A preliminary evaluation of the relationship of cannabinoid blood concentrations with the analgesic response to vaporized cannabis

Journal of Pain Research, 2016 · DOI: http://dx.doi.org/10.2147/JPR.S113138 · Published: August 31, 2016

Simple Explanation

This study investigates the relationship between cannabinoid blood concentrations and pain relief in patients with central neuropathic pain after using vaporized cannabis. The study found dose-dependent improvement in pain scores, with changes in THC and its metabolite related to changes in pain descriptors like itching, burning, and deep pain. However, these relationships were not statistically significant after adjusting for multiple comparisons, suggesting more research is needed to explore the connection between specific cannabinoids and pain relief.

Study Duration

Not specified

Participants

42 subjects with central neuropathic pain

Evidence Level

Level II: Randomized, placebo-controlled crossover trial

Key Findings

1
Dose-dependent improvement in pain score was evident across all pain scale elements after administration of vaporized cannabis.
2
Changes in the concentration of THC and its nonpsychotropic metabolite, 11-nor-9-carboxy-THC, were related to percent change from baseline of several descriptors (eg, itching, burning, and deep pain).
3
After adjusting for the FDR, significance was not sustained, indicating the need for further research with larger sample sizes and more frequent measurements.

Research Summary

This study evaluated the relationship between plasma concentrations of cannabinoids and the analgesic response to vaporized cannabis in 42 subjects with central neuropathic pain. The study found dose-dependent improvements in pain scores and identified relationships between THC concentrations and changes in specific pain descriptors, although these relationships were not significant after FDR adjustment. The findings suggest the need for future research to explore the relationship between plasma concentrations and the analgesic response to different cannabinoids, potentially leading to mechanism-based treatment approaches for neuropathic pain.

Practical Implications

Personalized Pain Treatment

Identifying specific cannabinoids associated with changes in pain descriptors could lead to personalized treatment approaches for neuropathic pain.

Hybrid Plant Selection

Defining cannabinoids that are associated with changes in pain descriptors would presumably enable optimization of an analgesic effect through selection of hybrid plants with high concentrations of these cannabinoids.

Mechanism-Based Treatment Development

Understanding the relationship between cannabinoid concentrations and pain relief could contribute to the identification of distinct pathophysiologic mechanisms and the development of mechanism-based treatment approaches.

Study Limitations

1
Small sample size limited the statistical power of the study.
2
The limited number of blood sampling time points restricted pharmacokinetic analysis.
3
False-discovery-rate-adjusted P-values were not significant.

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