A decade-long study from Israel has found that patients with severe lower back pain who used medical cannabis experienced marked declines in opioid consumption, disability, and pain severity. The researchers also reported reduced reliance on several other medications during the follow-up period.
The research involved 1,000 adults with severe lower back pain who had not previously used cannabis. Researchers followed the participants through a specialist orthopedic pain clinic, recording medication use, pain levels, and functional limitations each year.
By the end of the decade, opioid consumption had fallen by 90%. The researchers said the largest change occurred during year one, after which opioid use remained relatively stable.
Pain intensity declined by 84%, while measures of functional disability fell by 30%. Ninety-one percent reduced their opioid consumption by 50%. About 62% reached the study’s predefined benchmark for meaningful improvement in pain, while a similar proportion achieved the target reduction in disability.
The study, published in the European Spine Journal, also identified a broad decline in the use of other drugs commonly prescribed alongside pain treatments. Tapentadol and tramadol use fell to 5.6 percent of patients from a starting point of 89.7 percent. Benzodiazepine use dropped to 5.3 percent from a high of 78.8 percent at the beginning, while SSRI use declined to 5.8 percent from the 77.7 percent it was at the start. Gabapentinoid use decreased to 0.6 percent from the initial 31.3 percent.
According to the researchers, these changes were not required by the study protocol. Instead, medication decisions were made by doctors and patients according to symptoms and treatment response. Most of the decline in multiple-drug treatment occurred within the first two years.
Patients received cannabis in different forms, including dried flower intended to be vaporized and oils administered orally or under the tongue. Of the 1,000 participants at the start of the study, 638 remained through the final assessment.
The authors stressed that the findings do not establish that the improvements were as a result of cannabis use. The research was observational and did not include a control group, leaving room for other explanations. They also emphasized that the reported changes were considerably larger than those seen in earlier randomized clinical trials, which they said could indicate the influence of observational bias.
Even with those limitations, the researchers said the results showed sustained improvements that exceeded predefined thresholds for clinically meaningful changes in opioid consumption, pain and disability.
The findings suggest a potential association between long-term medical cannabis treatment and reduced use of opioids and other medications among patients with persistent back pain. However, the study’s design means further controlled research is needed to determine how much of the observed improvement can be directly attributed to marijuana therapy.
These findings are unlikely to be surprising to marijuana operators, such as Aurora Cannabis Inc. (NASDAQ: ACB) (TSX: ACB), that have always believed in the therapeutic benefits of marijuana for patients dealing with a variety of symptoms.
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