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Cited by 327Cannabis and Cannabinoid ResearchPain Mechanisms and TreatmentsPain Management and Opioid Use

A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain

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Wilsey, Barth, Marcotte, Thomas, Tsodikov, Alexander, Millman, Jeanna, Bentley, Heather, Gouaux, Ben, Fishman, Scott·2008·The Journal of Pain
DOI 10.1016/j.jpain.2007.12.010PMC PMC4968043
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Abstract

Unlabelled The Food and Drug Administration (FDA), Substance Abuse and Mental Health Services Administration (SAMHSA), and the National Institute for Drug Abuse (NIDA) report that no sound scientific studies support the medicinal use of cannabis. Despite this lack of scientific validation, many patients routinely use "medical marijuana," and in many cases this use is for pain related to nerve injury. We conducted a double-blinded, placebo-controlled, crossover study evaluating the analgesic efficacy of smoking cannabis for neuropathic pain. Thirty-eight patients with central and peripheral neuropathic pain underwent a standardized procedure for smoking either high-dose (7%), low-dose (3.5%), or placebo cannabis. In addition to the primary outcome of pain intensity, secondary outcome measures included evoked pain using heat-pain threshold, sensitivity to light touch, psychoactive side effects, and neuropsychological performance. A mixed linear model demonstrated an analgesic response to smoking cannabis. No effect on evoked pain was seen. Psychoactive effects were minimal and well-tolerated, with some acute cognitive effects, particularly with memory, at higher doses.Perspective This study adds to a growing body of evidence that cannabis may be effective at ameliorating neuropathic pain, and may be an alternative for patients who do not respond to, or cannot tolerate, other drugs. However, the use of marijuana as medicine may be limited by its method of administration (smoking) and modest acute cognitive effects, particularly at higher doses.

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  • Seven studies assessed CBM use on appetite in participants experiencing chronic pain, including two RCTs, two cross-sectional studies, two case series, and one pre-post study.

    “Seven studies assessed CBM use on appetite in participants experiencing chronic pain, including two RCTs,59,63 two cross-sectional studies,79,88 two case series,91,92 and one pre-post study.70”

    From Clinical Practice Guidelines for Cannabis and Cannabinoid-Based Medicines in the Management of Chronic Pain and Co-Occurring Conditions (2024) · cites this paper as [63]

  • This study reported that cannabinoids compounded the decreased neurocognitive performance of patients that was present at baseline.

    “This study reported that cannabinoids compounded the decreased neurocognitive performance of patients that was present at baseline.”

    From Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside (2009) · cites this paper as [155]

  • Smoking cannabis cigarettes improved spontaneous pain relief and pain unpleasantness visual analogue scale ratings in patients suffering from mixed forms of neuropathic pain, but failed to alter stimulus-evoked pain.

    “Smoking cannabis cigarettes also improved spontaneous pain relief and pain unpleasantness VAS ratings in patients suffering from mixed forms of neuropathic pain, but failed to alter stimulus-evoked pain.155”

    From Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside (2009) · cites this paper as [155]

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Authors
Wilsey, B., Marcotte, T., Tsodikov, A., Millman, J., Bentley, H., Gouaux, B., & Fishman, S.
Affiliations
  • VA Northern California Health Care System (US)
  • University of California San Diego (US)
  • University of California Davis Medical Center (US)
Corresponding author
Wilsey, Barth
ORCID
Venue
The Journal of Pain
Publisher
Elsevier BV
Published
2008-06
Volume
9
Issue
6
Pages
506-521
ISSN
1526-5900 (ISSN-L)
DOI
10.1016/j.jpain.2007.12.010
PMC
PMC4968043
OpenAlex
W2133895281
Cited by
327
References
84
Citations by year
2026: 5 · 2025: 9 · 2024: 13 · 2023: 11 · 2022: 19 · 2021: 20 · 2020: 25 · 2019: 30 · 2018: 34 · 2017: 23 · 2016: 20 · 2015: 27 · 2014: 22 · 2013: 19 · 2012: 12
FWCI
8.88
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Pain (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (UL1TR000002)
  • National Institute on Drug Abuse
  • National Center for Research Resources (UL1RR024146)
  • National Center for Advancing Translational Sciences
  • Center for Medicinal Cannabis Research, University of California, San Diego
Topics
  • Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
cannabis, neuropathic pain, medical cannabis, analgesic efficacy, pain intensity, evoked pain, psychoactive effects, cognitive effects, memory, dose-response relationship, central pain, peripheral neuropathic pain
MeSH terms
Adult, Affect, Aged, Cannabinoids, Dose-Response Relationship, Drug, Double-Blind Method, Humans, Marijuana Smoking, Middle Aged, Neuralgia, Neuropsychological Tests, Pain Measurement, Time Factors, Linear Models, Cross-Over Studies

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