The DOI matches its Crossref record; 37 of the 39 references it cites were found in a registry or an index.
Smoked cannabis for chronic neuropathic pain: a randomized controlled trial
Open accessAbstract
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).
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“An RCT of smoked cannabis found that it improved depressive symptoms significantly with a medium-sized effect over placebo.60”
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 [60]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Several additional studies found improvements in chronic pain associated with CBM use within samples that included participants concurrently using opioids to treat pain.52,54,60,100,101”
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 [60]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The short-form McGill pain questionnaire
Melzack, R. (1987) · Pain · doi:10.1016/0304-3959(87)91074-8 · Cited by 4,368
Core outcome measures for chronic pain clinical trials: IMMPACT recommendations
Dworkin, R. H., Turk, D. C., Farrar, J. T., Haythornthwaite, J. A., Jensen, M. P., Katz, N. P., Kerns, R. D., Stucki, G., Allen, R. R., Bellamy, N., et al. (2005) · Pain · doi:10.1016/j.pain.2004.09.012 · Cited by 3,732
Core outcome domains for chronic pain clinical trials: IMMPACT recommendations
Turk, D. C., Dworkin, R. H., Allen, R. R., Bellamy, N., Brandenburg, N., Carr, D. B., Cleeland, C., Dionne, R., Farrar, J. T., Galer, B. S., et al. (2003) · Pain · doi:10.1016/j.pain.2003.08.001 · Cited by 3,510
Dworkin, R. H., Turk, D. C., Wyrwich, K. W., Beaton, D., Cleeland, C. S., Farrar, J. T., Haythornthwaite, J. A., Jensen, M. P., Kerns, R. D., Ader, D. N., et al. (2008) · The Journal of Pain · doi:10.1016/j.jpain.2007.09.005 · Cited by 3,471
Bačkonja, M. (1998) · JAMA · doi:10.1001/jama.280.21.1831 · Cited by 1,529
Pharmacokinetics and Pharmacodynamics of Cannabinoids
Grotenhermen, F. (2003) · Clinical Pharmacokinetics · doi:10.2165/00003088-200342040-00003 · Cited by 1,514
A Shortened Version of the Profile of Mood States
Shacham, S. (1983) · Journal of Personality Assessment · doi:10.1207/s15327752jpa4703_14 · Cited by 1,231 · cited 1×
“The short-form Profile of Mood States was used to examine mood effects.(21) Quality of life was assessed using the EQ-5D health outcome instrument.”
MethodEFNS guidelines on pharmacological treatment of neuropathic pain
Attal, N., Cruccu, G., Haanpää, M. L., Hansson, P. T., Jensen, T. S., Nurmikko, T. J., Sampaio, C., Sindrup, S. H., & Wiffen, P. J. (2006) · European Journal of Neurology · doi:10.1111/j.1468-1331.2006.01511.x · Cited by 877
Hurst, N. P., Kind, P., Ruta, D. A., Hunter, M., & Stubbings, A. (1997) · Lara D. Veeken · doi:10.1093/rheumatology/36.5.551 · Cited by 825
Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis
Rog, D. J., Nurmikko, T. J., Friede, T., & Young, C. A. (2005) · Neurology · doi:10.1212/01.wnl.0000176753.45410.8b · Cited by 679
Cannabis in painful HIV-associated sensory neuropathy: A randomized placebo-controlled trial
Abrams, D. I., Jay, C. A., Shade, S. B., Vizoso, H., Reda, H., Press, S., Kelly, M. E., Rowbotham, M. C., & Petersen, K. L. (2007) · Neurology · doi:10.1212/01.wnl.0000253187.66183.9c · Cited by 598
Moulin, D., Clark, A., Gilron, I., Ware, M. A., Watson, C., Sessle, B. J., Coderre, T. J., Morley-Forster, P. K., Stinson, J., Boulanger, A., et al. (2007) · Pain Research and Management · doi:10.1155/2007/730785 · Cited by 552
Self-citationSvendsen, K. B., Jensen, T. S., & Bach, F. W. (2004) · BMJ · doi:10.1136/bmj.38149.566979.ae · Cited by 500
RICHTER, R. W., Portenoy, R. K., Sharma, U., LaMoreaux, L., Bockbrader, H. N., & Knapp, L. E. (2005) · Journal of Pain · doi:10.1016/j.jpain.2004.12.007 · Cited by 474
Smoked Medicinal Cannabis for Neuropathic Pain in HIV: A Randomized, Crossover Clinical Trial
Ellis, R. J., Toperoff, W., Vaida, F., van den Brande, G., Gonzales, J., Gouaux, B., Bentley, H., & Atkinson, J. H. (2009) · Neuropsychopharmacology · doi:10.1038/npp.2008.120 · Cited by 461
Blake, D. R., Robson, P., Ho, M., Jubb, R. W., & McCabe, C. S. (2006) · Rheumatology · doi:10.1093/rheumatology/kei183 · Cited by 433
Nurmikko, T. J., Serpell, M. G., Hoggart, B., Toomey, P. J., Morlion, B. J., & Haines, D. (2007) · Pain · doi:10.1016/j.pain.2007.08.028 · Cited by 431
Campbell, F. A., Tramèr, M. R., Carroll, D., Reynolds, D. J. M., Moore, R. A., & McQuay, H. J. (2001) · BMJ · doi:10.1136/bmj.323.7303.13 · Cited by 422
An analgesia circuit activated by cannabinoids
Meng, I. D., Manning, B. H., Martin, W. J., & Fields, H. L. (1998) · Nature · doi:10.1038/26481 · Cited by 411 · cited 1×
“An endogenous pain-processing system has been identified, mediated by endogenous cannabinoid ligands acting on specific cannabinoid receptors.(6) These findings, coupled with anecdotal evidence of the analgesic effects of smoked cannabis,(7) support a reconsideration of cannabinoid agents as analgesics.”
BackgroundNabilone for the treatment of pain in fibromyalgia.
Skrabek, R. Q., Galimova, L., Ethans, K., & Perry, D. (2008) · The Journal of Pain · doi:10.1016/j.jpain.2007.09.002 · Cited by 384 · cited 1×
“Oral cannabinoids such as tetrahydrocannabinol, cannabidiol and nabilone have, alone and in combination, shown efficacy in central(8,9) and peripheral(10) neuropathic pain, rheumatoid arthritis(11) and fibromyalgia.(12) The analgesic effects of smoked cannabis remain controversial, although it is used by 10%–15% of pa…”
BackgroundClinical characteristics and economic costs of patients with painful neuropathic disorders
Berger, A., Dukes, E. M., & Oster, G. (2004) · Journal of Pain · doi:10.1016/j.jpain.2003.12.004 · Cited by 351
A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain
Wilsey, B., Marcotte, T., Tsodikov, A., Millman, J., Bentley, H., Gouaux, B., & Fishman, S. (2008) · The Journal of Pain · doi:10.1016/j.jpain.2007.12.010 · Cited by 327
The leeds sleep evaluation questionnaire in psychopharmacological investigations?a review
Parrott, A. C., & Hindmarch, I. (1980) · Psychopharmacology · doi:10.1007/bf00434408 · Cited by 318
Mendell, J. R., & Sahenk, Z. (2003) · New England Journal of Medicine · doi:10.1056/nejmcp022282 · Cited by 271
Vaporization as a Smokeless Cannabis Delivery System: A Pilot Study
Abrams, D. I., Vizoso, H., Shade, S., Jay, C., Kelly, M., & Benowitz, N. (2007) · Clinical pharmacology and therapy · doi:10.1038/sj.clpt.6100200 · Cited by 263
Frank, B., Serpell, M. G., Hughes, J., Matthews, J. N. S., & Kapur, D. (2008) · BMJ · doi:10.1136/bmj.39429.619653.80 · Cited by 207
Cannabis use for chronic non-cancer pain: results of a prospective survey
Ware, M. A., Doyle, C. R., Woods, R., Lynch, M. E., & Clark, A. J. (2003) · Pain · doi:10.1016/s0304-3959(02)00400-1 · Cited by 185
Self-citationPatterns of cannabis use among patients with multiple sclerosis
Clark, A. J., Ware, M. A., Yazer, E., Murray, T. J., & Lynch, M. E. (2004) · Neurology · doi:10.1212/01.wnl.0000127707.07621.72 · Cited by 153
Self-citationBačkonja, M., Beydoun, A. A., Edwards, K. R., Schwartz, S. L., Fonseca, V. A., HES, M., MOREAUX, L. L., & Garofalo, E. (1999) · Survey of Anesthesiology · doi:10.1097/00132586-199908000-00055 · Cited by 153
Reinforcing and subjective effects of oral Δ9-THC and smoked marijuana in humans
Chait, L. D., & Zacny, J. P. (1992) · Psychopharmacology · doi:10.1007/bf02245145 · Cited by 143
Effect of intrapulmonary tetrahydrocannabinol administration in humans
Zuurman, L., Roy, C., Schoemaker, R. C., Hazekamp, A., den Hartigh, J., Bender, J., Verpoorte, R., Pinquier, J. L., Cohen, A., & van Gerven, J. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881108089581 · Cited by 139
Marijuana smoking: effect of varying delta 9-tetrahydrocannabinol content and number of puffs.
Azorlosa, J. L., Heishman, S. J., Stitzer, M. L., & Mahaffey, J. M. (1992) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/s0022-3565(25)10949-x · Cited by 117
The Pharmacohistory of Cannabis Sativa
Mechoulam, R. (2019) · Chapman & Hall/CRC eBooks · doi:10.1201/9780429260667-1 · Cited by 95
Discriminative stimulus and subjective effects of smoked marijuana in humans
Chait, L. D., Evans, S. M., Grant, K. A., Kamien, J. B., Johanson, C. E., & Schuster, C. R. (1988) · Psychopharmacology · doi:10.1007/bf00176846 · Cited by 82
Preference for high- versus low-potency marijuana
Chait, L. D., & Burke, K. A. (1994) · Pharmacology Biochemistry and Behavior · doi:10.1016/0091-3057(94)90082-5 · Cited by 52
Cannabis for Chronic Pain: Case Series and Implications for Clinicians
Ware, M. A., Gamsa, A., Persson, J., & Fitzcharles, M.-A. (2002) · Pain Research and Management · doi:10.1155/2002/380509 · Cited by 38
Self-citationLeahy, J. L. (2006) · Yearbook of Endocrinology · doi:10.1016/s0084-3741(08)70300-7 · Cited by 28
Flagged first, then by citations
2 of the 39 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- Good Clinical Practice: Consolidated Guidelines. International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use. E6(R1):1996; Switzerland. Available at: www .ich .org /cache /compo /276 -254-1 .html (accessed 2010 Aug. 18).
Cited by
Sorted by citations
Cannabinoids for Medical Use: A Systematic Review and Meta-analysis
Whiting, P. F., Wolff, R. F., Deshpande, S., Di Nisio, M., Duffy, S., Hernandez, A. V., Keurentjes, J. C., Lang, S., Misso, K., Ryder, S., et al. (2015) · JAMA · doi:10.1001/jama.2015.6358 · Cited by 2,169
Black, N., Stockings, E., Campbell, G., Tran, L. T., Zagic, D., Hall, W. D., Farrell, M., & Degenhardt, L. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30401-8 · Cited by 564
Cannabis-based medicines for chronic neuropathic pain in adults
Mücke, M., Phillips, T., Radbruch, L., Petzke, F. W., & Häuser, W. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012182.pub2 · Cited by 606
The draft genome and transcriptome of Cannabis sativa.
van Bakel, H., Stout, J. M., Cote, A. G., Tallon, C. M., Sharpe, A. G., Hughes, T. R., & Page, J. E. (2011) · Genome Biology · doi:10.1186/gb-2011-12-10-r102 · Cited by 575
Stockings, E., Campbell, G., Hall, W. D., Nielsen, S., Zagic, D., Rahman, R., Murnion, B., Farrell, M., Weier, M., & Degenhardt, L. (2018) · Pain · doi:10.1097/j.pain.0000000000001293 · Cited by 460
Metadata
- 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)
- 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
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
