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Published: 05 December 2023

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Oral cannabidiol (CBD) as add-on to paracetamol for painful chronic osteoarthritis of the knee: a randomized, double-blind, placebo-controlled clinical trial.

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Background: Painful knee osteoarthritis (KOA) is common, pharmacological treatment, however, is often hampered by limited tolerability. Cannabidiol, which preclinically showed anti-inflammatory, analgesic activity, could supplement established analgesics, but robust clinical trials are lacking. The aim of our study was to investigate the effects of oral high-dose CBD administered over 8 weeks on pain, function and patient global assessment as an add-on to continued paracetamol in chronic symptomatic KOA.

Methods: Prospective, randomized, placebo-controlled, double-blind, parallel-group study. Single center, Outpatient Clinic, Department of Special Anaesthesia and Pain Therapy at Medical University of Vienna, Austria. Eligibility criteria included: age: 18–98 years; painful KOA; score ≥5 on the pain subscale of the Western Ontario and McMasters Universities Osteoarthritis (WOMAC) Index; KOA confirmed by imaging. Participants were on continued dosage of paracetamol 3 g/d and randomly assigned by web-based software 1:1 to oral cannabidiol 600 mg/d (n = 43) or placebo (n = 43). Study period: 8 weeks. Primary outcome: Change in WOMAC pain subscale scores (0 = no pain, 10 = worst possible pain) from baseline to week 8 of treatment. Trial Registration: ClinicalTrials.gov Identifier: NCT04607603. Trial is completed.

Interpretation: In KOA patients, oral high-dose add-on cannabidiol had no additional analgesic effect compared to adding placebo to continued paracetamol. Our results do not support the use of cannabidiol as an analgesic supplement in KOA

(Source: https://www.sciencedirect.com/science/article/pii/S2666776223001965 )

Also see 

• Cannabis & Pain – Media Hype & the Placebo Reality?
• Cannabis and Cannabinoids for Pain and Posttraumatic Stress Disorder in Military Personnel and Veterans (The Cannabis Placebo Factor)

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Published: 04 December 2023

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Researchers examined cannabis use among heroin users over a 20-year period.

With cannabis marketing propaganda proliferating in the commercialized settings, it’s no wonder nearly 44% of US adults think marijuana is safer than tobacco. 

People with heroin dependency don't use less of that drug if they start also using cannabis, according to a new study.

The findings cast some doubt on the idea that cannabis might help people reduce their dependence on opioids, experts say.

"Despite suggestions that cannabis may be used as a method for reducing opioid use, we found no evidence to suggest a relationship between the use of these [substances]," Dr. Jack Wilson, a researcher at The Matilda Centre for Research in Mental Health and Substance Use at the University of Sydney.

"Increasing the availability of cannabis is unlikely to have an impact one way or the other on the opioid crisis and overdose death rate," said Dr. Andrew Saxon, a professor of psychiatry and behavioral sciences at the University of Washington School of Medicine, and a member of the American Psychiatric Association's council on addiction psychiatry.

The study found that cannabis use was very common among those who were dependent on heroin. However, there wasn't a consistent relationship between the patterns of use of the two drugs, and no evidence to suggest that cannabis use reduced long-term opioid use.

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Published: 29 November 2023

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A Yale-led analysis of the genomes of more than 1 million people has shed light on the underlying biology of cannabis use disorder and associated risks.

From the abstract: As recreational use of cannabis is being decriminalized in many places and medical use widely sanctioned, there are growing concerns about increases in cannabis use disorder (CanUD), which is associated with numerous medical comorbidities. A genetically informed causal relationship analysis indicated a possible effect of genetic liability for CanUD on lung cancer risk, suggesting potential unanticipated future medical and psychiatric public health consequences.

This study yields new insights into the genetic architecture of CanUD and how this risk interacts with traits crucial to public health and raises important concerns regarding the potential adverse consequences of the secular trend toward increased cannabis use consequent to legalization. https://www.nature.com/articles/s41588-023-01563-z

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Published: 29 November 2023

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Abstract

Context: Cannabis use among the general population has increased over time, in part due to decriminalization of use and greater social acceptance of cannabis use. These changes have contributed to increased availability of cannabis products, thus raising the likelihood that a subset of adolescent and young adult athletes will use cannabis. Therefore, it is imperative that clinicians and other providers working with young athletes have a thorough understanding of the impact cannabis can have on the athletic performance and overall health of a young athlete.

Survey studies suggest that up to 1 in 4 athletes have used cannabis at least once in the last year. Age, sex, race, sexual orientation, level of competition, and country of residence of an athlete all contribute to differing rates of cannabis use among athletes. The scientific literature does not support using cannabis for athletic performance, and multiple studies have demonstrated notable impairments in objective athletic performance measures. Cannabis use can also negatively impact an athlete’s overall health via cardiovascular, gastrointestinal, and mental health symptoms and disorders.

Conclusion: Cannabis use among adolescent and young adult athletes is common, and rates of use are influenced by many different factors. Current evidence suggests that cannabis use can worsen sport performance, negatively impact an athlete’s general health, and contribute to negative mental health outcomes. (Source: Cannabis Use in Adolescent and Young Adult Athletes: A Clinical Review  2023 (sagepub.com)