Dose-dependent Effects of Smoked Cannabis on Capsaicin-induced Pain and Hyperalgesia in Healthy Volunteers

Wallace, Mark; Schulteis, Gery; Atkinson, J. Hampton; Wolfson, Tanya; Lazzaretto, Deborah; Bentley, Heather; Gouaux, Ben; Abramson, Ian

doi:10.1097/01.anes.0000286986.92475.b7

Cited by 199 publications

(204 citation statements)

References 41 publications

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“…Although the high marijuana strength increased pain tolerance at the earlier timepoints, the effect dissipated and decreased at the later timepoints below baseline values. A similar effect has been identified in an earlier study assessing marijuana-induced analgesia in a model of postinjury pain, where the responses to nociceptive stimuli were determined after a transdermal injection of capsaicin (Wallace et al, 2007). Under this facilitated pain state, the moderate marijuana strength decreased pain, whereas the higher marijuana strength increased pain at a single timepoint.…”

Section: Discussionsupporting

confidence: 73%

Comparison of the Analgesic Effects of Dronabinol and Smoked Marijuana in Daily Marijuana Smokers

Cooper

Comer

Haney

2013

Neuropsychopharmacol

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Recent studies have demonstrated the therapeutic potential of cannabinoids to treat pain, yet none have compared the analgesic effectiveness of smoked marijuana to orally administered D 9 -tetrahydrocannabinol (THC; dronabinol). This randomized, placebocontrolled, double-dummy, double-blind study compared the magnitude and duration of analgesic effects of smoked marijuana and dronabinol under well-controlled conditions using a validated experimental model of pain. Healthy male (N ¼ 15) and female (N ¼ 15) daily marijuana smokers participated in this outpatient study comparing the analgesic, subjective, and physiological effects of marijuana (0.00, 1.98, or 3.56% THC) to dronabinol (0, 10, or 20 mg). Pain response was assessed using the cold-pressor test (CPT): participants immersed their left hand in cold water (4 1C), and the time to report pain (pain sensitivity) and withdraw the hand from the water (pain tolerance) were recorded. Subjective pain and drug effect ratings were also measured as well as cardiovascular effects. Compared with placebo, marijuana and dronabinol decreased pain sensitivity (3.56%; 20 mg), increased pain tolerance (1.98%; 20 mg), and decreased subjective ratings of pain intensity (1.98, 3.56%; 20 mg). The magnitude of peak change in pain sensitivity and tolerance did not differ between marijuana and dronabinol, although dronabinol produced analgesia that was of a longer duration. Marijuana (1.98, 3.56%) and dronabinol (20 mg) also increased abuse-related subjective ratings relative to placebo; these ratings were greater with marijuana. These data indicate that under controlled conditions, marijuana and dronabinol decreased pain, with dronabinol producing longer-lasting decreases in pain sensitivity and lower ratings of abuse-related subjective effects than marijuana.

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Section: Discussionsupporting

confidence: 73%

Comparison of the Analgesic Effects of Dronabinol and Smoked Marijuana in Daily Marijuana Smokers

Cooper

Comer

Haney

2013

Neuropsychopharmacol

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“…Experimental pain and non-opioid analgesics found an inverse dose-response relation for delta-9-tetrahydrocannabinol [94].…”

Section: Dosing Regimesmentioning

confidence: 93%

“…The majority of studies found no effect on the pain parameters except for brush and pinprick evoked pain [94]. However, in an older study applying electrical skin pain and repeated pressure algometry, the pain detection thresholds, but not the pain tolerance thresholds to these pain stimulations, were increased after administration of delta-9-tetrahydrocannabinol.…”

Section: Delta-9-tetrahydrocannabinolmentioning

confidence: 94%

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Assessing efficacy of non‐opioid analgesics in experimental pain models in healthy volunteers: an updated review

Staahl

Olesen

Arendt‐Nielsen

et al. 2009

Brit J Clinical Pharma

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AIMExperimental pain models may help to evaluate the mechanisms of analgesics and target the clinical indications for their use. This review, the second in a series of two, addresses how the efficacy of non-opioid analgesics have been assessed in human volunteers using experimental pain models. METHODSA literature search was completed for randomized controlled studies that included human experimental pain models, healthy volunteers and non-opioid analgesics. RESULTSNonsteroidal anti-inflammatory drugs worked against various types of acute pain as well as in hyperalgesia. Analgesia from paracetamol was difficult to detect in experimental pain and the pain needed to be assessed with very sensitive methods like evoked brain potentials. The N-methyl-D-aspartate antagonists exemplified by ketamine generally needed strong, long-lasting or repeated pain in the skin for detectable analgesia, whereas pain in muscle and viscera generally was more easily attenuated. Gabapentin worked well in several models, particularly those inducing hyperalgesia, whereas lamotrigine was weak in modulation of experimental pain. Imipramine attenuated pain in most experimental models, whereas amitriptyline had weaker effects. Delta-9-tetrahydrocannabinol attenuated pain in only a few models.

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“…Estas sustancias que mantienen y potencian la transmisión dolorosa, son responsables de la cronificación y amplificación del dolor 36. Al respecto, se evalúa la planta a la forma de cigarrillo o vaporizada comparado con un placebo, observándose un prometedor efecto analgésico, principalmente en aquellos preparados con mayor concentración de THC (9,6%). El problema de estos estudios, es que incluyen una pequeña muestra de pacientes y los cigarrillos empleados contenían distintas concentraciones de THC [37][38][39][40] .…”

Section: Cannabis Y Dolorunclassified

Potencial uso terapéutico de cannabis

et al. 2017

Rev. méd. Chile

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Dose-dependent Effects of Smoked Cannabis on Capsaicin-induced Pain and Hyperalgesia in Healthy Volunteers

Abstract: This study suggests that there is a window of modest analgesia for smoked cannabis, with lower doses decreasing pain and higher doses increasing pain.

Cited by 199 publications

References 41 publications

Comparison of the Analgesic Effects of Dronabinol and Smoked Marijuana in Daily Marijuana Smokers

Comparison of the Analgesic Effects of Dronabinol and Smoked Marijuana in Daily Marijuana Smokers

Assessing efficacy of non‐opioid analgesics in experimental pain models in healthy volunteers: an updated review

Potencial uso terapéutico de cannabis

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