In a new study, researchers found that medicinal cannabis might not ease sleep problems in people with chronic pain over the long term, because frequent users might build up a tolerance to its sleep-inducing effects.
Another study showed that based on current evidence cannabinoids (the active chemicals in medicinal cannabis) do not have a role in cancer-related pain.
Chronic pain is thought to affect between 19% and 37% of adults in the developed world and is often accompanied by sleep problems, including difficulty getting to (latency) and staying asleep, and waking up early.
In the first study, the researchers wanted to find out what impact medicinal cannabis might have on sleep problems experienced by people over the age of 50 with chronic pain that had lasted at least a year.
They examined the sleep quality and pain scores of 128 people who were being treated at a specialist pain clinic: 66 of them used medicinal cannabis to manage their sleep problems and 62 didn’t.
In all, around one in four (24%) said they always woke up early and weren’t able to get back to sleep; one in five (20%) reported always finding it difficult to fall asleep; and around one in five (27%) said they woke up during the night.
Medicinal cannabis users had used the drug for an average of 4 years, consuming around 31 g a month. Most (69%) smoked it, with around 20% either using cannabis oil or vapor.
After taking account of potentially influential factors, they found medicinal cannabis users were less likely to wake during the night than non-users.
But there were no differences between the two groups in the time taken to get to sleep or frequency of early awakening.
Further analysis of the sleep patterns of the medicinal cannabis users showed that frequency of use was associated with greater difficulty falling asleep and more frequent waking during the night.
In the second study, the researchers wanted to find out if cannabinoids—active compounds (THC or CBD); THC extract; medicinal cannabis; and approved drugs containing cannabis—might effectively reduce cancer pain.
They searched out data from clinical trials comparing the use of cannabinoids with dummy pills (placebo) or when used in addition to opioids to relieve cancer pain in adults.
They pooled the data from five relevant studies, involving 1442 people. The resulting analysis showed that changes in average pain intensity scores were no different between those taking cannabinoids and those given placebo.
What’s more, cannabinoids were linked to a much higher risk of side effects, such as drowsiness and dizziness.
The team concludes that for any medication to be useful, its pros need to outweigh its cons.
The findings are published in BMJ Supportive & Palliative Care and BMJ Supportive & Palliative Care.
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