January 22, 2019
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Cannabis could be used to treat chronic pancreatitis pain

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Medical cannabis could be an effective adjunctive therapy for the treatment of pain associated with chronic pancreatitis, according to research published in Clinical Gastroenterology and Hepatology.

Timothy B. Gardner, MD, MS, of the section of gastroenterology and hepatology at Dartmouth-Hitchcock Medical Center and colleagues wrote that pain is the most troubling aspect of chronic pancreatitis.

“Clinical management of painful chronic pancreatitis includes abstinence from alcohol and tobacco products, analgesic medications (including opioids), antidepressant medications, and pancreatic enzyme replacement,” they wrote. “Medical cannabis has been proposed as a therapy for chronic pain and has shown some efficacy in neuropathic and cancer pain.”

Researchers conducted a retrospective cohort study comprising 53 patients who were enrolled in active opioid contracts for painful chronic pancreatitis. They separated patients into groups based on whether they were in a state-sponsored medical cannabis program.

Investigators used objective measures of pain — like hospital admissions and current opioid used converted into morphine equivalent dose (MED) — to assess differences in pain control in the two groups.

Patients in the medical cannabis group (n = 34) experienced decreased mean daily opioid use (126.6 ± 195.6 MED) compared with patients who were not using medical cannabis (183.5 ± 284.5 MED). They also experienced decreased hospital admissions and emergency department visits in the past calendar year. However, the differences did not reach statistical significance.

Gardner and colleagues wrote that limitations in the study, including the small sample size, contributed to the non-significant differences and called for further investigation.

“Given the limitations and small sample size, this study should serve as a platform for future investigations on this topic,” they wrote. “However, these findings suggest that medical cannabis may be an effective adjunctive therapy in treating the pain associated with chronic pancreatitis and either replace or minimize the need for chronic opioid therapy.” – by Alex Young

Disclosures: The authors report no relevant financial disclosures.