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Cannabis Reduces HIV-Related Neuropathic Pain

Smoking active versus placebo cannabis linked to greater pain reduction; generally well tolerated

FRIDAY, Aug. 8 (HealthDay News) -- Smoking cannabis reduced neuropathic pain in patients with HIV infection and was generally well tolerated, according to research published online Aug. 6 in Neuropsychopharmacology.

Ronald J. Ellis, M.D., Ph.D., of the University of California San Diego, and colleagues analyzed data from a crossover trial in which participants with HIV and sensory predominant polyneuropathy smoked placebo and active cannabis. Participants were allowed to continue their usual analgesics. Twenty-eight subjects completed both treatments.

Cannabis was associated with greater pain relief (median difference in pain intensity change 3.3 points) on the 20-point Descriptor Differential Scale, the investigators found. In addition, the proportion of subjects who had 30 percent or greater pain relief was larger for cannabis than placebo (0.46 versus 0.18). Two subjects dropped out for safety reasons, for a case of cannabis-induced psychosis and smoking-related cough.

"The therapeutic application of cannabis depends on palatability and safety concerns as well as efficacy. Smoking is not an optimal delivery system. Long-term use of smoked cannabis is associated with symptoms suggestive of obstructive lung disease, and although short-term use is not, many individuals cannot tolerate smoking. Alternative administration routes for cannabinoids, including vaporization and mucosal sprays, are currently approved for clinical use in Great Britain and Canada and are under evaluation in the United States. Cannabis has potent psychotropic effects including 'paradoxical' effects (e.g., depersonalization, hallucination, suspiciousness) in an important minority of individuals," the authors write.

Two co-authors are employees of the Center for Medicinal Cannabis Research at the University of California San Diego, and another has received compensation from Eli Lilly Pharmaceuticals.

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