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Martin J. De Vita
Meta-analyzes revealed that cannabinoid-based drugs were associated with modest increases in the experimental threshold of pain and tolerance in healthy adults; However, they did not seem to reduce the intensity of ongoing experimental pain.
These results, published in JAMA Psychiatry, indicate that cannabinoid analgesia may be primarily mediated by an affective component rather than a sensory component.
"Cannabis-based medicines are widely used to treat pain, and many people think that cannabis is an effective painkiller. Despite increased legalization, the specific analgesic properties of cannabinoid-based medicines remain poorly understood » Martin J. De Vita, MS, of the Department of Psychology, Syracuse University, said Hiatio Psychiatry. "Randomized controlled trials that tested the effects of cannabinoids on pain reactivity gave mixed results. Some studies have found analgesic effects, while others have reported increases in cannabis-induced pain reactivity. "
In a systematic review and meta-analysis, researchers examined the link between cannabinoid drug delivery and the experimental effects of pain in studies on healthy adults. They conducted research in online clinical databases for studies involving healthy participants without chronic pain and controlled experimental administration of any quantified dose cannabinoid preparation.
Using random effects meta-analyzes to group the data and produce summary estimates, the researchers measured experimental pain threshold, pain tolerance, pain intensity, pain, and mechanical hyperalgesia.
Cannabinoids have been associated with modest increases in the experimental threshold of pain and tolerance in healthy adults. However, according to a meta-analysis, they do not seem to reduce the intensity of ongoing experimental pain.
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De Vita and his colleagues included 18 placebo-controlled studies with 442 participants (52.7% men) in their meta-analyzes. According to the report, the average quality level of the studies was good. The analyzes revealed that higher doses of cannabinoids were related to a significant analgesic effect, but that lower doses were not. The effect on pain inconvenience and tolerance to pain differed by type of cannabinoid, the results showed.
Data from the 10 studies of 275 participants who assessed the pain threshold – who provided data for 18 comparisons between cannabinoid and placebo-controlled conditions – revealed that the cannabinoid was associated with small increases in the threshold. of pain (P = 0.006). The results of eight studies involving 266 participants with data on 13 pain tolerance comparisons revealed that pain tolerance increased from small to medium (P = 0.04).
In addition, the results of five studies involving 112 participants, who assessed the unpleasantness of pain and provided data for nine comparisons, showed a decrease in the severity of persistent experimental pain.P = 0.002).
"Our cumulative results showed that, although cannabinoids can prevent the onset of pain by producing small increases in pain thresholds, they do not significantly reduce the intensity of experimental pain already experienced," said De Vita. "Instead, cannabinoid-based drugs have made experimental pain less unpleasant and more tolerable."
In the 13 studies examining the intensity of experimental pain in 272 participants, who had data for 22 comparisons, the administration of cannabinoids was not related to a reduction in the intensity of the pain. experimental pain. In addition, five studies providing data for nine comparisons of mechanical hyperalgesia showed that the administration of cannabinoids was not associated with lower mechanical hyperalgesia.
"We have a lot to catch up with when it comes to understanding how cannabinoids affect pain," said De Vita Hiatio Psychiatry. "Our study suggested a significant influence of cannabinoids on the affective dimensions of experimental pain. In practice, this observation may be considered in the context of treatment goals and a strong clinical judgment when considering cannabinoids in the management of pain.
"A better understanding of cannabinoid analgesia will help clinicians and patients to be more informed about the use of cannabis-based medicines to treat pain," he continued. "That being said, the database needs to be developed with more research." – by Savannah Demko
Disclosure: The authors do not report any relevant financial information.
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