Grant for a study into the effect of cannabis on chronic pain

There is a need for more knowledge in the field of medicinal cannabis

The Leiden University Medical Center (LUMC), together with the Center for Human Drug Research (CHDR), will investigate whether medicinal cannabis provides pain relief for patients with nerve pain. In addition, they are trying to find out for which patients with nerve pain cannabis works optimally. ZonMw has awarded 1.9 million euros to this research on behalf of the Ministry of Health, Welfare and Sport.

“A lot of clinical research on cannabis is carried out with the whole plant, which contains all kinds of active substances,” says Geert Jan Groeneveld, neurologist in the Anaesthesiology Department and Chief Medical and Scientific Officer at CHDR. “In this study, we will investigate in a very controlled manner whether two components of cannabis, tetrahydrocannabinol (THC) and cannabidiol (CBD), can help patients with chronic nerve pain. That has never been carried out, so a unique study. ”

Proof of effect of cannabis
“In this study we will focus on patients with nerve pain from various causes, such as diabetes, herpes or an accident,” says Albert Dahan, professor of Anaesthesiology at the LUMC. “These patients are now being treated with antidepressants or even opiates, but for a large proportion of the patients these drugs do not work.”

Both are enthusiastic about the study and think it can provide evidence for the effectiveness of medicinal cannabis for nerve pain. “With this study we also want to determine in what proportion we should administer the components of cannabis, THC and CBD,” says Groeneveld.

Determining proportions
THC has an analgesic effect but also causes people to get high and sometimes also anxious. CBD could potentially reduce these side effects of THC. Groeneveld: “We will determine in which combination we should administer THC and CBD on the basis of a study in healthy people. In this study they are treated with a THC-CBD combination or with a placebo. We hope to start with this at the beginning of 2021. ” The results of this will be used for a subsequent study, in which 200 patients with nerve pain are treated for 5 weeks with the THC-CBD combination and 5 weeks with a placebo.

Characteristics of patients
“We will first characterize the patients extensively. We look at how they respond to stimuli such as cold and pain. Even the tiny nerves in their cornea are being examined, ”says Dahan. The researchers believe that these features predict whether cannabis treatment will work for nerve pain. “We hope to use this data to find out which patient groups benefit from this treatment and which do not,” Groeneveld explains.

Need for more knowledge
There is a need for more knowledge in the field of medicinal cannabis. For this reason, the Ministry of VWS has commissioned this subsidy. The studies will take place over the next 3 to 4 years. The CHDR will be involved in the design and implementation of the clinical studies and the patients will be treated at the pain clinic of the LUMC.

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