Smoked cannabis reduces pain caused by HIV-associated neuropathy

Nurses General Nursing

Published

http://pub.ucsf.edu/newsservices/releases/200702061/

Smoked cannabis reduces pain caused by HIV-associated neuropathy

In a randomized placebo-controlled trial, patients smoking cannabis experienced a 34 percent reduction in intense foot pain associated with HIV--twice the rate experienced by patients who smoked placebo.

"This placebo-controlled clinical trial showed that people with HIV who smoked cannabis had substantially greater pain reduction than those who did not smoke the cannabis," said study lead author Donald I. Abrams, MD, UCSF professor of clinical medicine. "These results provide evidence that there is a measurable medical benefit to smoking cannabis for these patients."

"The beauty of this study is the use of the pain model as a neutral and physiological anchor for pain measurement. Patients' eyes were averted during the measurements and were uninfluenced by expectations. Smoked cannabis was shown to work on the pain system by shrinking the area of painfully sensitive skin created by the model. The response was comparable to strong pain relievers we have studied, such as morphine"

- Karin L. Petersen, MD, UCSF assistant adjunct professor of neurology

The study, published in the February 13 issue of the journal "Neurology," looked at 50 HIV patients with HIV-associated sensory neuropathy, a painful and often debilitating condition that is the most common peripheral nerve disorder that occurs as a complication of HIV infection. Occurring usually in the feet and characterized at times by tingling, numbness, the sensation of pins and needles, burning, and sharp intense pain, severe peripheral neuropathy can make walking or standing difficult.

Specializes in Peds Cardiology,Peds Neuro,Pedi ER,PICU, IV Jedi.
Who cares which component of the canabis-smoking provides relief? As far as I'm concerned, if the PT feels that an action/medication/intervention is beneficial to them, who are we to say nay?

Our screwed up, partially puritanical, partially libertine society and heavy-handed governmental nannies are responsible for denying utilization of a particularly useful plant.

:yeahthat: :yeahthat:

I know there's a cannibis pill, it's just a shame that the federal government can't get their heads around the fact that this drug CAN actually be good for you.

Specializes in SICU.

Vaporization allows for the patient to titrate the dose in a way he/she cannot with a pill. It's mind-boggling to me that cannabis is listed as a Schedule 1 substance by the DEA. Doesn't that mean "zero medicinal benefits?"

Specializes in NICU.

Hello??? Brownies people? You can eat pot too! and it will have the same affect and won't hurt any body's lungs!

Specializes in ICU.

AIDS patients suffering from debilitating nerve pain got as much or more relief by smoking marijuana as they would typically get from prescription drugs -- and with fewer side effects -- according to a study conducted under rigorously controlled conditions with government-grown pot.

In a five-day study performed in a specially ventilated hospital ward where patients smoked three marijuana cigarettes a day, more than half the participants tallied significant reductions in pain.

"It would be interesting to know if factors such as stress, or sleep disorders etc. were taken into account. They can be quite memory inhibiting and are more likely to be present in the control group, as a lack of mental stimulation can increase self doubt, decrease confidence and cause a form of panic. Could this have put the control group behind, at the same time the motivated groups were leaping ahead and would this not effect the measurement of the outcome? "

By contrast, less than one-quarter of those who smoked "placebo" pot, which had its primary psychoactive ingredients removed, reported benefits, as measured by subjective pain reports and standardized neurological tests.

The White House belittled the study as "a smoke screen," short on proof of efficacy and flawed because it did not consider the health impacts of inhaling smoke.

But other doctors and advocates of marijuana policy reform said the findings, in today's issue of the journal Neurology, offer powerful evidence that the Drug Enforcement Administration's classification of cannabis as having "no currently accepted medical use" is outdated.

"This should be a wake-up call for Congress to hold hearings to investigate the therapeutic use of cannabis and to encourage more research," said Barbara T. Roberts, a former interim associate deputy director in the White House Office of National Drug Control Policy, now with Americans for Safe Access, which promotes access to marijuana for therapies and research.

Countless anecdotal reports have suggested that smoking marijuana can help relieve the pain, nausea and muscular spasticity that often accompany cancer, AIDS, multiple sclerosis and other ailments. But few well-controlled studies have been conducted.

The new study enrolled 50 AIDS patients with severe foot pain caused by their disease or by the medicines they take.

The team first measured baseline pain, both subjectively (patients ranked their pain on a scale of 1 to 100) and with two standardized tests, one involving a small hot iron held to the skin and another involving hot chili pepper cream.

Then, for five days, patients lit up at 8 a.m., 2 p.m. and 8 p.m. using a calibrated puff method that calls for inhaling for five seconds, holding one's breath for 10, then waiting 45 seconds before the next.

The cigarettes were kept frozen and locked in a safe, then thawed and humidified one day before use. Cigarette butts and other debris were collected, weighed and returned to the safe to ensure no diversion for recreational purposes.

Grown on the government's official pot farm in Mississippi, the drug was about one-quarter the potency of quality street marijuana. The inactive version was chemically cleansed of cannabinoids, the drug's main active ingredients.

"It smelled like and looked like" normal marijuana, said study leader Donald I. Abrams, a physician at San Francisco General Hospital, where the smoking ward was located. Like the patients, Abrams was not told who had the active pot until the study was over.

Thirteen of 25 patients who smoked the regular marijuana achieved pain reduction of at least 30 percent, compared with six of 25 who smoked placebo pot. The average pain reduction for the real cannabis was 34 percent, compared with17 percent for the placebo.

Opioids and other pills can reduce nerve pain by 20 to 30 percent but can cause drowsiness and confusion, Abrams said. And many patients complain that a prescription version of pot's main ingredient in pill form does not work for them.

That was true for Diana Dodson, 50, who received an AIDS diagnosis in 1997 after a blood transfusion.

"I have so many layers of pain I can hardly walk," said Dodson, who was in the new study. Prescription drugs made her feel worse. "But inhaled cannabis works," she said.

Patients in the study -- all of whom had smoked pot previously -- reported no notable side effects, though the researchers acknowledged that people unfamiliar with the drug may not fare as well.

Igor Grant, director of the University of California Center for Medicinal Cannabis Research, which funded the research, said the study was probably the best-designed U.S. test of marijuana's medical potential in decades. He called the results "highly believable."

But David Murray, chief scientist at the White House Office of National Drug Control Policy, called the findings "not particularly persuasive." The study was relatively small, he said, and it is likely that those who received the real pot were aware of that, introducing a bias of expected efficacy.

"We're very much supportive of any effort to ameliorate the suffering of AIDS patients," Murray said. But even if ingredients in marijuana prove useful, he added, they ought to be synthesized in a pill to make dosing more accurate and to minimize lung damage.

Separately, ending a six-year effort, a Massachusetts group learned yesterday that it had won a legal victory against the DEA in its battle for federal permission to grow its own cannabis for federally approved studies, instead of relying on government pot.

In an 87-page opinion, administrative law judge Mary Ellen Bittner ruled that it "would be in the public interest" to allow a University of Massachusetts researcher to cultivate marijuana under contract to the Multidisciplinary Association for Psychedelic Studies (MAPS), which sponsors medical research on marijuana and other drugs.

The DEA is not obligated to follow the advice of its law judges, but the detailed decision should make it difficult for the agency to balk, said MAPS President Rick Doblin.

OK, so ANOTHER study finds that medicinal Marijuana is effective, the DEA goes "nyah nyah can't hear you", and then kicks it off to "We should make it a pill so big pharma can make more money er so it's more effective" and then a statement that the DEA is not obligated to follow the advice of it's own law judges.

The statement about "smoke screen" is hilarious to, considering the myriad of other ways of administering the drug which leads to a near zero inhalation of plant matter/tar.

Does that make anyone else go "Whaaaat?", or is it just me. It looks like the DEA is just going to ignore every piece of evidence that it disagrees with because "drugs are bad" or "it's a lie".

Wonder if that'll ever change.

(Crossposted from another forum I frequent.)

Specializes in acute medical.

The saddest thing I have ever seen are two pensioners with terminal conditions discussing which legitimate medications they can afford, and which they can never afford, to assist in comfort and pain control. I have a person smoke ordinary garden grass in the belief it will help with pain. Its a difficult debate. We all know the benefits and the downsides of marijuana. I personally hate the smell of the stuff, and like any drug would never touch it. But for ppl who are dying, should we stop them if it eases their pain? Also, I have heard that it helps ppl increase their appetite.

Should governments examine controlled usage for ppl who are suffering?

Or is it the beginning of breaking the iceberg - once one group of ppl can use it, then others will be clamouring for the right to do so, for what they consider to be legitimate reasons?

We know controlled substances are sold on the black market, as are illegal substances such as marijuana. Does legitimising it for certain groups make it more available for those who are not in that class?

How can one be nonbiased toward such issues?

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