medical testimonies database contains 83 testimonies from cannabis users with pain
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the long history of use of cannabis as an analgesic, and the obvious problems
with synthetic drugs, the War on Drugs prevented people from reconsidering cannabis
until the mid-seventies, when several studies were published.
suffering from cancer usually suffer from severe pain. This can be for a number
of reasons, such as the invasion of their bones, inflammation or damage caused
to nerves. It is a form of pain which is notoriously hard to treat effectively.
the University of Iowa Noyes et al (1975a) gave oral THC or a placebo at random
to hospitalised cancer patients who were in severe pain. The THC relieved pain
for several hours at very low doses and longer periods at higher doses (15 - 20
mg). It also acted as a sedative at the higher dose. It had fewer physical side
effects than other commonly used analgesics. There was no incidence of nausea
or vomiting unlike many other analgesics - indeed more than half of the patients
had an increased appetite.
Noyes et al conducted another study (1975b). This time they gave codeine, THC
and placebo to 36 patients with advanced cancer. Codeine and cannabis were equally
effective, but some patients found the psychoactive effects of THC uncomfortable.
However these people did not know they were going to take a psychoactive drug
and were obviously frightened. If they had been told beforehand perhaps they would
not have been uncomfortable. Many of the patients however felt they generally
had a sense of well-being that was absent before. As a result of this experiment,
the researchers estimated that 10mg of THC was roughly equivalent to 60mg of codeine.
study revealing potential additive effects of THC on standard medication was done
by Holdcroft et al (1997). It centred on a patient who had severe chronic pain
of gastrointestinal origin. The patient used morphine as an analgesic.It was found
that the patient required a substantially lower amount of morphine when they were
treated with oral THC in the form of cannabis oil.
differing mechanism of analgesic action cannabis uses compared to existing (mainly
opioid) medications means that not only are additive effects likely, but it could
be useful in patients resistant to existing medications, and be useful in treating
pain which existing medications fail to deal with adequately. The National Institutes
of Health suggested that 'Neuropathic pain represents a treatment problem for
which currently available analgesics are, at best, marginally effective. ...THC...may
be useful in this inadequately treated type of pain'. The findings of Growing
et al (1998) concurred with this conclusion, and suggested that this might be
the area of greatest medical potential.
et al (1990) found that a paraplegic patient, who suffered leg pain, gained pain-relief
after taking a single dose of THC.
et al (1978) did a trial using a nitrogen analogue of THC. This too showed significant
analgesic effects, and was effective as both codeine and secobarbital. A further
study using the synthetic THC analogue Levonantradol was done by Jain et al (1981).
The trial population was patients who had moderate to severe post-operative pain.
They were administered Levonantrodol by injection, and found significant pain
relief as a result.
Canada, Milstein et al (1975) studied the analgesic effect of smoked cannabis
in normal subjects. Half of them had used cannabis before. The researchers caused
pain by pressing onto the subjects thumbnails. The subjects were able to withstand
more pressure after they had smoked cannabis. Strangely, the analgesic effect
was greater in the experienced users.
article by Noyes and Baram (1974) showed that cannabis relieved the pain of a
headache in three patients with an equivalent or better efficacy than aspirin
or ergotamine tartrate. Petro (1980) found that two patients suffering pain from
a muscle spasticity disorder had a reduction in their discomfort after inhaling
it has been found that the body's natural cannabinoid, anandamide is involved
in the control of pain. Calignano et al (1998) found that rats release anandamide
when cells are damaged. This then causes seemingly pain-relieving effects in the
areas of the brain and spinal cord that process pain stimuli. An ACM bulletin
in 1998 demonstrated that when anandamide is used with another naturally occuring
compound in the body, palmitylethanolamide, pain was reduced by up to 100 times.
A. et al (1998) Control of pain by endogenous cannabinoids, Nature 394:
Growing L et al (1998) Therapeutic use of cannabis: clarifying the debate, Drug
and Alcohol Review 17: 445-452.
A et al (1997) Pain relief with oral cannabinoids in familial Mediterranean fever.
Anaesthesia, 52: 483
of Lords Select Committee on Science and Technology (1998) Science and Technology
- Ninth report. Science and Technology Committee Publications, UK.
of Medicine (1999) Marijuana and medicine: Assessing the science base.
National Academy Press
AK, Ryan JR, McMahon FG, Smith G. (1981) Evaluation of intramuscular levonantradol
and placebo in acute postoperative pain. Journal of Clinical Pharmacology
M. et al. (1990) Delta-9-tetrahydrocannabinol shows antispastic and analgesic
effects in a single case double-blind trial. European Archives of Psychiatry
and Clinical Neuroscience 240: 1-4.
S.L., MacCannell K., Karr, G. and Clark S. (1975) Marijuana-produced changes in
pain tolerance: Experienced and non-experienced subjects. International Pharmacopsychiatry
Institutes of Health (1997) Workshop on the Medical Utility of Marijuana: Report
to the Director. Washington, D.C.
R., Baram D. (1974) Cannabis analgesia. Compr. Psychiatry 15 : 531.
Noyes R., Brunk S.F., Baram D.A. and Canter A. (1975a) Analgesic effect of delta-9-tetrahydrocannabinol.
Journal of Clinical Pharmacology 15: 139-143.
Noyes R., Brunk S.F., Avery D.H. and Canter A. (1975b) The analgesic properties
of delta-9-tetrahydrocannabinol and codeine. Clinical Pharmacology and Therapeutics
D. (1980) Marihuana as a therapeutic agent for muscle spasm and spasticity. Psychosomatics
J.R. (1890) Therapeutic uses and toxic effects of Cannabis indica. Lancet
Cannabinoid/anandamide-receptor systems involved in peripheral control of pain,
ACM Bulletin, July 26, 1998.
M, Gantt C, Machin D. (1978) Effect of a nitrogen analog of tetrahydrocannabinol
on cancer pain. Clinical Pharmacology and Therapeutics 23:397401.
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