Both smoked marijuana and pills made using marijuana's top active ingredient relieve pain, a new, small study found. Which to choose? Well, smoked pot worked faster, but the pills' effects lasted longer, the study found.
This is the first study to compare smoked marijuana with pills containing dronabinol (AKA delta-9 tetrahydrocannabinol AKA THC), the study scientists, a team of three psychiatrists from Columbia University in New York, wrote in a paper published today. And while anecdotal evidence—and several small studies—have shown that marijuana works for pain, dronabinol pills aren't yet U.S. Food and Drug Administration-approved for pain. Instead, their labels say they're for nausea, vomiting, low appetite and weight loss from chemotherapy and HIV/AIDS.
Comparing pills and pot contributes to a debate within the debate about marijuana for medicine: Do pills made of isolated, marijuana-derived chemicals work as well as smoking the whole plant? Whole-plant proponents say that marijuana has several chemicals that work together to produce the effects patients want. Smoked marijuana may also work faster than pills and allow patients to titrate exactly how much effect they get, by stopping smoking when they've had enough. Meanwhile, other researchers say pills could provide pain relief without lung irritation. In the political climate around medical marijuana research, pills are also much more likely to receive research funding and approval.
The Columbia study looked at 30 healthy volunteers, 15 men and 15 women, who are regular pot smokers. The researchers tried to look for people with about equal tolerance to pot. Over two to four weeks, the researchers asked the volunteers to come into the New York Psychiatric Institute and take pills and smoke marijuana cigarettes of varying strengths, including placebo pills with no dronabinol in them at all.
After taking their treatment, the researchers had the volunteers stick their left hands and forearms into a tank of icy water. The researchers recorded how long it took for the volunteers to say they started feeling pain and how long the volunteers could keep their arms submerged before having to pull out because of pain. (Sounds like a fun study, doesn't it?)
Low-dose marijuana cigarettes and dronabinol both decreased pain sensitivity compared to placebo, the researchers found. How quickly people started feeling pain and how long they could tolerate pain didn't differ between the two treatments. But 20-milligram dronabinol pills produced an effect that peaked later and lasted longer than smoked pot. Both treatments caused an increase in heart rate.
The study is a helpful start to proving both marijuana's and dronabinol's effectiveness against pain, but it has a couple drawbacks. It looked at daily marijuana smokers, who may not react to pot and dronabinol pills the same way that non-pot smokers would. The researchers said they expected the pain relief to work better in non-pot smokers, but for more unpleasant side effects to show up, too.
The results also may not necessarily translate to other kinds of pain. In other studies, different kinds of pain have reacted differently to dronabinol and marijuana. Several studies have shown both work for pain from nerve damage called neuropathy. Other studies found that five-milligram dronabinol pills didn't help people with either pain after surgery nor pain from heat, and that 20-milligram pills were ineffective for pain from inflammation and for a condition called hyperalgesia, in which people are hyper-sensitive to pain.
Generally people want marijuana or dronabinol for chronic pain, not the immediate, acute pain of freezing your hand. The researchers wrote that they used the cold water test because it helps them keep the level of pain constant. Chronic pain sufferers may have different pain levels from one day to the next, making their pain more difficult to study. But a clinical trial to get FDA approval would need to look not at healthy people, but at those who actually need pain medicine.
The Columbia researchers published their work in the journal Neuropsychopharmacology.
Since there are studies out there showing medical use and efficacy I am not sure why they still hold it to legally be a class 1 substance. At the very least it should be class 2
Drugs prescribed from a Doctor are managing care via science and measurability.
Drugs on the street are just a gamble.
Both come with side effects and consequences.
Drugs prescribe by a doctor come with a sense of moral and legal responsibility.
Drugs off the street do not come with no supporting science, and no measurability, no sense of moral rsponsibilty (we really do not know what crap you got off the street, mixed with this or that or how much). If you get sick from drugs off the street, can you complain to your dealer, sue him a mistake or ask him to modify your dosage, if it makes you sicker; no moron. But he can give you something more addictive and later charge you more for it.
Drugs off the street can take temporarily your pain away, then later permantly your health, life, famil\friends and money.
I tried it (in baked form) for my chronic pain, that I've had since 2006. It did absolutely nothing for it. Instead, it ended up shooting migrainal vertigo and tinnitus through the roof. Still have no idea what is causing the pain but, I'm stuck with morphine, lortab and gabapentin for a while it seems.
Would you rather be in pain, or stoned and in pain?
How stupid can you get.
MANY studies have shown smoked cannabis is weaker than ingested cannabis.
So why are we surprised smoked THC is weaker than ingested pill THC?
If they had wanted a fair portrayal of the pain management effects, they would have compared edible marijuana with THC pills.
yes. and as we know, marijuana absolutely HAS to be smoked.
this is pathetic second rate science. why is nobody pointing this out?
My understanding is that smoking pot does contribute to lung cancer. I was told that it was worse than smoking cigarettes - yuck!!!
Doctors prescribe medicine and pharmacists dispense them.
The link to the study in this article doesn't work because whoever made it doesn't quite know how dois work. The doi is 10.1038/npp.2013.97 not just npp.2013.97. The study can be found at http://dx.doi.org/10.1038/npp.2013.97 (not http://dx.doi.org/npp.2013.97).
@ Geawiel : Don't know how much you've found to be true in your case, but periodically I've had bouts of cluster headache. Back when I was first diagnosed, they thought migraine. Turns out, in these severe scenarios, 80% of the men are actually getting a cluster headache, not a migraine. Only 20 % of the men were getting actual migraine. And exactly opposite for women. 80% of them are experiencing migraine, with 20% cluster headache. In my case it's cluster, much of it caused by occupational nerve damage. Overload from stimuli by area resulting in the typical constriction of the circulatory system, and the standard range of other things like the vertigo, extreme sensitivity to light, nausea, tinitis, and blood pressure in the stroke range making my eyes feel like they are ready to fall out from nails being driven in behind them.
I've found through much trial and error that my physical demands on myself, combined with stuff like steadfast refusal to reduce coffee intake, salts, sugars, and the like were what my malfunction is. With your gabapentin, they are blocking nerve reception. You've got a real problem there, and you could do yourself good with a dedicated stretching and posture regimen, emphasizing whichever side of your body the damage is worst and keeping in mind that your aim is to take stress off of your neck and shoulders in the things you do. Build core strength, keep things being lifted or carried close to the body, not picking up weight at arm's length, etc.. The object being that your nerves move. Sometimes, our bodies can get past some limited amount of nerve damage. Sometimes a critical nerve can become pinched. Could have happened long ago. Sometimes we can work them loose.
You might try asking your doctor about Imitrex for an attack. Depends on your blood pressure, because it will drive it up. Still, with you on morphine and gabapentin, you are just about at the end of the line for strength of countering substances. I was getting the Imitrex injectors which were quite expensive, but I found that with it, I didn't need the painkilling stuff or a blocker or a trip to the emergency room. Good luck to you.
the chemical in marijuana that helps with pain, etc is not the THC, its the CBD. Taking CBD pills would help more. But there is not the "high" that is caused by the heated THCa.
Raw Cannabis juice (entire plant soaked in sugar water and pressed) regularly is really the best way to go for medical purposes; but again, no high.
Pills, and other baked goods are a bad idea as it is more difficult to control the dosage and effects. This is part of the reason pharmaceuticals have so many bad side effects: our bodies don't always need the same amount of chemical adjustments--which is what pills are. But in either case, responsibility must be taken.