Marijuana is just as effective at treating symptoms of neuropathy as opioids are, according to the results of a new survey. And what’s more, the majority of patients with the often-painful condition say they’re using cannabis with more than 20 percent THC, raising questions about the quality of prior studies that relied on government-grown marijuana that is generally lower in potency.
The company NuggMD, which connects patients to doctors for medical cannabis recommendations, surveyed 603 patients who said neuropathy was either their primary or secondary reason for using marijuana. Because one of the most common symptoms is neuropathy is pain, patients first rated their pain levels on a scale of 1–10, both before and after using cannabis as a treatment.
The results, which were shared exclusively with Marijuana Moment, showed clear signs of relief. “The average pain level before cannabis use was 7.64, while the average pain level after cannabis use was 3.44,” the study found. That amounts to “an average pain relief level of 4.2 out of 10 for participants.”
That’s roughly the same, or an even higher, level of relief than is typically seen from conventional treatments such as prescription opioids, according to prior research. A 2017 randomized trial, for example, found that neuropathy patients rated the pain reliving effects of oxycodone and acetaminophen at 4.4, ibuprofen and acetaminophen at 4.3, codeine and acetaminophen at 3.9 and hydrocodone and acetaminophen at 3.5.
Yet, as the new survey points out, just ten states explicitly list neuropathy as a qualifying condition for medical marijuana.
Additionally, researchers emphasized that while “increasing the dosage of cannabinoids did not necessarily lead to more effective relief,” patients were generally recommended—and benefitted from—higher potency cannabis in excess of 20 percent THC. That could help explain why past studies on marijuana and neuropathy that relied on lower THC cannabis haven’t quite matched NuggMD’s findings.
“Our survey results demonstrated that individuals using high-THC cannabis found more significant pain relief for their neuropathy,” the study’s authors said, adding that “much of the research on cannabis as a treatment for neuropathy uses low-quality cannabis with low THC levels, focus[es] on CBD, or uses isolated compounds and not full-spectrum products.”
Of those surveyed, a majority of neuropathy patients (58.6 percent) reported using marijuana flower exceeding 20 percent THC. Smaller proportions used concentrates (26.3 percent), which typically contain much higher percentages of the intoxicating cannabinoid, as well as flower under 20 percent THC (11.1 percent) and non-inhalable products (3.9 percent).
In other words, most patients who described cannabis as an effective treatment were using higher-potency products, which are common in many state-legal markets and significantly more potent than government-grown marijuana used for research purposes.
“According to our survey, the most constant variable was the use of high-potency cannabis with a THC content of 20 percent or more,” the new report’s authors write. “This finding is important to note because much of the research on the efficacy of cannabis for pain typically involves cannabis products with a potency below 20 percent THC. These research studies often result in claims that THC is ineffective for pain relief.”
For decades, federally approved research into marijuana required scientists to exclusively use cannabis grown at a single farm authorized by the Drug Enforcement Administration (DEA). Experts have long criticized the quality of that “research-grade” marijuana. One study found that the chemical profile of the government’s cannabis was more similar to industrial hemp than the marijuana available on commercial markets.
That monopoly on marijuana cultivation for research was recently broken as DEA approved additional manufacturers to grow a more diverse array of cannabis varieties. But the new survey’s findings suggest that past research into the efficacy of cannabis on neuropathy may have been compromised as the result of using exclusively low-THC products.
“These products often used in research are not representative of what medical cannabis patients are obtaining on the recreational and medical markets,” authors said.
Congressional lawmakers have raised concerns about scientists’ lack of access to marijuana that reflects what’s sold in state-licensed dispensaries. Several attempts to reform the policy have advanced in both chambers but have not yet passed. And while President Joe Biden signed legislation last year meant to streamline the research process for marijuana, provisions in the House version of the measure that would have allowed scientists to obtain retail cannabis for research were not included in the final bill.
National Institute on Drug Abuse (NIDA) Director Nora Volkow has also said that the restriction—in addition to the fact that marijuana is classified as a Schedule I drug under the Controlled Substances Act (CSA)—has stymied research into the risks and benefits of cannabis.
Results from the new NuggMD study—which caveats that it “does not provide causal evidence of cannabis being effective in the treatment of neuropathic pain”—also reveal just how strongly patients prefer medical marijuana over various alternative treatments.
Asked what option they would use if they lacked access to medical marijuana, more respondents said that they would take nothing and tolerate the symptoms (128) rather than use opioids (112). Another 36 patients said they’d use alcohol, even though drinking is sometimes associated with neuropathy.
“Neuropathy is a chronic condition needing long-term treatment,” NuggMD Chief Medical Officer Brian Kessler said in a statement. “I hear from many patients who are worried about the risk of severe side effects and dependence when using opioids and drugs like gabapentin over extended periods of time. For many patients, medical marijuana offers a safer alternative that improves their quality of life.”
The survey adds to the growing body of scientific literature identifying benefits from medical cannabis as an alternative to traditional pharmaceuticals.
For example, a separate study published earlier this month showed marijuana use is associated with improved quality of life—including better job performance, sleep, appetite and energy.
Another, from the University of Colorado, found that consistent cannabis use is associated with improved cognition and reduced pain among cancer patients and people receiving chemotherapy.
A study published in the International Journal of Drug Policy this month found that states that have legalized medical marijuana have seen significant reductions in health insurance premiums compared to states where cannabis remained completely illegal.
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