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Low-Dose Vaporized Cannabis Significantly Improves Neuropathic Pain
Open accessAbstract
Unlabelled We conducted a double-blind, placebo-controlled, crossover study evaluating the analgesic efficacy of vaporized cannabis in subjects, the majority of whom were experiencing neuropathic pain despite traditional treatment. Thirty-nine patients with central and peripheral neuropathic pain underwent a standardized procedure for inhaling medium-dose (3.53%), low-dose (1.29%), or placebo cannabis with the primary outcome being visual analog scale pain intensity. Psychoactive side effects and neuropsychological performance were also evaluated. Mixed-effects regression models demonstrated an analgesic response to vaporized cannabis. There was no significant difference between the 2 active dose groups' results (P > .7). The number needed to treat (NNT) to achieve 30% pain reduction was 3.2 for placebo versus low-dose, 2.9 for placebo versus medium-dose, and 25 for medium- versus low-dose. As these NNTs are comparable to those of traditional neuropathic pain medications, cannabis has analgesic efficacy with the low dose being as effective a pain reliever as the medium dose. Psychoactive effects were minimal and well tolerated, and neuropsychological effects were of limited duration and readily reversible within 1 to 2 hours. Vaporized cannabis, even at low doses, may present an effective option for patients with treatment-resistant neuropathic pain.Perspective The analgesia obtained from a low dose of delta-9-tetrahydrocannabinol (1.29%) in patients, most of whom were experiencing neuropathic pain despite conventional treatments, is a clinically significant outcome. In general, the effect sizes on cognitive testing were consistent with this minimal dose. As a result, one might not anticipate a significant impact on daily functioning.
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“In neuropathic pain, cannabis containing both a lower dose (1.29 % THC) and higher dose (3.53 % THC) delivered by vaporizer demonstrated a significant analgesic response (Wilsey et al, 2013).”
From The endogenous cannabinoid system: a budding source of targets for treating inflammatory and neuropathic pain (2018) · cites this paper as Wilsey et al, 2013
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Metadata
- Authors
- Wilsey, B., Marcotte, T., Deutsch, R., Gouaux, B., Sakai, S., & Donaghe, H.
- Affiliations
- VA Northern California Health Care System (US)
- University of California San Diego (US)
- University of California, Davis (US)
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 14
- Issue
- 2
- Pages
- 136-148
- ISSN
- 1526-5900 (ISSN-L)
- PMC
- PMC3566631
- OpenAlex
- W2167149788
- Cited by
- 314
- References
- 64
- Citations by year
- 2026: 13 · 2025: 16 · 2024: 14 · 2023: 24 · 2022: 27 · 2021: 36 · 2020: 21 · 2019: 27 · 2018: 37 · 2017: 25 · 2016: 26 · 2015: 20 · 2014: 16 · 2013: 11
- FWCI
- 11.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Johns Hopkins University
- National Institutes of Health
- University of California, Davis
- National Institute on Drug Abuse (R01DA030424)
- National Center for Research Resources (UL1RR024146)
- 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
- vaporized cannabis, neuropathic pain, delta-9-tetrahydrocannabinol, analgesic efficacy, treatment-resistant pain, neuropsychological performance, number needed to treat
- MeSH terms
- Administration, Inhalation, Adult, Affect, Cannabis, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Hyperalgesia, Male, Phytotherapy, Middle Aged, Neuralgia, Neuropsychological Tests, Pain Measurement, Socioeconomic Factors, Dronabinol, Volatilization, Linear Models, Treatment Outcome, Pain Threshold, Patient Selection, Cross-Over Studies
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