The long and the short of it is that they don’t think enough research has yet been done to prove that “medicinal” cannabis will help with pain or chronic pain issues.

As always the mantra of more research is needed.

Our editorial comment at this point is to ask  why research and use can’t progress hand in hand

Their approach is somewhat beyond our simple thinking here at CLR  as the  use of cannabis for pain relief most likely started a millenia or more before anybody thought about creating the  The International Association for the Study of Pain (IASP)

 

Here is their press release

IASP Position Statement on the Use of Cannabinoids to Treat Pain

Mar 18, 2021

INTERNATIONAL ASSOCIATION FOR THE STUDY OF PAIN COMPLETES COMPREHENSIVE REVIEW OF RESEARCH ON THE USE OF CANNABINOIDS TO TREAT PAIN AND FINDS THAT THERE IS A LACK OF SUFFICIENT EVIDENCE TO ENDORSE THE GENERAL USE OF CANNABINOIDS FOR THE TREATMENT OF PAIN

 

WASHINGTON, DC – MARCH 18, 2021 – The International Association for the Study of Pain (IASP) said in a statement today that due to a lack of evidence from high quality research, it does not endorse the general use of cannabinoids [1] to treat pain. IASP has also published a list of research priorities which need to be addressed in order to properly determine the potential efficacy, and to confirm the safety of, cannabinoids when used in the treatment of pain.

In addition to the statement, the IASP journal PAIN has published a series of 13 linked scientific articles that comprehensively review all of the relevant laboratory and clinical research on this topic. These reviews took place over the last two-and-a-half years and represent the work of IASP’s Presidential Task Force on Cannabis and Cannabinoid Analgesia. These articles form the body of evidence that informed IASP’s position.

Although there are preclinical data supporting the hypothesis of cannabinoid analgesia, current uncertainties, especially in the clinical evidence, dictate that the evidence base regarding efficacy and safety fails to reach the threshold at which IASP can endorse their general use for pain control. The studies and the statement are limited to the use of cannabinoids to treat pain, and not for other conditions for which cannabinoids are currently being used.

“While IASP cannot endorse the general use of cannabinoids for treatment of pain at this time, we do not wish to dismiss the lived experiences of people with pain who have found benefit from their use,” said Andrew Rice, Professor of Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London and chair of the IASP’s Presidential Task Force on Cannabis and Cannabinoid Analgesia.

“This is not a door closing on the topic,” he added, “but rather a call for more rigorous and robust research to better understand any potential benefits and harms related to the possible use of medical cannabis, cannabis-based medicines and synthetic cannabinoids for pain relief, and to ensure the safety of patients and the public through regulatory standards and safeguards.”

“The IASP statement is important and timely because we are concerned that in certain jurisdictions medical cannabis may have been introduced without reference to the conventional statutory regulatory procedures for approving marketing of medicines,” Rice said. “Furthermore, where “recreational” use of cannabis is now permitted, there is a risk that patients could use cannabis for pain relief without the usual safeguard of a medical consultation and monitoring.”

Previous president of IASP Dr. Lars Arendt-Nielsen, who established and co-chaired the Task Force emphasize that “IASP is also calling for the delivery of a comprehensive research agenda. Priorities include identifying patients with pain who may receive the most benefit from cannabis or cannabinoids, and who may be at risk of the most harm. It is also necessary to expand the range of chemical entities tested, identify appropriate doses and their effects, and determine optimal delivery methods.”

 

About IASP

The International Association for the Study of Pain (IASP) works to support research, education, clinical treatment, and better patient outcomes for all pain conditions with the goal of improving pain relief worldwide.

With more than 5,800 members representing 134 countries, 96 national chapters, and 24 Special Interest Groups (SIGs), IASP fosters the exchange of ideas and education to advance the field of pain science. Membership is open to all professionals involved in research, diagnosis, or treatment of pain. Patients with lived experiences contribute at all levels in the organization.

 

www.iasp-pain.org

media@iasp-pain.org

@IASPpain


NOTES

[1]   Cannabinoids are broadly defined here as constituents of cannabis or synthetic compounds with pharmacological activity on the endocannabinoid system. This covers:

  • “Medical or medicinal cannabis” which is a term used for cannabis plants, plant material, or full plant extracts when used for medical purposes, but which do not have regulatory approval for marketing as a therapeutic.
  • “Medicinal cannabis extracts” (also known as licensed cannabis-based medicines) this term has been used for preparations derived from cannabis plants and which have regulatory approval for marketing as a therapeutic.
  • Synthetic cannabinoids are pharmacologically active compounds, usually having affinity for and activity at cannabinoid receptors, which may have regulatory approval for marketing as a therapeutic.

 

 

Journal Article Abstract

We report a systematic review and meta-analysis of studies which assessed the antinociceptive efficacy of cannabinoids, cannabis-based medicines, and endocannabinoid system modulators on pain-associated behavioural outcomes in animal models of pathological or injury-related persistent pain. In April 2019, we systematically searched 3 online databases and used crowd science and machine learning to identify studies for inclusion. We calculated a standardised mean difference (SMD) effect size for each comparison and performed a random effects meta-analysis. We assessed the impact of study design characteristics and reporting of mitigations to reduce the risk of bias. We meta-analysed 374 studies in which 171 interventions were assessed for antinociceptive efficacy in rodent models of pathological or injury-related pain. Most experiments were conducted in male animals (86 %). Antinociceptive efficacy was most frequently measured by attenuation of hypersensitivity to evoked limb withdrawal. Selective CB1, CB2, non-selective cannabinoid receptor agonists (including delta-9-tetrahydrocannabinol; THC), and PPAR-alpha agonists (predominantly palmitoylethanolamide; PEA) significantly attenuated pain-associated behaviours in a broad range of inflammatory and neuropathic pain models. Fatty acid amide hydrolase (FAAH) inhibitors, monoacylglycerol lipase (MGL) inhibitors and cannabidiol (CBD) significantly attenuated pain-associated behaviours in neuropathic pain models but yielded mixed results in inflammatory pain models. The reporting of criteria to reduce the risk of bias was low, therefore the studies have an unclear risk of bias. The value of future studies could be enhanced by improving the reporting of methodological criteria, the clinical relevance of the models and behavioural assessments. Notwithstanding, the evidence supports the hypothesis of cannabinoid-induced analgesia.

More at https://journals.lww.com/pain/Abstract/9000/A_systematic_review_and_meta_analysis_of.98088.aspx

 

Peter McCusker writes at CBE

Setback For Millions As Leading Global Pain Group Baulks At Medical Cannabis

DESPITE the United Nations recently recognising the medical benefits of cannabis, an influential global body says there is insufficient evidence to endorse it for the treatment of pain.

In what many will see a blow to progress of medical cannabis across the globe the The International Association for the Study of Pain (IASP) says further research is needed.

Its impacts may be immediately felt in the UK after the Advisory Council for the Misuse of Drugs (ACMD) recently said the IASP’s report would have a ‘powerful influence on the practice around prescribing cannabis-based medicines for the treatment of pain’.

A Lack Of Research 

The announcement by the IASP’s Presidential Task Force on Cannabis and Cannabinoid Analgesia received a mixed response with leading clinician Prof Mike Barnes describing it as a ‘setback for millions of people’.

More at  https://journals.lww.com/pain/Abstract/9000/A_systematic_review_and_meta_analysis_of.98088.aspx

 

At Cannabiz Australia they report on a number of fronts.

Why?

Because Australia is putting all its eggs in one basket when it comes to cannabis.

The (official) view currently in Australia is the only cannabis that can be mentioned in polite society is medical cannabis therefore both industry and government players are really relying on organisations like the  IASP to give cannabis the green light so they can ply their concotions on patients in Australia and internationally.

Of course as any regular cannabis user will know the use of cannabis for pain whether it be a bad back, headache, sore muscles.. the list is endless; tends to be an entirely individual thing and most will know better than the experts how to self medicate in terms of strength , volume and quality of product and the joy of the whole process is that consumers can’t kill themselves in the process of  doing so.

But then again what do consumers & patients know. It is always best to rely on the triumvirate of experts at associations; politicians and listed companies and their executives to instruct us as to what we really want because as we all know they really have our best interests at heart.

Cannabis industry hits back: pain management claims are putting patients at risk

Pain organisations express doubts over efficacy of medicinal cannabis

 

Medicinal cannabis and chronic pain: absence of evidence is not evidence of absence