Daily cannabis use may cause cannabis-induced hyperalgesia.


Journal

The American journal on addictions
ISSN: 1521-0391
Titre abrégé: Am J Addict
Pays: England
ID NLM: 9208821

Informations de publication

Date de publication:
11 2023
Historique:
revised: 28 06 2023
received: 21 02 2023
accepted: 25 07 2023
medline: 1 11 2023
pubmed: 8 8 2023
entrez: 8 8 2023
Statut: ppublish

Résumé

Public opinion about cannabis as a medical treatment is generally favorable. As many as 35% of primary care patients report medical use of cannabis, most commonly for pain treatment. We designed a way to test whether cannabis helps chronic pain. A retrospective cohort study was conducted to explore whether daily long-term cannabis use was associated with increased pain sensitivity using the cold pressor test (CPT) to measure pain tolerance. Patients who used cannabis every day were compared to patients who inhaled tobacco and control patients who never used tobacco or cannabis. The effect of cannabis use on CPT was assessed using a generalized linear model. Patients using cannabis daily had a median CPT of 46 s, similar to those who did not use cannabis but who inhaled tobacco (median CPT 45 s). Patients who used both cannabis and tobacco had the lowest CPT (median 26 s). The control group had a median CPT of 105 s. Cannabis use was associated with a significantly decreased pain tolerance (χ² This suggests a phenomenon similar to opioid-induced hyperalgesia; a drug that reduces pain short term, induces pain long term-opponent process. Daily cannabis use may make chronic pain worse over time by reducing pain tolerance. In terms of risk/benefit, daily cannabis users risk addiction without any long-term benefit for chronic pain.

Sections du résumé

BACKGROUND AND OBJECTIVES
Public opinion about cannabis as a medical treatment is generally favorable. As many as 35% of primary care patients report medical use of cannabis, most commonly for pain treatment. We designed a way to test whether cannabis helps chronic pain.
METHODS
A retrospective cohort study was conducted to explore whether daily long-term cannabis use was associated with increased pain sensitivity using the cold pressor test (CPT) to measure pain tolerance. Patients who used cannabis every day were compared to patients who inhaled tobacco and control patients who never used tobacco or cannabis. The effect of cannabis use on CPT was assessed using a generalized linear model.
RESULTS
Patients using cannabis daily had a median CPT of 46 s, similar to those who did not use cannabis but who inhaled tobacco (median CPT 45 s). Patients who used both cannabis and tobacco had the lowest CPT (median 26 s). The control group had a median CPT of 105 s. Cannabis use was associated with a significantly decreased pain tolerance (χ²
CONCLUSION AND SCIENTIFIC SIGNIFICANCE
This suggests a phenomenon similar to opioid-induced hyperalgesia; a drug that reduces pain short term, induces pain long term-opponent process. Daily cannabis use may make chronic pain worse over time by reducing pain tolerance. In terms of risk/benefit, daily cannabis users risk addiction without any long-term benefit for chronic pain.

Identifiants

pubmed: 37550852
doi: 10.1111/ajad.13456
doi:

Substances chimiques

Hallucinogens 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

532-538

Informations de copyright

© 2023 The Authors. The American Journal on Addictions published by Wiley Periodicals LLC on behalf of The American Academy of Addiction Psychiatry (AAAP).

Références

Kosiba JD, Maisto SA, Ditre JW. Patient-reported use of medical cannabis for pain, anxiety, and depression symptoms: systematic review and meta-analysis. Soc Sci Med. 2019;233:181-192. doi:10.1016/j.socscimed.2019.06.005
Lapham GT, Matson TE, Carrell DS, et al. Comparison of medical cannabis use reported on a confidential survey vs documented in the electronic health record among primary care patients. JAMA Netw Open. 2022;5(5):e2211677. doi:10.1001/jamanetworkopen.2022.11677
Erratum in: JAMA Netw Open. 2022;5(6):e2219924.
Sihota A, Smith BK, Ahmed SA, et al. Consensus-based recommendations for titrating cannabinoids and tapering opioids for chronic pain control. Int J Clin Pract. 2021;75(8):e13871. doi:10.1111/ijcp.13871
Hill KP, Gold MS, Nemeroff CB, et al. Risks and benefits of cannabis and cannabinoids in psychiatry. Am J Psychiatry. 2022;179(2):98-109. doi:10.1176/appi.ajp.2021.21030320
Wang L, Hong PJ, May C, et al. Medical cannabis or cannabinoids for chronic non-cancer and cancer related pain: a systematic review and meta-analysis of randomised clinical trials. BMJ. 2021;374:n1034. doi:10.1136/bmj.n1034
Longo R, Oudshoorn A, Befus D. Cannabis for chronic pain: a rapid systematic review of randomized control trials. Pain Manag Nurs. 2021;22(2):141-149. doi:10.1016/j.pmn.2020.11.006
Gilman JM, Schuster RM, Potter KW, et al. Effect of medical marijuana card ownership on pain, insomnia, and affective disorder symptoms in adults: a randomized clinical trial. JAMA Netw Open. 2022;5(3):e222106. doi:10.1001/jamanetworkopen.2022.2106
Hill KP, Palastro MD, Johnson B, Ditre JW. Cannabis and pain: a clinical review. Cannabis Cannabinoid Res. 2017;2(1):96-104. doi:10.1089/can.2017.0017
Baker TB, Piper ME, McCarthy DE, Majeskie MR, Fiore MC. Addiction motivation reformulated: an affective processing model of negative reinforcement. Psychol Rev. 2004;111(1):33-51. doi:10.1037/0033-295X.111.1.33
Stockings E, Campbell G, Hall WD, et al. Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies. Pain. 2018;159(10):1932-1954.
Campbell G, Hall WD, Peacock A, et al. Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study. Lancet Public Health. 2018;3(7):e341-e350. doi:10.1016/S2468-2667(18)30110-5
Liu CW, Bhatia A, Buzon-Tan A, et al. Weeding out the problem: the impact of preoperative cannabinoid use on pain in the perioperative period. Anesth Analg. 2019;129(3):874-881. doi:10.1213/ANE.0000000000003963
Jamal N, Korman J, Musing M, et al. Effects of pre-operative recreational smoked cannabis use on opioid consumption following inflammatory bowel disease surgery: a historical cohort study. Eur J Anaesthesiol. 2019;36(9):705-706.
Ekrami E, Ozturk SS, Kopac O, et al. Association between Cannabis use and Postoperative Opioid Consumption. The Anesthesiology Annual Meeting of the American Society of Anesthesiologists; 2022. http://www.asaabstracts.com/strands/asaabstracts/abstract.htm?year=2022&index=17&absnum=6927
Piomelli D, Cooper Z, Abrams D, Grant I, Patel S. A guide to The National Academy of science report on cannabis: an exclusive discussion with panel members. Cannabis Cannabinoid Res. 2017;2(1):155-159. doi:10.1089/can.2017.29009.dpi
IASP Presidential Task Force on Cannabis and Cannabinoid Analgesia. International Association for the Study of pain presidential task force on cannabis and cannabinoid analgesia position statement. Pain. 2021;162(suppl 1):S1-S2. doi:10.1097/j.pain.0000000000002265
McPartland JM, Guy GW, Di Marzo V. Care and feeding of the endocannabinoid system: a systematic review of potential clinical interventions that upregulate the endocannabinoid system. PLoS One. 2014;9(3):e89566. doi:10.1371/journal.pone.0089566
Zehra A, Burns J, Liu CK, et al. Cannabis addiction and the brain: a review. J Neuroimmune Pharmacol. 2018;13(4):438-452. doi:10.1007/s11481-018-9782-9
Koob G. Drug addiction, dysregulation of reward, and allostasis. Neuropsychopharmacology. 2001;24(2):97-129. doi:10.1016/S0893-133X(00)00195-0
Rolan P, Krishnan A, Salter T, Sullivan M, White J, Gentgall P. Comparison of pain models to detect opioid-induced hyperalgesia. J Pain Res. 2012;5:99-106. doi:10.2147/JPR.S27738
Oaks Z, Stage A, Middleton B, Faraone S, Johnson B. Clinical utility of the cold pressor test: evaluation of pain patients, treatment of opioid-induced hyperalgesia and fibromyalgia with low dose naltrexone. Discov Med. 2018;26(144):197-206.
Cooper ZD, Haney M. Sex-dependent effects of cannabis-induced analgesia. Drug Alcohol Depend. 2016;167(112):112-120. doi:10.1016/j.drugalcdep.2016.08.001
De Vita MJ, Moskal D, Maisto SA, Ansell EB. Association of cannabinoid administration with experimental pain in healthy adults: a systematic review and meta-analysis. JAMA Psychiatry. 2018;75(11):1118-1127. doi:10.1001/jamapsychiatry.2018.2503
van de Donk T, Niesters M, Kowal MA, Olofsen E, Dahan A, van Velzen M. An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia. Pain. 2019;160(4):860-869. doi:10.1097/j.pain.0000000000001464
Jackson D, Singh S, Zhang-James Y, Faraone S, Johnson B. The effects of low dose naltrexone on opioid induced hyperalgesia and fibromyalgia. Front Psychiatry. 2021;12:593842. doi:10.3389/psyt.2021.593842
Belkin M, Reinheimer HS, Levy J, Johnson B. Ameliorative response to detoxification, psychotherapy, and medical management in patients maintained on opioids for pain. Am J Addict. 2017;26(7):738-743. doi:10.1111/ajad.12605
Johnson B, Ulberg S, Shivale S, Donaldson J, Milczarski B, Faraone SV. Fibromyalgia, autism, and opioid addiction as natural and induced disorders of the endogenous opioid hormonal system. Discov Med. 2014;18(99):209-220.
Anugu V, Ringhisen J, Johnson B. Autism case report: cause and treatment of “high opioid tone” autism. Front Psychol. 2021;12:657952. doi:10.3389/fpsyg.2021.657952
Powers JM, Maisto SA, Zvolensky MJ, Heckman BW, Ditre JW. Longitudinal associations between pain and use of cigarettes and E-cigarettes in the Population Assessment of Tobacco and Health (PATH) study. Nicotine Tob Res. 2023;25(3):404-411. doi:10.1093/ntr/ntac197
LaRowe LR, Ditre JW. Pain, nicotine, and tobacco smoking: current state of the science. Pain. 2020;161(8):1688-1693. doi:10.1097/j.pain.0000000000001874
Behrend C, Prasarn M, Coyne E, Horodyski M, Wright J, Rechtine GR. Smoking cessation related to improved patient-reported pain scores following spinal care. J Bone Jt Surg. 2012;94(23):2161-2166. doi:10.2106/JBJS.K.01598

Auteurs

Yanli Zhang-James (Y)

Department of Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, New York, USA.

Evelyn Wyon (E)

Department of Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, New York, USA.

Dennis Grapsas (D)

State University of New York Upstate Medical University, Norton School of Medicine, Syracuse, New York, USA.

Brian Johnson (B)

Department of Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, New York, USA.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH