Medicinal cannabis not effective for long-term sleep problems

Tuesday January 21st, 2020

People with chronic pain who have trouble sleeping might build up a tolerance to medicinal cannabis, which would negate its effectiveness, researchers warn today.

Preliminary research published online in BMJ Supportive & Palliative Care today (20 January 2020) analysed sleeping patterns of people aged 50 and over who had chronic pain that had lasted at least a year.

The Israeli study involved 128 people being treated at a specialist pain clinic, 66 of whom used medicinal cannabis to manage their sleep problems.

Out of the entire cohort, 24% said they always woke up early and were unable to get back to sleep; 20% reported always finding it difficult to fall asleep; and 27% said they woke up during the night.

Medicinal cannabis users had used the drug for an average of four years, consuming about 31g a month. The researchers found that after taking account of potentially influential factors, medicinal cannabis users were less likely to wake during the night than non-users.

But there were no differences between the two groups in the time taken to get to sleep or frequency of early awakening. Further analysis of the sleep patterns of the medicinal cannabis users showed that frequency of use was associated with greater difficulty falling asleep and more frequent waking during the night.

Writing in the latest edition of BMJ Supportive & Palliative Care, the authors say: “This may signal the development of tolerance.

“These findings have large public health impacts considering the ageing of the population, the relatively high prevalence of sleep problems in this population, along with the increasing use of medicinal cannabis.”

A second study in the same journal claims that cannabinoids do not have a role in cancer-related pain.

The research team, from Leeds and Hull, UK, used pooled data from five clinical trials, comparing the use of cannabinoids with a placebo or when used in addition to opioids to relieve cancer pain in 1442 adults.

They found that changes in average pain intensity scores were no different between those taking cannabinoids and those given placebo, while cannabinoids were associated with a significantly higher risk of side effects.

Although the researchers admit a pain score might not be the best measure to adequately capture the complexity of longstanding pain, they say: “This systematic review provides good evidence that cannabinoids do not have a role in cancer-related pain.”

Sznitman S, Vulfsons S, Meiri D et al. Medicinal cannabis and insomnia in older adults with chronic pain: a cross sectional study. BMJ Supportive & Palliative Care 21 January 2020; doi 10.1136/bmjspcare-2019-001938

http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2019-001938

Boland E, Bennett M, Allgar V et al. Cannabinoids for adult cancer-related pain: systematic review and meta-analysis. BMJ Supportive & Palliative Care 21 January 2020; doi 10.1136/bmjspcare-2019-002032

http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2019-002032

Tags: Alternative Therapy | Asia | Cancer | Pain Relief | UK News

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