Cited by 451Cannabis and Cannabinoid ResearchPain Mechanisms and TreatmentsPain Management and Opioid Use

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Smoked cannabis for chronic neuropathic pain: a randomized controlled trial

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Ware, M. A., Wang, T., Shapiro, S., Robinson, A., Ducruet, T., Huynh, T., Gamsa, A., Bennett, G. J., Collet, J.-P.·2010·Canadian Medical Association Journal

DOI 10.1503/cmaj.091414PMC PMC2950205

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Abstract

BACKGROUND: Chronic neuropathic pain affects 1%-2% of the adult population and is often refractory to standard pharmacologic treatment. Patients with chronic pain have reported using smoked cannabis to relieve pain, improve sleep and improve mood. METHODS: Adults with post-traumatic or postsurgical neuropathic pain were randomly assigned to receive cannabis at four potencies (0%, 2.5%, 6% and 9.4% tetrahydrocannabinol) over four 14-day periods in a crossover trial. Participants inhaled a single 25-mg dose through a pipe three times daily for the first five days in each cycle, followed by a nine-day washout period. Daily average pain intensity was measured using an 11-point numeric rating scale. We recorded effects on mood, sleep and quality of life, as well as adverse events. RESULTS: We recruited 23 participants (mean age 45.4 [standard deviation 12.3] years, 12 women [52%]), of whom 21 completed the trial. The average daily pain intensity, measured on the 11-point numeric rating scale, was lower on the prespecified primary contrast of 9.4% v. 0% tetrahydrocannabinol (5.4 v. 6.1, respectively; difference = 0.7, 95% confidence interval [CI] 0.02-1.4). Preparations with intermediate potency yielded intermediate but nonsignificant degrees of relief. Participants receiving 9.4% tetrahydrocannabinol reported improved ability to fall asleep (easier, p = 0.001; faster, p < 0.001; more drowsy, p = 0.003) and improved quality of sleep (less wakefulness, p = 0.01) relative to 0% tetrahydrocannabinol. We found no differences in mood or quality of life. The most common drug-related adverse events during the period when participants received 9.4% tetrahydrocannabinol were headache, dry eyes, burning sensation in areas of neuropathic pain, dizziness, numbness and cough. CONCLUSION: A single inhalation of 25 mg of 9.4% tetrahydrocannabinol herbal cannabis three times daily for five days reduced the intensity of pain, improved sleep and was well tolerated. Further long-term safety and efficacy studies are indicated. (International Standard Randomised Controlled Trial Register no. ISRCTN68314063).

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The short-form McGill pain questionnaire
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Method
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Authors: Ware, M. A., Wang, T., Shapiro, S., Robinson, A., Ducruet, T., Huynh, T., Gamsa, A., Bennett, G. J., & Collet, J.-P.
Affiliations: McGill University (CA)
University of British Columbia (CA)
ORCID: Ware, M. A.
Ducruet, T.
Venue: Canadian Medical Association Journal
Publisher: CMA Impact Inc.
Published: 2010-08-30
Volume: 182
Issue: 14
Pages: E694-E701
ISSN: 0820-3946 (ISSN-L)
1488-2329
DOI: 10.1503/cmaj.091414
PMC: PMC2950205
OpenAlex: W2120142285
Semantic Scholar: 6125159a7712bfe53b79c9d5d0c060fe71bcf8a6
Cited by: 450
References: 39
Citations by year: 2026: 18 · 2025: 24 · 2024: 18 · 2023: 29 · 2022: 36 · 2021: 31 · 2020: 37 · 2019: 31 · 2018: 39 · 2017: 34 · 2016: 33 · 2015: 35 · 2014: 32 · 2013: 16 · 2012: 20
FWCI: 12.45
Type: journal article
Language: en
Open access: gold
doi.org
Locations: Canadian Medical Association Journal (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: McGill University
Louise and Alan Edwards Foundation
Canadian Institutes of Health Research (JHM-50014)
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: chronic neuropathic pain, cannabis smoking, tetrahydrocannabinol, post-traumatic neuropathic pain, pain intensity, sleep quality, mood, quality of life, adverse events, cannabis potency, cannabinoids, headache, dizziness, dry eye, cough, numbness, burnout, burnout prevention, burnout intervention, burnout symptoms
MeSH terms: Adult, Aged, Chronic Disease, Double-Blind Method, Female, Humans, Male, Marijuana Smoking, Middle Aged, Neuralgia, Pain Measurement, Placebos, Quality of Life, Sleep, Dronabinol, Linear Models, Treatment Outcome, Cross-Over Studies

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Smoked cannabis for chronic neuropathic pain: a randomized controlled trial

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