Medical cannabis in the treatment of chronic pain
“This is the first and largest study of the long term safety of medical cannabis use by patients suffering from chronic pain ever conducted,” says lead author, Dr. Ware, pain specialist at the Montreal General Hospital of the MUHC and associate professor in Family Medicine and Anesthesia at McGill University. “We found that medical cannabis, when used by patients who are experienced users, and as part of a monitored treatment program for chronic pain over one year, appears to have a reasonable safety profile.”
As part of the Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS), that started in 2004, the researchers followed 215 adult patients, with chronic non-cancer pain, who used medical cannabis, and compared them to a control group of 216 chronic pain sufferers who were not cannabis users. The study involved seven clinical centres with pain management expertise across Canada located in Fredericton, Halifax, London, Montreal, Toronto and Vancouver.
The cannabis users were given access to herbal cannabis containing 12.5 per cent THC from a licensed cannabis producer. Cannabis was dispensed through the hospital pharmacy at each site, and patients collected their supply every month after completing the necessary visits and tests. Along with information on adverse effects, subjects underwent lung function and cognitive testing, and were asked about their pain, mood and quality of life over the one year of follow up. A number of the subjects underwent complete panels of blood tests for routine biochemistry, liver and kidney function, and selected hormone levels. The average amount of cannabis used overall was 2.5 grams per day whether smoked, vaporized or taken as edibles.
“Our data show that daily cannabis users had no greater risk than non-users (control group) to experience serious adverse events,’’ explains Dr. Aline Boulanger, director of the pain clinic at the Centre hospitalier de l’Université de Montréal. ‘’We found no evidence of harmful effects on cognitive function, or blood tests among cannabis consumers and we observed a significant improvement in their levels of pain, symptom distress, mood and quality of life compared to controls. ’’
However, the researchers did report an increased risk of non-serious adverse events in medical cannabis consumers such as headache, nausea, dizziness, somnolence, and respiratory problems associated with smoking.
“It is important to note the limitations of the study,” adds Dr. Ware. “Patients were self-selected, not randomized, and most were experienced users. So what we are seeing is that it appears to be a relatively safe drug when used by people who have already determined that it helps them. We cannot draw conclusions about safety issues of new cannabis users”.
About the study
The study was funded by the Canadian Institutes of Health Research (CIHR). The article Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS) is available online.
The sites involved in this study were the Alan Edwards Pain Management Unit at the Montreal General Hospital of the McGill University Health Centre and the Pain clinic at the Centre hospitalier de l’Université de Montréal – Hôtel-Dieu, (Montréal, QC); the QEII Health Sciences Centre (Halifax, NS), the Wasser Pain Management Centre of the Mount Sinai Hospital (Toronto, ON); the London Health Research Institute of St. Joseph’s Health Care (London, ON); the Stan Cassidy Center for Rehabilitation (Fredericton, NB); and the Arthritis Research Center of Canada (Vancouver, BC).
About The Research Institute of the McGill University Health Centre
The Research Institute of the McGill University Health Centre (RI-MUHC) is a world-renowned biomedical and healthcare research centre. The Institute, which is affiliated with the Faculty of Medicine of McGill University, is the research arm of the McGill University Health Centre (MUHC) - an academic health centre located in Montreal, Canada, that has a mandate to focus on complex care within its community. The RI-MUHC supports over 500 researchers, and over 1,200 students, devoted to a broad spectrum of fundamental, clinical and health outcomes research at the Glen and the Montreal General Hospital sites of the MUHC. Our research facilities offer a dynamic multidisciplinary environment that fosters collaboration and leverages discovery aimed at improving the health of individual patients across their lifespan. Over 1,600 clinical research projects and trials are conducted within the organization annually. The RI-MUHC is supported in part by the Fonds de recherche du Québec - Santé (FRQS). www.rimuhc.ca