中文(简体)
Albanian
Arabic
Armenian
Azerbaijani
Belarusian
Bengali
Bosnian
Catalan
Czech
Danish
Deutsch
Dutch
English
Estonian
Finnish
Français
Greek
Haitian Creole
Hebrew
Hindi
Hungarian
Icelandic
Indonesian
Irish
Italian
Japanese
Korean
Latvian
Lithuanian
Macedonian
Mongolian
Norwegian
Persian
Polish
Portuguese
Romanian
Russian
Serbian
Slovak
Slovenian
Spanish
Swahili
Swedish
Turkish
Ukrainian
Vietnamese
Български
中文(简体)
中文(繁體)

Investigation of Cannabis for Chronic Pain and Palliative Care

只有注册用户可以翻译文章
登陆注册
链接已保存到剪贴板
状态
赞助商
New York State Psychiatric Institute

关键词

抽象

The use of cannabis for severe medical conditions is being legalized in different states, increasing the mandate to make cannabis legal for medically ill patients. However, there is a lack of placebo-controlled studies investigating the efficacy of cannabis. Dronabinol (synthetic, oral Δ-9-THC) is FDA approved for the appetite stimulation in AIDS-related anorexia and nausea/vomiting in chemotherapy patients. Nabilone, a synthetic analogue of THC, is approved for nausea/vomiting in chemotherapy patients. These medications have been found to be effective for these disorders, but there remains an interest in studying cannabis, partly due to the numerous cannabinoids contained within the cannabis plant. Among these is cannabidiol, which does not produce subjective effects, but has been shown to have potent anti-inflammatory effects. In addition, there is data indicating that cannabidiol may be effective for neuropathic pain and nausea/vomiting.
The goal is to investigate the effects of high CBD/low THC cannabis on symptoms such as pain, nausea/vomiting, and quality of life in seriously ill participants. While there is data beginning to emerge that cannabis may have a beneficial effect on these symptoms, there are few placebo controlled, double-blind studies. Additionally, the administration of cannabis to medically ill patients may be limited by its subjective effects, such as anxiety, intoxication, or paranoia. Most cannabis available today has high levels of Δ-9-THC (about 15%). By using cannabis that is high in CBD, but low in - Δ-9-THC, it is hypothesized that some of these effects can be avoid, while maximizing the therapeutic effects, if any.

描述

The goal of this study is to perform a double-blind, placebo-controlled study to investigate the efficacy of cannabis, compared to placebo, in medically ill participants seeking relief symptoms such as pain, nausea, and vomiting. Participants who meet criteria for severe conditions will be referred from their clinicians . Cannabis that has a high concentration of cannabidiol, which is a cannabinoid that does not change perception or produce intoxication, and low in Δ-9-THC will be used. In this way, the hope is to maximize the benefit of cannabis, while lowering the possible side effects of cannabis in medically ill participants.

The overall goal of this study is to compare active high cannabidiol (CBD)/ low (−)-trans-Δ9- tetrahydrocannabinol (THC) cannabis vs placebo cannabis in patients with serious medical disorders. Participants will be referred from clinicians and will come to the laboratory daily (3-5 times weekly) for cannabis (15.76% CBD; 3.11% Δ-9-THC) vs placebo (0.0% CBD/ 0.01% Δ-9-THC). The cannabis will be vaporized or smoked as a cannabis cigarette. The participants can choose which option they prefer. The cross-over design will be used where participants receive 2 weeks of active cannabis vs two weeks of placebo in counterbalanced order, with participants blinded to the condition. The outcome measures primarily include measures of pain, with secondary measures of mood, nausea/appetite, quality of life, and the both the potentially positive and negative subjective effects of cannabis (e.g., high, mellow, anxious, paranoid).

日期

最后验证: 01/31/2019
首次提交: 02/10/2016
提交的预估入学人数: 02/15/2016
首次发布: 02/16/2016
上次提交的更新: 02/25/2019
最近更新发布: 02/27/2019
实际学习开始日期: 11/30/2050
预计主要完成日期: 11/30/2050
预计完成日期: 11/30/2050

状况或疾病

Chronic Pain

干预/治疗

Drug: Smoked Cannabis High CBD/low THC

Drug: Smoked Placebo Cannabis Low CBD/low THC

相 1

手臂组

干预/治疗
Active Comparator: Smoked Cannabis High CBD/low THC
Participants will visit the Marijuana Research Laboratory 3-5 weekdays per week for 4 weeks to be administered 1-2 Smoked Cannabis High CBD/low THC cigarettes (15.76% CBD; 3.11% THC) over the course of a 2-3 hour session.
Drug: Smoked Cannabis High CBD/low THC
Participants will visit the Marijuana Research Laboratory 3-5 weekdays per week for 4 weeks to be administered 1-2 cannabis cigarettes (15.76% CBD; 3.11% THC) over the course of a 2-3 hour session.
Placebo Comparator: Smoked Placebo Cannabis Low CBD/low THC
Participants will visit the Marijuana Research Laboratory 3-5 weekdays per week for 4 weeks to be administered 1-2 cannabis cigarettes (0.01% THC; 0.00% CBD) over the course of a 2-3 hour session.
Drug: Smoked Placebo Cannabis Low CBD/low THC
Participants will visit the Marijuana Research Laboratory 3-5 weekdays per week for 4 weeks to be administered 1-2 cannabis cigarettes (0.01% THC; 0.00% CBD) over the course of a 2-3 hour session.

资格标准

有资格学习的年龄 21 Years 至 21 Years
有资格学习的性别All
接受健康志愿者
标准

Inclusion Criteria:

1. One of the medical diagnoses (cancer, amyotrophic lateral sclerosis, Parkinson's disease, spinal cord injury, neuropathy, and phantom limb pain, thalamic pain, pain related to injury of nerve plexus/plexi, and neuropathic facial pain), with reports of pain (at least 3 on item 3 on the 9 item Brief Pain Inventory)that remains despite their current medical treatment.

2. Age 21-60

3. Able to give informed consent, and comply with study procedures

4. Experience inhaling substances.

Exclusion Criteria:

1. Meet DSM-V criteria for current major psychiatric illness, such as bipolar disorder, major depression, active suicidality, or psychosis, that could be exacerbated by the administration of cannabis

2. Meet criteria for major neurological disorder, such as mild cognitive impairment or neurodegenerative disorders (such as movement disorders, dementia), that could be exacerbated by the administration of cannabis.

3. Women who are not practicing an effective form of birth control (condoms, diaphragm, birth control pill, IUD) or currently pregnant

4. Current (weekly) use of cannabis

5. Participants on supplemental oxygen

6. Participants with a substance use disorder involving marijuana or opioids.

结果

主要结果指标

1. Change in pain ratings using the McGill Pain Questionnaire [4 weeks]

Participants will be asked to rate their pain over the 4 weeks of receiving active cannabis vs placebo.

2. Change in sickness-related impairment using the Sickness Impact Profile [4 weeks]

Participants will be asked to rate physical symptoms for the 4 weeks of the study.

3. changes in physical and emotional well being using the RAND-36 item medical outcomes survey, a health-related quality of life survey instrument [4 weeks]

RAND-36 item medical outcomes survey taps eight health concepts: physical functioning, bodily pain, role limitations due to physical health problems, role limitations due to personal or emotional problems, emotional well-being, social functioning, energy/fatigue, and general health perceptions.

4. Changes in symptoms of pain using the 9 item Brief Pain Inventory [4 weeks]

次要成果指标

1. Change in cognitive status using the Short Portable Mental Status Questionnaire (SPMSQ) [4 weeks]

2. Change in symptom prevalence, characteristics and degree of stress using the Memorial Symptom Assessment Scale (MSAS) [4 weeks]

3. Change in the psychological state and psychological well being using the Mental Health Inventory-5 (MHI-5) [4 weeks]

4. Changes in quality of life using the Multidimensional Index of Life Quality (MILQ) Questionnaire [4 weeks]

5. Changes in quality of life using the McGill Quality of Life Questionnaire [4 weeks]

6. Change in symptoms of pain, mood and appetite using the Edmonton Symptom Assessment System (ESAS) [4 weeks]

7. Memorial Symptom Assessment Scale (MSAS) [4 weeks]

8. Change in mood using the Hamilton Depression Rating Scale [4 weeks]

9. Change in mood Hamilton Anxiety Rating Scale [4 weeks]

10. Change in mood using the Montgomery-Asberg Depression Rating Scale [4 weeks]

11. Change in mood and quality of life using the Columbia Suicide Severity Rating Scale [4 weeks]

加入我们的脸书专页

科学支持的最完整的草药数据库

  • 支持55种语言
  • 科学支持的草药疗法
  • 通过图像识别草药
  • 交互式GPS地图-在位置标记草药(即将推出)
  • 阅读与您的搜索相关的科学出版物
  • 通过药效搜索药草
  • 组织您的兴趣并及时了解新闻研究,临床试验和专利

输入症状或疾病,并阅读可能有用的草药,输入草药并查看所使用的疾病和症状。
*所有信息均基于已发表的科学研究

Google Play badgeApp Store badge