Study: Cannabis Inhalation Associated With Long-Term Pain Relief, Opioid-Sparing Effects in Patients With Treatment-Resistant Lower Back Pain
Petah Tikva, Israel: Patients suffering from chronic lower back pain report sustained improvements and less reliance on prescription medications following the long-term use of cannabis, according to observational data published in the scientific journal Biomedicines.
Israeli investigators assessed the safety and efficacy of inhaled botanical cannabis over five years in a cohort of over 200 patients with treatment-refractory low back pain. (State-licensed cannabis products are available by prescription in Israel.)
At year five, nearly 90 percent of patients experienced a greater than 30 percent reduction in their chronic pain, with 77 percent of participants reporting a greater than 50 percent pain reduction. Over 95 percent of the study’s participants had ceased their use of opioids by the study’s conclusion. Adverse events from cannabis were mild.
Researchers reported: “In this five-year retrospective analysis of prospectively collected outcomes from 241 treatment-refractory CLBP [chronic low back pain] patients, inhaled medical cannabis was associated with large, statistically robust, and clinically meaningful sustained improvements in pain, disability, pain severity, and pain interference. Concomitant medication trajectories showed near-universal displacement of opioids (100 percent to 4.6 percent), NSAIDs (100 percent to 7.1 percent), SSRI/SNRIs (80. percent to 5.4 percent), and gabapentinoids (38.6 percent to 2.5 percent).”
The study’s authors concluded, “These five-year observational data are consistent with inhaled medical cannabis being a clinically meaningful option in CLBP patients who have failed multimodal conventional therapy, with a benefit–risk profile dominated by large, sustained PROM [patient-reported outcome measures] improvements; near-universal opioid sparing; and predominantly mild, well-characterized adverse events. … The within-patient benefit-risk profile … supports consideration of cannabis as a potentially clinically meaningful, opioid-sparing option in patients who have failed multimodal conventional therapy, pending confirmation in randomized comparative trials.”
Data published in the Journal of the American Medical Association reports that nearly one in three patients with chronic pain use cannabis as an analgesic agent and many of those who do substitute it in place of opioids.
Full text of the study, “Long-term inhaled cannabis therapy for chronic low back pain: A five-year retrospective analysis of prospectively collected patient-reported outcomes in 241 treatment-refractory patients,” appears in Biomedicines.