VS steunt eindelijk Cannabis als pijnstiller
Neuropathische pijn groot probleem
Iets wat we in ons Instituut al jaren doen overigens. Alleen de ziekenkostenverzekeraars werken niet echt mee. Die laten de patiënten er zelf voor betalen. Dat is toch snel 50 Euro voor een potje met 5 gram, best veel dus!
Indicaties voor Cannabis als pijnstiller
Juist daarom legde dit rapport en de onderzoeken de focus op de behandeling van neuropathische pijn met Cannabis. Want het merendeel van alle patiënten in de VS, maar ook in Nederland, worden niet of niet genoeg behandeld:
‘Treatment alternatives are limited’
- Studies in Pain and Other Neurologic Conditions Chronic pain, is one of the most prevalent conditions in California and in the US generally. It is therefore not surprising that neuropathic pain is widespread, affecting 5-10% of the US population. Only a few classes of medications are approved for use as analgesics in these conditions. Opioids, anti convulsants, anti-depressants, and many patients obtain only partial relief, even when using combinations of all available therapies. Among the most difficult to treat neuropathic pain are those secondary to HIV, diabetes, and trauma to the nervous system.
Because these neuropathic disorders are so prevalent, and treatment alternatives are so limited, the CMCR focused on these conditions. A distinguishing scientific feature of this program of pain research, made possible only by the coordinating function of the CMCR. This is the commonality of measures and methods across the research studies. This allows for the distinctive advantage of comparability of results across studies.
Additionally, we studied treatment of the same type of pain condition (e.g., HIV neuropathy) in more than one geographic site. Finding comparable results at two or more sites studying the same disease is scientifically important. This is since this suggests that the results are generally valid. Rather than being due to chance, or the specific characteristics of a single sample of patients, or of a particular team of researchers.
De studies waren allemaal erg strak, met mooie onderzoeksdesigns, niets op aan te merken, zelfs met fake joints.
- This research used the gold standard design for assessment of therapeutic effects, the randomized clinical trial. In this approach participants are assigned by chance. Like flipping a coin, to an experimental treatment, in this case cannabis, or to a placebo (an inactive treatment). The placebo in all of our studies was a marijuana (cannabis) cigarette, made with cannabis from which the “active” ingredients. For example delta-9-tetrahydrocannabinol (THC), had been removed.
Vier studies in neuropathische pijn en MS
- The cigarette therefore had the appearance and the aroma of a marijuana cigarette. But without the crucial chemical ingredients hypothesized to be therapeutically active. Randomization ensures factors which might skew the results (like age, duration or intensity of pain) are equally present in both the experimental and placebo condition. Placebo is essential, since the expectation of pain relief from any treatment is a powerful analgesic itself.
All of our protocols used measures of pain recommended by expert consensus as standard in the field. For studies of smoked cannabis, the researchers used a standard, timed method of inhalation. Research using vaporized cannabis used similar, state-of-the art technology. Researchers measured blood concentrations of the primary active ingredient of cannabis (THC). Allowing estimates of relationships between dose, concentration, and magnitude of pain relief.
To date, the CMCR has completed four studies in the treatment of neuropathic pain. Two studies have focused on neuropathic pain resulting from HIV infection or the drugs used to treat HIV. One has focused on neuropathic pain of varying causes, and one has used an experimental model of neuropathic pain tested in healthy volunteers. The results from these four studies have been convergent, with all four demonstrating a significant decrease in pain after cannabis administration.
Cannabis net zo goed als reguliere pijnstiller
- The magnitude of effect in these studies, expressed as the number of patients needed to treat to produce one positive outcome, was comparable to current therapies.
Two additional studies involving neuropathic pain are underway. Multiple Sclerose (MS) is one of the most common chronic and disabling diseases of the nervous system. Caused by loss of the insulating sheath surrounding nerve fibers, the disease usually begins in young adulthood. Although it may initially wax and wane in intensity and be of mild severity, it often steadily progresses, causing fatigue, loss of balance, muscle weakness, and muscle spasticity. Affecting up to 70% of people with the disease, muscle spasms lead to pain, inability to walk. And difficulties with self-care, causing most of the everyday life disability from this disease.
- There is as yet no cure for MS. Treatments for muscle spasticity are only partially effective and have side effects which are not easily tolerated. Making the search for new therapies of high importance. Given this background, the CMCR identified MS spasticity as an additional target for therapeutic research. As with all CMCR studies, the research used the most rigorous scientific approach to testing therapies, a randomized clinical trial, supplemented by modern measurement of muscle spasticity, everyday function, life quality, and side effects.
Results to date have found a significant improvement in both an objective measure of spasticity and pain intensity in patients whose standard therapy had provided inadequate relief.
Februari 2010, prof. dr. Jan M. Keppel Hesselink
‘VS steunt eindelijk Cannabis als pijnstiller’
Bekijk hier video’s van onze patiënten over neuropathie.