Can Cannabis Wean Chronic Pain Patients Off Opioids? South African Clinical Trial Aims To Find Out

South Africa is looking for 300 participants to take part in a first-ever cannabis trial that will examine the plant’s potential as an effective alternative treatment for chronic pain among patients currently using opioids. Results of this year-long study being undertaken by the Cannabis Research Institute of South Africa (CRI) are expected in late 2023, reported Business Insider. 

South Africa showed an openness to marijuana in 2018 when the Constitutional Court decriminalized personal use. Four years later, however, the South African Health Products Regulatory Authority (SAHPRA) has yet to officially approve marijuana-based medicine for pain relief. 

Trial Details 

The trial, in partnership with Releaf Cannabis E-Clinics, will provide participants with medical marijuana throughout the study and will make certain that participants “stay on the medication until weaning off opioids becomes possible." Volunteers will be obliged to fill out questionnaires every month prior to receiving their next prescription. 

To become a participant in the study, people need to prove they suffer from chronic pain. Usually, these patients have illnesses like multiple sclerosis, rheumatoid arthritis, osteoarthritis and cancer-related conditions, among others. 

Finding Alternative For Opioids 

Among the most common pain medications are opioids, such as morphine, fentanyl, and tramadol, which are all very addictive and dangerous. If overdosed they can often result in death. According to the World Health Organization (WHO), of the approximately 500,000 deaths worldwide from drug use, more than 70% are connected to opioids. Also, 66% of 107,622 Americans who died in 2021 due to drug poisoning or overdose were related to synthetic opioids like fentanyl.

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The figures come as no surprise when considering that the synthetic opioid fentanyl is up to 50 times stronger than heroin and 100 times stronger than morphine. 

As for South Africa, the number of people admitted for opioid-related treatment over the past decade has increased according to a study done by members of the South African Medical Research Council (SAMRC).

"Chronic pain is defined as pain that lingers for longer than six months and can be categorized as visceral, somatic, and neurogenic. Given the broad spectrum, a wide range of treatments exist, from over-the-counter drugs; to opiates such as morphine, oxycodone, or codeine, which instruct the body's natural opioid receptors to prevent the nerves responsible for pain from signaling," said Dr. Shiksha Gallow, principal investigator in the research study. 

"In addition, opiates are associated with a plethora of side effects, including sedation, respiratory depression - and even death” she added. “With the global increase in opiate addiction, which brings with it far-reaching repercussions, from ill health to broader societal issues such as crime, the research will be focussed on establishing a safer alternative to treating pain."

Over the last several years, more studies looking into the effectiveness of cannabis as a replacement for opioids for chronic pain have been undertaken. Results of a study done at the Rothman Orthopedic Institute at Thomas Jefferson University were released in Nov. 2021. Participants, involving 73% of chronic patients, stopped taking opioids and stated that pain severity decreased and that they enjoyed improvements in their mental and physical health as well as quality of life

In fact, the Centers for Disease Control and Prevention (CDC) confirmed that several studies “have found that marijuana can be helpful in treating neuropathic pain, a specific type of chronic pain caused by damaged nerves,” and that "more research is needed to know whether marijuana works better than other options to manage pain."

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