As a spine surgeon, Richard Price frequently encounters a common question from his patients: "Should I try cannabis for my back pain?" This inquiry highlights the growing interest in medical marijuana as a potential treatment for chronic pain, particularly for conditions like lower back pain, which is recognized as the leading cause of disability worldwide.
Upon examining the available research, Dr. Price discovered a notable lack of high-quality studies on the effectiveness of cannabis for chronic pain management. Although many patients report that cannabis significantly alleviates their discomfort and aids in sleep, scientific validation has been sparse. However, recent findings from two major clinical trials conducted in Europe have sparked renewed interest among medical professionals, including Dr. Price.
The first clinical trial, published in Nature Medicine, demonstrated that a specific blend of cannabis oil—containing the psychoactive component THC, along with CBD and other natural compounds—effectively surpassed a placebo in providing pain relief. The second trial compared this proprietary cannabis tincture with traditional opioids, revealing that patients experienced fewer gastrointestinal side effects, such as constipation, and achieved better pain management over six months compared to those taking painkillers.
Dr. Price considers these findings groundbreaking, emphasizing their potential to bolster the growing body of evidence supporting the role of cannabis in treating chronic pain. He notes that the regulatory landscape in the U.S., where cannabis remains classified as a Schedule 1 drug, complicates the execution of large-scale clinical trials. The German company Vertanical, which funded these studies, anticipates approval to market their full-spectrum cannabis oil, known as VER-01, in several European countries shortly. However, the U.S. FDA requires that similar research be conducted domestically, potentially delaying availability for years.
The results from the European trials are particularly noteworthy, especially the fact that cannabis outperformed opioids in providing pain relief and improving sleep quality. Kevin Boehnke, an assistant professor of anesthesiology at the University of Michigan, noted that despite certain limitations in the studies, they reflect real-world scenarios where many individuals prefer cannabis over opioids due to its efficacy and reduced side effects.
Although Vertanical's cannabis tincture may not be accessible in the U.S. in the near future, Boehnke encourages those suffering from low back pain to consider similar cannabis products as a viable alternative to opioids. While he acknowledges that the effects may not be identical, he believes the evidence is compelling enough for patients to explore this option.
Despite the promising findings, some experts, like Simon Haroutounian from the Washington University Pain Center, urge caution. He acknowledges the necessity of rigorous studies but believes the results may be specific to the particular cannabis compound tested. In the trial, participants in the cannabis group reported, on average, a 30% reduction in pain after 12 weeks, compared to a 20% reduction in the placebo group. Haroutounian points out that the actual treatment effect is likely the difference between these two outcomes.
Supporters of medical cannabis emphasize its safety profile, particularly when compared to opioids, which pose risks of overdose and addiction. Dr. Fischer from Vertanical highlights that participants in the studies showed no signs of dependency or withdrawal, often experiencing minimal intoxication, allowing them to maintain normal daily activities.
While there is currently only one FDA-approved cannabis-derived medication, Epidiolex, which does not contain THC, experts agree that THC plays a critical role in pain relief and sleep improvement. Boehnke notes that chronic pain medications rarely provide a single solution; instead, they often require a combination of treatments tailored to each patient's needs.
Many patients navigating chronic pain express a desire for cannabis options, as highlighted by Ellen Lenox Smith from the U.S. Pain Foundation. She advocates for FDA approval of cannabis products to enhance availability and reliability for patients suffering from chronic pain. As a long-term medical marijuana user herself, Smith emphasizes the importance of quality research to assist others in making informed decisions about their pain management.
Dr. Richard Price views cannabis as a reasonable treatment alternative for patients who are not candidates for surgery, but he emphasizes the need for further research to validate the European findings in the U.S. As interest in cannabis for chronic back pain continues to grow, both patients and healthcare providers are eager for more comprehensive studies that can guide effective pain relief strategies.
