Cited by 105Cannabis and Cannabinoid ResearchPain Mechanisms and TreatmentsPain Management and Opioid Use

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Synergistic affective analgesic interaction between delta-9-tetrahydrocannabinol and morphine

Roberts, John D., Gennings, Chris, Shih, Margaret·2006·European Journal of Pharmacology

DOI 10.1016/j.ejphar.2005.11.036

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Abstract

Evidence for an analgesic interaction between delta-9-tetrahydrocannabinol (Delta(9)-THC) and morphine was sought using an experimental pain model applied to normal volunteers. The study incorporated a double blinded, four treatment, four period, four sequence, crossover design. Subjects received Delta(9)-THC 5 mg orally or placebo and 90 min later morphine 0.02 mg/kg intravenously or placebo. Fifteen minutes later subjects rated the pain associated with the application of thermal stimuli to skin using two visual analog scales, one for the sensory and one for the affective aspects of pain. Among sensory responses, neither morphine nor Delta(9)-THC had a significant effect at the doses used, and there was no significant interaction between the two. Among affective responses, although neither morphine nor Delta(9)-THC had a significant effect, there was a positive analgesic interaction between the two (p = 0.012), indicating that the combination had a synergistic affective analgesic effect. The surprisingly limited reported experimental experience in humans does not support a role for Delta(9)-THC as an analgesic or as an adjunct to cannabinoid analgesia, except for our finding of synergy limited to the affective component of pain. Comparison of our results with those of others suggests that extrapolation from experimental pain models to the clinic is not likely to be a straight-forward process. Future studies of Delta(9)-THC or other cannabinoids in combination with opiates should focus upon clinical rather than experimental pain.

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Authors: Roberts, J. D., Gennings, C., & Shih, M.
Affiliations: Virginia Commonwealth University (US)
Los Angeles County Department of Public Health (US)
Corresponding author: Roberts, John D.
ORCID: Roberts, John D.
Gennings, Chris
Venue: European Journal of Pharmacology
Publisher: Elsevier BV
Published: 2006-01
Volume: 530
Issue: 1-2
Pages: 54-58
ISSN: 0014-2999 (ISSN-L)
DOI: 10.1016/j.ejphar.2005.11.036
OpenAlex: W2145508348
Cited by: 103
References: 19
Citations by year: 2026: 1 · 2025: 2 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 6 · 2020: 8 · 2019: 10 · 2018: 7 · 2017: 9 · 2016: 1 · 2015: 5 · 2014: 5 · 2013: 5 · 2012: 7
FWCI: 1.70
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: European Journal of Pharmacology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords: delta-9-tetrahydrocannabinol, morphine, analgesic interaction, synergistic analgesia, affective pain, sensory pain, experimental pain models, thermal pain
MeSH terms: Adolescent, Adult, Analgesics, Double-Blind Method, Drug Synergism, Female, Hot Temperature, Humans, Injections, Intravenous, Male, Middle Aged, Morphine, Pain, Pain Measurement, Dronabinol, Cross-Over Studies

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Synergistic affective analgesic interaction between delta-9-tetrahydrocannabinol and morphine

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