Medicinal cannabis may not aid sleep in people with chronic pain

Medicinal cannabis may not ease sleep problems in people with chronic pain ‘because frequent users can build up tolerance to its sleep-inducing effects’

  • Researchers assessed sleep quality and levels of pain of 128 people with pain
  • Found that cannabis users less likely to wake during the night
  • But this effect reduced over time and users did not get to sleep more quickly
  • Second study found that cannabinoids do not ease cancer-related pain 

Medicinal cannabis may not ease the sleep problems of people with chronic pain, a study has suggested.

Scientists in Israel believe frequent users of the drug build up tolerance to its effects, rendering it useless after time. 

Researchers assessed the sleep quality and pain levels of 128 people being treated at a specialist clinic. 

They found cannabis users were less likely to wake up during the night, compared to those who did not use the drug.

But over time, the benefit of cannabis on waking in the night was reversed, with the drug being associated with waking up more often. 

Cannabis users also found it harder to fall asleep than those who steered clear of the drug, according to the study. 

Medicinal cannabis is to be given to 20,000 British patients in first major trial of drug’s clinical effect (file)

This indicated that tolerance to the beneficial effects of the drug may develop with further use, the researchers said. 

Medicinal cannabis is not legally prescribed for sleep problems in the UK. Limited prescriptions are given out for cannabis-based medications which treat illnesses including multiple sclerosis and epilepsy.

In the US, some states allow doctors to use prescribe medicinal cannabis to treat some conditions. 

It is also legal for recreational use in 11 states, meaning that people are free to use it to try to treat their sleep problems.  

The latest study was published in the British Medical Journal’s Supportive and Palliative Care journal.  

Study author Dr Sharon Sznitman, from the University of Haifa, said the findings may ‘signal development of tolerance’. 

What is chronic pain? 

Chronic pain is defined as continuous long-term pain that either lasts more than 12 weeks, or persists for an unusual length of time following trauma or surgery.

It is widespread: almost ten million Britons suffer almost daily, according to the British Pain Society. 

The mainstay treatment is normally painkillers.

However, a swathe of new studies shows that our most frequently used strong pain medications are not only ineffective for common conditions, they are also dangerous — and may even themselves cause chronic pain. 

She and her colleagues wrote: ‘These findings have large public health impacts considering the ageing of the population, the relatively high prevalence of sleep problems in this population, along with the increasing use of medicinal cannabis.’

The scientists assessed the sleep quality and pain scores of 128 people over the age of 50 being treated at a specialist clinic.

Sixty-six of them used cannabis to manage their sleep problems, while a further 62 did not. 

One in four (24 per cent) said they always woke up early and weren’t able to get back to sleep.

And one in five (20 per cent) said they always found it difficult to fall asleep. Another 27 per cent said they woke up during the night.

Cannabis users had used the drug for an average of four years, consuming around 31 grams a month.  

Most (69 per cent) smoked it, while around 20 per cent used either using cannabis oil or vapour.

Despite waking up less during the night, cannabis users did not get to sleep more quickly or wake up early less often.

The scientists took into account other factors which might have influenced people’s sleep. 

These included the average amount of pain people were experiencing, their use of sleep aids or antidepressants, as well as age and gender. 

However, the researchers did say the study was only observational and so could not establish a causal link. 

They also recognised there were not many people who took part in the study and the time of day when they had cannabis was not recorded. 

Cannabinoids ‘do not ease cancer-related pain’ 

A second study found cannabinoids, the active chemicals in medicinal cannabis, do not ease cancer-related pain. 

University of Hull researchers collected data from five studies involving 1,442 people.

They found changes in average pain intensity scores were no different between those taking cannabinoids and those given placebo.

Cannabinoids were also linked with significantly higher risk of side effects, including drowsiness and dizziness.   

Dr Jason Boland and his colleagues wrote: ‘This systematic review provides good evidence that cannabinoids do not have a role in cancer-related pain.’ 

Chronic pain is defined as that which continues for more than 12 weeks, despite medication or treatment.  

Around 43 per cent of UK adults experience it, with around 14.3 per cent suffering pain which is severe or disabling.   

In the US, 20.4 per cent of adults suffer, with around eight per cent experiencing ‘high-impact’ pain. 

The term medicinal or medical cannabis relates to medicines based on the drug which are used to relieve symptoms. 

Some products are available on prescription on the NHS in the UK and they are used to ease the effects of conditions including epilepsy and MS. 

But they are not routinely available because of concerns not enough research has been done into their benefits.

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