Study Reveals Medical Cannabis Equally Effective as Opioids for Pain Relief with Fewer Side Effects

A recent comprehensive study has delved into the comparative efficacy of medical cannabis and opioids in the treatment of chronic non-cancer pain. The study’s groundbreaking findings indicate that cannabis may not only be as effective as opioids in providing pain relief but also tends to result in fewer treatment discontinuations, suggesting a potentially safer profile with a reduced risk of adverse events.

Published in the renowned journal BMJ Open, this study encompasses an extensive review of 90 randomized controlled trials (RCTs). These trials, which collectively involved a significant cohort of 22,028 participants, focused on comparing the effects of opioids, medical cannabis, and placebos in pain management. Of these, 84 trials were meticulously analyzed in the qualitative assessment presented in the report.

The authors of the study highlight that their research offers critical insights into the pain management domain. They state, “Our findings suggest that both opioids and cannabis for medical use may provide benefits for a minority of chronic pain patients.” A notable emphasis of the study is on the safety profile of cannabis compared to opioids. The authors point out that, unlike opioids, cannabis does not induce respiratory depression, a serious side effect that can lead to non-fatal or fatal overdose incidents.

This study is distinguished as the first network meta-analysis that investigates the comparative effectiveness of medical cannabis and opioids specifically for chronic non-cancer pain management. Chronic pain is a prevalent issue, affecting approximately 20% of the global population. It is conventionally treated with opioids. The study’s authors recognize that there is “moderate” evidence indicating minor enhancements in pain relief attributed to opioids. However, they also discovered “low to moderate certainty evidence” that indicates medical cannabis is similarly beneficial in alleviating pain. This evidence marks a significant step in understanding the potential role of medical cannabis in chronic pain treatment, offering a potentially safer alternative to traditional opioid therapy.

Comparing Medical Cannabis and Opioids in Pain Management

The study, which presents low certainty evidence from 82 randomized controlled trials (RCTs) involving 19,693 patients, suggests that the pain relief offered by medical cannabis may be comparable to that provided by opioids, with little to no significant difference observed. This finding is particularly notable as it explores the efficacy of two widely used pain management options.

In terms of treatment discontinuation, the study highlights that while both opioids and cannabis likely lead to higher rates of discontinuation compared to placebo, the occurrence appears more frequent with opioids, largely due to adverse effects. This aspect underscores the importance of considering patient tolerance and side effects in the choice of pain management treatment.

The researchers further concluded that medical cannabis may offer small improvements in pain relief, physical function, and sleep quality similar to those provided by opioids. However, it is noteworthy that these improvements come with fewer discontinuations due to adverse events, suggesting a potentially safer profile for medical cannabis in some aspects.

Interestingly, the study found that neither opioids nor cannabis were more effective than placebo in improving role, social, or emotional functioning. Additionally, there seems to be little to no difference in sleep quality between the two substances, based on the low-certainty evidence available.

Despite these promising findings, the study’s authors from McMaster University in Ontario, Canada, emphasize the need for further research. Among the medical cannabis trials reviewed, none administered inhaled forms of cannabis, making the generalizability of the findings to smoked or vaporized cannabis uncertain. The researchers highlighted that smoking-related studies were excluded due to inadequate duration of follow-up, typically less than four weeks.

The study also faced limitations in directly comparing the effects of opioids and cannabis due to the scarcity of trials that directly contrast the two interventions for chronic pain, with only one trial making such a direct comparison.

Researchers discovered that a substantial majority of the trials, amounting to 83 percent, exhibited a high risk of bias in at least one area during their evaluation of the evidence’s quality. These domains include crucial factors such as random sequence generation, allocation concealment, blinding of participants and personnel, and loss of participants to follow-up.

The challenges in cannabis research, such as the issues related to the blinding of study participants, also contribute to potential biases. For example, in a recent study examining the interaction between cannabis and exercise, participants had to source their state-legal cannabis due to legal constraints, leading to participants being aware of the cannabinoid content of their products. This requirement inadvertently affected the blinding process, thereby influencing the study’s outcomes. Such obstacles highlight the complexities and limitations faced in contemporary cannabis research, underscoring the necessity for more rigorous and diverse studies in this field.

Exploring Cannabis as a Pain Management Alternative

Recent studies on cannabis and its application in pain management are progressively highlighting the potential of cannabinoids as an effective substitute for opioids in alleviating pain. Recent studies have been shedding light on the effectiveness of cannabis in not only reducing pain intensity but also providing a more ‘holistic’ relief. For instance, a study conducted last November revealed that both cannabis and opioids were equally effective in mitigating pain. However, cannabis stood out for its additional benefits, such as enhancing sleep quality, focus, and emotional well-being.

In a similar vein, another research article published in the Journal of Dental Research made a compelling discovery about pure CBD (cannabidiol). The study found that CBD could be as effective as certain opioid formulations commonly used in dentistry for alleviating acute dental pain. The authors of this study emphasized the potency of a single dose of CBD, equating it to current analgesic regimens in managing emergency dental pain. This groundbreaking research is hailed as the first randomized clinical trial to test CBD for dental pain relief and holds the potential for FDA approval of CBD in dental pain management.

Regarding cancer-related pain, a study released earlier this year provided insights into the use of medical cannabis by cancer survivors. The study found that over half of the cancer survivors (51 percent) who used medical cannabis did so to manage pain. A significant majority of these patients reported experiencing some level of benefit from the drug.

In a separate research, findings indicated that legal access to CBD substantially decreased opioid prescription rates, with a reduction of 6.6 percent to 8.1 percent in opioid prescriptions. This correlation suggests a potential role for CBD in addressing the opioid crisis.

Another study, published in the journal Cannabis last summer, highlighted the link between medical cannabis use and a decrease in pain levels, along with a reduced dependence on opioids and other prescription medications. Study participants not only experienced reduced levels of pain and anxiety but also noted enhancements in their physical and mental well-being, improved sleep quality and mood, along a decreased dependency on several prescription medications, such as opioids and benzodiazepines.

More recently, research featured in the Journal of Endometriosis and Uterine Disorders made a notable discovery regarding CBD-infused tampons. The study found that these tampons led to a statistically significant reduction in pain for severe cramps and menstrual pain, offering a similar pain-relieving effect to anti-inflammatories but with fewer side effects.

Looking ahead, a comprehensive research project by Johns Hopkins University researchers aims to delve deeper into the effects and efficacy of cannabis therapy. This extensive project, supported by a five-year grant of $10 million from the National Institute on Drug Abuse (NIDA), aims to monitor 10,000 medical cannabis patients for a period exceeding one year. The researchers, in collaboration with federal researchers and nonprofits, will gather data on various aspects of cannabis therapy, including dosing, delivery methods, chemical composition of products, potential medication interactions, and other treatment nuances. This large-scale study is poised to significantly enhance the understanding of cannabis therapy’s impact and effectiveness.