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Cited by 257Cannabis and Cannabinoid ResearchPain Management and Opioid UsePain Mechanisms and Treatments

Efficacy of Dronabinol as an Adjuvant Treatment for Chronic Pain Patients on Opioid Therapy

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Narang, Sanjeet, Gibson, Daniel, Wasan, Ajay D., Ross, Edgar L., Michna, Edward, Nedeljkovic, Srdjan S., Jamison, Robert N.·2008·The Journal of Pain
DOI 10.1016/j.jpain.2007.10.018
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Abstract

Unlabelled We assessed the efficacy of dronabinol (Marinol capsules; Solvay Pharmaceuticals, Brussels, Belgium), a synthetic Delta(9)-THC (tetrahydrocannabinol), in 30 patients taking opioids for chronic pain to determine its potential analgesic effects as an adjuvant treatment. Phase I of this 2-phase study was a randomized, single-dose, double-blinded, placebo-controlled, crossover trial in which subjects were randomly administered either 10 mg or 20 mg of dronabinol or identical placebo capsules over the course of three, 8-hour visits. Baseline self-report measures, hourly ratings of pain intensity, pain relief, pain bothersomeness, treatment satisfaction, mood, side effects, and blood serum levels were obtained. Phase II was an extended open-label titrated trial of dronabinol as add-on medication to patients on stable doses of opioids. Results of the Phase I study showed that patients who received dronabinol experienced decreased pain intensity and increased satisfaction compared with placebo. No differences in benefit were found between the 20 mg and 10 mg doses. In the Phase II trial, titrated dronabinol contributed to significant relief of pain, reduced pain bothersomeness, and increased satisfaction compared with baseline. The incidence of side effects was dose-related. Overall, the use of dronabinol was found to result in additional analgesia among patients taking opioids for chronic noncancer pain.Perspective This study examines the effect of adding a cannabinoid to the regimen of patients with chronic pain who report significant pain despite taking stable doses of opioids. The results of our preliminary study suggest that dronabinol, a synthetic THC, may have an additive effect on pain relief.

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Crossref · 10.1016/j.jpain.2007.10.018

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  • In a phase I and phase II study, THC as an adjunct to opioid therapy for chronic pain enhanced pain relief in patients under an opioid therapeutic regimen.

    “A phase I, and phase II study examining the efficacy of THC as an adjunct to opioid therapy for the treatment of chronic pain showed that THC enhanced pain relief in patients under opioid therapeutic regimen (Narang et al, 2008).”

    From The endogenous cannabinoid system: a budding source of targets for treating inflammatory and neuropathic pain (2018) · cites this paper as Narang et al, 2008

  • Patients reported improvements in sleep problems and disturbances while experiencing an increase in sleep adequacy in the open-label phase of the study.

    “Patients additionally reported improvements in sleep problems and disturbances while experiencing an increase in sleep adequacy in the open-label phase of the study.168”

    From Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside (2009) · cites this paper as [168]

  • Oral dronabinol produced significant pain relief versus placebo when combined with opioid therapy in both a double-blind, placebo-controlled crossover phase and a subsequent open-label extension.

    “Oral dronanbinol produced significant pain relief versus placebo when combined with opioid therapy in both a double-blind, placebo-controlled crossover phase and a subsequent open-label extension.168”

    From Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside (2009) · cites this paper as [168]

  • Side effects such as nausea, drowsiness, and dizziness are more frequent with higher doses of cannabinoids.

    “Side effects such as nausea, drowsiness, and dizziness are more frequent with higher doses of cannabinoids (Narang et al, 2008;Portenoy et al, 2012).”

    From Opioid-Sparing Effect of Cannabinoids: A Systematic Review and Meta-Analysis (2017) · cites this paper as Narang et al, 2008

  • In Narang 2008, in single-dose studies, 10 and 20 mg dronabinol significantly increased the amount of analgesic relief reported compared to placebo; TOTPAR was 31.1 in the placebo group, compared with 39.7 with dronabinol 10 mg and 41.7 with dronabinol 20 mg.

    “In single-dose studies, 10 and 20 mg dronabinol significantly increased the amount of analgesic relief reported compared to placebo”

    From Opioid-Sparing Effect of Cannabinoids: A Systematic Review and Meta-Analysis (2017) · cites this paper as Narang 2008

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Authors
Narang, S., Gibson, D., Wasan, A. D., Ross, E. L., Michna, E., Nedeljkovic, S. S., & Jamison, R. N.
Affiliations
Brigham and Women's Hospital (US)
ORCID
Venue
The Journal of Pain
Publisher
Elsevier BV
Published
2008-03
Volume
9
Issue
3
Pages
254-264
ISSN
1526-5900 (ISSN-L)
DOI
10.1016/j.jpain.2007.10.018
OpenAlex
W2089180001
Cited by
257
References
56
Citations by year
2026: 5 · 2025: 6 · 2024: 12 · 2023: 9 · 2022: 31 · 2021: 22 · 2020: 21 · 2019: 18 · 2018: 25 · 2017: 16 · 2016: 16 · 2015: 14 · 2014: 12 · 2013: 4 · 2012: 16
FWCI
4.21
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Pain (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
Keywords
dronabinol, chronic non-cancer pain, opioid analgesics, adjuvant analgesia, tetrahydrocannabinol, cannabinoids, analgesia, pain intensity, treatment satisfaction, dose-response relationship, adverse effects
MeSH terms
Adjuvants, Pharmaceutic, Adult, Aged, Analgesics, Opioid, Chronic Disease, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Male, Middle Aged, Pain, Pain Measurement, Dronabinol, Cross-Over Studies, Analgesics, Non-Narcotic

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