Chronic pain management is a popular use of medical cannabis among adults, teens, and even children. Numerous studies confirm the validity and appropriateness of using cannabinoids to relieve pain of various origins.
The mechanisms of such relief are:
- The basic mechanism of pain relief with cannabis;
- Advantages over nonsteroidal anti-inflammatory analgesics;
- Increased efficacy of opiate analgesics;
- Pain relief in chronic renal failure;
- Pain relief in oncology;
- Relief of neuropathy in HIV;
- Use in paleativics for oncology;
- Acute postoperative pain.
The amount of cannabis needed for pain relief
In countries such as Canada, the United States, the United Kingdom, the Netherlands, and Israel, the average amount of medical cannabis a patient uses is 0.67 to 3 grams per day. The study we are looking at today has shown that it is possible to reduce the amount of cannabis needed for pain relief by 20 times through the use of special technical inhalation devices. This isn’t the first study to confirm the effectiveness of microdosing, though – similar experiments were conducted in 2008, 2013, and 2015 and showed that doses of 3 and 5 mg relieved drug-resistant neuropathy.
Of all the treatments, cannabis inhalation is the easiest, fastest, and most effective way to relieve pain, but the amount of cannabinoids that are ingested varies greatly depending on the variety of cannabis and the intensity of inhalation. Even with computer measurements of plasma THC concentrations – which controlled for the number of puffs, length of inhalation, length of breath-hold and time between puffs – it was noticed that these levels differed significantly among the experiment participants. Not surprisingly, medical devices are appearing on the global market to solve the problem of precise delivery of cannabinoids when inhaled.
The Syqe Inhaler
One such device is called The Syqe Inhaler, developed in Israel, its task is to accurately measure different dosages of cannabinoids from raw plants. In two seconds of heating and atomizing, 90% of tetrahydrocannabinol acid (THC-a) goes through a decarboxylation process into the pharmacologically active form of THC. The device has automatic thermal and flow controllers that ensure the delivery of cannabinoid vapors to the lungs, regardless of each patient’s breathing pattern. The device also monitors and records the entire inhalation process, allowing for a treatment log. The Syqe Inhaler is programmed to accurately deliver different dosages (0.5 – 1.5 mg of THC) according to the patient’s needs, allowing for individualization of the THC regimen.
This device caught our attention because it was tested in a randomized, double cross-over placebo-controlled study conducted in Ga. Haifa, Israel between March 2016 and July 2017. The main goal of the study was to determine the therapeutic window for chronic pain relief. Participants were 27 adults diagnosed with radiculopathy, diabetic neuropathy, complex regional pain syndrome, other focal neuropathies and phantom pain between the ages of 18 and 67 (mean, 48 years).
Each of them visited the research center three times and received their own inhaler loaded with chips containing 22% THC, 0.1% CBD, <0.2% CBN or placebo cannabis buds from the Netherlands. For this study, the machine was programmed to measure selective doses of 0.5 mg or 1 mg of THC, using an algorithm that electronically controlled inhalation characteristics such as temperature, duration, and vapor flow. Researchers consistently measured patients’ plasma THC levels at different intervals before and after inhalation, as well as blood pressure and heart rate. Subjects also rated pain levels on a visual analogue scale (VAS) of pain measurement.
It turned out that using such a small dosage of 0.5 mg of THC in most patients relieved pain by 25%, which patients defined as noticeable relief. Doubling the dosage, on the other hand, raises the effectiveness almost twice as much, with the pain relief effect rated as significantly greater. At the same time, in the first experiment with the dosage, THC did not cause patients to feel psychoactive, but the second experiment had such an outcome. Scientists note that depending on the dose of THC, the effects are extremely high and varied, which requires the proper precision for the correct medical use of cannabinoids.
The fact that a significant number of pain patients use large amounts of cannabis daily shows the chasm between scientific research and treatment practice.