Cannabis extract found to be effective for lower back pain

A drug derived from cannabis eases chronic lower back pain without serious side effects or signs of addiction, making it a potentially powerful alternative to existing pain medications.

There are currently few treatment options for patients experiencing chronic pain, with many having to take opioids that come with a high risk of addiction.

The experimental drug VER-01 is an extract from the cannabis plant containing 5 per cent tetrahydrocannabinol (THC), the principal active ingredient.

In a clinical trial, 820 people with chronic lower back pain were randomly assigned to take VER-01 or a placebo for 12 weeks. At the end of this period, people taking the drug had a reduction in their pain scores of 1.9 on average on a scale of 0 to 10, while those taking a placebo had a 1.4-point reduction. There were no adverse events indicating a risk of withdrawal or abuse with the medication.

The study is the most rigorous to date to show clinically proven and non-addictive cannabis-based treatment of chronic pain, reinforcing a growing interest in cannabis as a pain treatment.

“It’s one of the first really high-quality studies for medical cannabis which many people, both researchers and patients, have been waiting for,” says Winfried Meissner at Jena University Hospital in Germany, a researcher on the study. “So far evidence is poor, past studies are of lower quality, fewer patients.”

Those who took VER-01 also had significant improvements in sleep quality and physical function and most of the side effects were mild, including dizziness, fatigue, dry mouth and nausea. Patients gradually increased their dosage during the treatment period, taking up to 13 doses per day.

The treatment was especially effective for back pain caused by nerve damage, known as neuropathic pain. Meissner says patients with chronic pain should always be treated first with physical therapy, but painkillers can help those who are unable to move. “Even a relatively small pain reduction might help [patients] go to exercise,” he says.

Although the reduction in pain wasn’t massive, it is rare to see huge reductions in chronic pain, says Marta Di Forti at King’s College London, who wasn’t involved in the study. “The fact people can sleep better, which is a secondary outcome of the study, will have an immense impact on the ability to function,” she says. “When you look at chronic pain you don’t look at giant effects.”

Di Forti says it was striking the trial showed no signs of patients becoming dependent on the drug, and she hopes it will lead to it being prescribed. She often hears from patients who say cannabis helps their pain and buy the plant from a drug dealer, which she finds concerning. There is huge variability in THC levels in cannabis joints and patients can end up smoking cannabis all day, heightening risks of the drug, she says.

“In a world where there are claims of cannabis treating everything, at least here we have a randomised control trial testing it,” she says. “The fact it works for pain is wonderful news in my view.”