Medical cannabis may ease anxiety, chronic pain

The study, a collaboration between the University of Auckland and GP Dr Graham Gulbransen, who opened the first medical cannabis clinic in Aotearoa New Zealand, examined the records of 400 patients assessed for treatment at Dr Gulbransen’s west Auckland clinic Cannabis Care.

Products containing cannabidiol (CBD oil), an active compound derived from the cannabis plant which does not give people a ‘high’, were legalised for prescription by doctors in New Zealand in 2017. CBD is FDA-approved for the treatment of two childhood seizure disorders, but early evidence suggests it could also help treat anxiety and chronic pain, and may reduce psychotic symptoms of schizophrenia. Due to a lack of large-scale, controlled studies in humans, there are no prescribing guidelines.

The new study found that CBD oil taken for four weeks significantly improved the self-reported quality of life most for patients living with non-cancer chronic pain and anxiety-related mental health conditions. Patients with cancer or neurological symptoms also experienced improved quality of life, but to a lesser degree. Because symptom assessments were subjective, it is not possible to determine how much of this was due to placebo effect.

“Our findings show that CBD is well-tolerated in most patients and can markedly ease symptoms in a range of hard-to-treat conditions, and that there are people keen to access this and self-fund the medication (about $300 per month),” says Professor Bruce Arroll, senior author in the study and head of the Department of General Practice and Primary Healthcare at the University of Auckland.

“The study has limitations due to drop-out and other factors, but the findings are consistent with other evidence and underline the need for more research to allow us to fully realise the therapeutic potential of medical cannabis.”

Of the first 400 patients, 397 received a prescription for CBD. Slightly more patients were female (214 or 54 percent) than male (183 or 46 percent). Patients were asked to rate their own pain, anxiety, debility, and depression across different areas of their lives before taking CBD, and then four weeks after starting the treatment. They were also asked to also rate satisfaction with CBD after four weeks. Just over a quarter, or 110, patients completed all assessments; although a greater number – 250 - gave feedback on their satisfaction with CBD.  

After taking CBD oil, patients with non-cancer pain symptoms reported on average improved mobility and ability to complete their usual activities and less pain, anxiety and depression. Patients with mental health-related symptoms reported improved ability to complete activities and reduced pain, anxiety and depression. Overall, patients with cancer-related pain reported less pain, but no other improvements.

Of the 250 patients who rated their satisfaction with CBD use, 70 percent (175) reported it was good, very good or excellent; while 30 percent (75) reported no benefit from CBD use. Adverse side-effects, which included sedation and vivid dreams, were reported by 25 out of 253 patients (10 percent) reached at follow-up, while two (0.8 percent) reported a worsening of a pre-existing condition. The CBD seemed to be very well tolerated.

“Of those first 400 patients referred or self-referred to my clinic, 62 chose not to take CBD oil. Reasons included death, the cost barriers, severe illness, participating in a clinical trial, or consuming cheaper illicit cannabis products,” says Dr Gulbransen. “Our evidence of CBD’s potential benefits in treating pain and anxiety, if corroborated by future clinical trials, suggests we may need to consider subsidising medical cannabis.”

The study is published in the British Journal of General Practice Open (BJGP Open).

Read the article:

British Journal of General Practice Open (BJGP Open): Cannabidiol prescription in clinical practice: an audit on the first 400 patients in New Zealand