and non-cannabis users, the acute self-reporting of individual cannabis users suggested it was indeed effective for their pain. In fact, the study reports that the mean score for cannabis' efficacy on pain as self-reported by individual cannabis users was seven out of 10. The researchers hypothesize this odd inconsistency could possibly be due to cannabis' effects on other lifestyle aspects, such as improving sleep, which subsequently improves well being.

This data point importantly suggests that the effects of cannabis on the overall wellbeing of a patient suffering from chronic pain cannot be easily measured by simply trying to calculate acute pain severity.

A systematic review of all the current research by the National Academies of Sciences in 2017 concluded there is, "substantial evidence that cannabis is an effective treatment for chronic pain in adults." This review did note, however, that variations in different clinical study conclusions reflected the assortment of different doses and routes of administration, suggesting more specific work needed to be done to accurately find effective consumption methods.

One of the most significant limitations of this new study stems from the fact that for the majority of this Australian study, medicinal cannabis was illegal. This means the study collected no data on how subjects were consuming the cannabis or what form it took. David Caldicott, a researcher from Australian National University, even suggested in an interview with Buzzfeed, that all this study proves is that medical marijuana in an illicit market doesn't work.

"This paper shows that an unregulated market doesn't appear to work, but it certainly doesn't prove that medicinal cannabinoids don't work for pain,' says Caldicott.

It is also very significant to note the overall numbers of cannabis users versus non-cannabis users in the study seems to be markedly out of balance. At the final four-year follow up point there were a total of 1,217 subjects still in contact with the researchers. Of that number, only six percent (or 79 subjects) reported daily or near-daily cannabis use, and only 16 percent reported using cannabis at any point over the past 12 months.

In Australia, medical cannabis usage was only approved for a very limited number of conditions in 2016. While the United States and Canada are moving to more broadly allow recreational usages of the drug, Australia is moving much more slowly and conservatively. Despite the disappointing limitations of this study, and its conclusions being somewhat inconsistent with broader international research, it may slow down further medical cannabis legislation in the country over the coming years.

The study was published in the journal The Lancet Public Health.

Source: UNSW Sydney, National Drug & Alcohol Research Center

7 comments
b@man
It does make you forget pain. But this is an obviously a flawed and biased study of a very few targeted people and contradicts other studies that show opioid use decreases with cannabis, and that is what is important and renders this, so called, study irrelevant...
piperTom
As the article points out, in the illicit market there is no way to control quality and this "study" didn't even attempt to measure it. The wonder is that this junk science could find a publisher.
paul314
Another obvious interpretation of the study is that participants had a range of chronic pain levels and a range of responses to opioids. If the patients with the most intractable chronic pain were mostly the ones driven to try (illegal) marijuana, you'd see results much like this. I'm sure that the researchers did their best to control for this effect, but since pain is almost entirely self-reported that's hard to do accurately. (And once-a-year recollections are also not that reliable.)
Mik-Fielding
The apparent 'results' of this 'study' are completely opposite from my own personal experience and I know of many others who agree with me. The question remains is; who in fact supported this study and what was their involvement in vested interests in the pharmaceutical industries ...
Edouin
Two points from 20 years personal experience: 1. My brother broke his back. He now occasionally utilizes Canaboid oil, claims to me that greatly reduces his pain. What do I know, but I believe him. 2 yrs so far. 2. I use THC pills to assist in chronic Nerve Pain. It is not intended as an opioid or pain killer, but it helps me COPE during periods of extreme pain when no pain killer (fast acting, short term) can help me. Other than being continually wacked out of my head on pain killers (I have several years missing from my memory!), I use these pills in combination with Meditation and my "normal" non-opioid pain pills. It works for me. The THC helps me in coping when my Nerve Pain breakthrough's reach 8 or 9, by assisting me to relax into my Mindfulness breathing pattern. Sure, it hurts like a bastard at first, but once I am in the groove, the pain is (mostly) just "ignored" until the flare-up resides. I recover much faster from these breakthroughs than I did when on Methadone (which was pretty much useless!!!), and many, many, other drugs I have tried over the years. It is hard to find that "balance" between dizziness, fatigue, and occasional forgetfulness, to be able to effectively, and quickly counteract sudden pain onsets, and the THC is THE medication I now NEED to live. No other drug can offer the speed I need to effectively remove pain breakthroughs, without constantly injecting myself with some Anaesthesia at the point of pain. See, no need to over-drug my brain; The THC, and I strongly suspect, the Canaboid Oil my bro uses, is indeed effective. Where did they get this data for their study? The Orangutan exhibit at the Sydney Zoo?
asninsp
"Self-reported" ... so they take the subjective opinion of people who are stoned ??? .. sounds more like a study paid for by big pharma to ensure their profits aren't diminished by something you don't have to pay for. Over the counter opioids are responsible for more additions than heroin, morphine, amphetamines and cocaine combined ... who are they kidding?
david635
These are the problems with the Lancet study. https://prohbtd.com/inside-the-aussie-study-that-says-cannabis-doesnt-relieve-pain