First clinical study finds microdosing of THC may reduce chronic pain
The study echoes what many doctors and medical cannabis experts are already saying, based on previous studies and anecdotal evidence. For optimal pain relief, results suggest that 500 micrograms of THC is the most effective dose, with study subjects participating in three or four inhalations per day. An Israeli medical technology company has completed and presented its first clinical trial demonstrating that microdoses of inhaled tetrahydrocannabinol (or THC) can act as an effective pain reliever without stimulating the many common side effects associated with cannabis use. Elon Eisenberg, Dean of the Faculty of Medicine and Principal Investigator at the Technion-Israel Institute of Technology in Haifa. The CEO added that the information gathered as part of the study “may allow us to achieve treatment results that were not possible before”, regarding the treatment of symptoms.
For the first time, researchers have conducted a clinical trial to demonstrate that extremely low and precise doses of inhaled THC can effectively relieve pain, while avoiding the common side effects associated with cannabis use.
The study, which was conducted by the Israeli company Syqe Medical and published in the European Journal of Pain earlier this month is the first scientific confirmation that microdosing, meaning the use of extremely low doses of active substances to treat various ailments, does indeed work with cannabis.
Although widely supported, there has so far been little scientific evidence to support or even fully explore the claims for the benefits and safety of microdosing. The multidose, double-blind, placebo-controlled study was conducted at Rambam Medical Center in Israel and looked at levels of THC in the blood, pain relief, cognitive function and psychoactivity.
THC for pain reduction in diabetic neuropathy
In patients with painful diabetic peripheral neuropathy, there is an association between plasma levels of tetrahydrocannabinol (THC) and pain outcomes, according to study results published in the Journal of Pain. These results may underscore the importance of available plasma levels when evaluating the therapeutic effects of THC.
As evidence accumulates about the potential benefits of THC for painful neuropathy, more data is needed to help identify potential effective dosages.
This review aimed to explore the association between plasma THC levels and pain response in painful diabetic neuropathy that participated in a randomized, double-blind, placebo-controlled crossover study to investigate the short-term efficacy of inhaled cannabis. Each study participant was seen in 4 sessions, receiving a low (1%), medium (4%) or high (7%) dose of THC from cannabis, with a 2 week elimination period between administration of doses.
The original study included 16 adults with type 1 or 2 diabetes, spontaneous and evoked pain in the feet, and painful diabetic peripheral neuropathy. All study participants were included in the current secondary analysis
The visual analogue scale was used to assess pain response and the Trail-Making test was used to measure psychomotor speed, attention and cognitive sequencing. The researchers analyzed 3 pain outcomes: spontaneous, evoked by the foam brush, and evoked by von Frey.
Pain intensity and cognitive tests were performed at specific times over 4 hours and blood samples were taken to determine plasma THC levels at 0, 15, 30, 45, 60, 150 and 240 minutes.
Statistical analysis revealed a U-shaped association between plasma THC levels and pain rating. As plasma THC levels increased, pain decreased, to a point where a further increase in plasma THC levels was associated with worsening pain scores.
Specifically, spontaneous pain scores decreased with increasing plasma THC values up to 15,59 ng / mL. Beyond this concentration of THC, there was no additional benefit from a further increase in plasma THC values with regard to analgesia. When the plasma THC level exceeded 31 ng / ml, worsening pain scores were observed. Therefore, the therapeutic window in this study group was determined to be between 16 and 31 ng / ml plasma THC levels.
The data suggests a minor linear effect of plasma THC values on cognitive function, as only one of the three cognitive tests found a significant relationship between higher THC values and decreased cognitive performance.
“This study is the first to show that human sensitivity to THC is significantly higher than previously thought, indicating that if we can treat patients with much higher precision, lower amounts of the drug will be needed, which will result in fewer side effects and overall treatment effectiveness, ”said Syqe Medical CEO Perry Davidson. “Syqe's drug delivery technology is also applicable to opioids and other compounds which, while potentially effective, are notoriously associated with dangerous side effects. The introduction of a tool to prescribe drugs in such low doses with such high resolution can allow us to achieve treatment results that were not possible before.
These results underscore the importance of measuring plasma cannabinoid levels in future research, the researchers wrote. We can conclude from the results of the study that low doses of cannabis can provide desirable effects while avoiding cognitive debilitations, contributing significantly to daily functioning, quality of life and patient safety. The doses given in this study, being so low, require very high precision in the treatment modality.