Cannabinoids have been shown to reduce the intensity of pain, including inflammatory pain, neuropathic pain, and cancer pain
The National Football League (NFL) dropped a noteworthy $1 million dollar cannabis-centric press release at the start of February that is still making headlines. Specifically, the NFL announced it had awarded a total of $1 million to the University of California San Diego to be used in the study of the impact cannabinoids have on pain management, and to the University of Regina to be used to study the impact cannabinoids have on neuroprotection from concussion in football players.
According to Dr. Kevin Hill, co-chair of the NFL-NFLPA Joint Pain Management Committee, "The NFL is eager to advance the science of pain management and performance in an effort to improve the health and safety of the players." Despite the investigations into the impact cannabis could play in enhancing the quality of life of NFL players, the league is making no change to its Policy and Program on Substances of Abuse. Thus, no NFL players are permitted to participate in these studies.
We also spoke with Anna Symonds, an A4C Athlete Ambassador and contributor in helping accumulate the NFL’s 1 million dollar grant to University of California, San Diego (UCSD). Through her role, she was connected with the researchers at UCSD's acclaimed Center for Medicinal Cannabis Research who were looking to develop a study proposal for the NFL's research RFP (request for proposal). According to Symonds, "This groundbreaking study will be a clinical trial with professional rugby players, using cannabis flower vaporized in a medical-grade device. The clinical and scientific team needed to know exactly how the demands of elite rugby take place; the logistics of training, matches, and the season; and the ways in which players are already using cannabis. Basically, the study should be as practical as possible to real world use."
We also engaged physicians nationwide in the cannabinoid medicine and integrative medicine fields to get their takes on the role cannabis can play in alleviating that pain, including digging into some completed studies as well as feedback on the NFL's commissioned studies.
Dr. Jordan Tishler is faculty at Harvard Medical School, president of the Association of Cannabinoid Specialists, and CEO at inhaleMD. Dr. Tishler noted that, while the funding of research on cannabinoids and pain is well overdue, he believes the quality of the research being done presently is still hampered by funding. Whether the funding is NFL, private companies, or the government, Dr. Tishler says the funding all so small that we’re continuing to get small, open-label, observational studies that hint at the answers, but can’t prove anything. Ultimately Dr. Tishler stands firm on the need from the federal government to earmark a few hundred million for a concerted research initiative into cannabinoid medicine.
Dr. Dustin Sulak is an integrative physician and leader in the field of cannabinoid medicine, regarding cannabis as a treatment for pain management. Dr. Sulak noted that cannabinoids have been shown to reduce the intensity of pain, including inflammatory pain, neuropathic pain, and cancer pain.[1,2,3] Cannabinoids reduce spasticity and the pain associated with muscle spasm.[4] Beyond decreasing the intensity of pain, many patients report that cannabis changes the nature of the pain, making it more bearable and less distracting. In certain situations, cannabinoids can increase the intensity of acute pain.
Dr. Jacob Hascalovici is the Chief Medical Officer at Clearing, a comprehensive digital healthcare platform for individuals living with long term pain. Dr. Hascalovici mentioned that CBD treatments are currently showing a lot of promise for long term pain, both in neuropathic and musculoskeletal conditions. Although CBD is only one type of cannabis product and much research remains to be performed regarding cannabis’s ability to offer pain relief, Dr. Hascalovici is excited about the NFL-funded cannabis research studies, as their results could potentially help steer clinical pain relief away from opioids and toward solutions that may have fewer side effects and prove more suitable for long-term use.
Dr. Rebecca Siegel is a clinical psychiatrist and author of the newly published book,
THE BRAIN ON CANNABIS: What You Should Know about Recreational and Medical Marijuana. Dr. Siegel
applauds the NFL for taking this step forward. Though there have been many scholarly articles written related to the use of medical cannabis and chronic pain, Dr. Siegel believes we need more formal, controlled research studies to really evaluate the use of cannabis for a range of conditions, including pain management. The industry really needs to focus on more research. For example, the Journal for Clinical Medicine Research June 2020 published a review on clinical trials of pain reduction with cannabis administration in adults. The article concluded that there is some available evidence for the effectiveness of cannabis-based medicine for certain types of chronic pain, including neuropathic pain for different neurological and orthopedic conditions.
1] Lynch, M. E., and Mark A. Ware. "Cannabinoids for the treatment of chronic non-cancer pain: an updated systematic review of randomized controlled trials." Journal of neuroimmune pharmacology 10.2 (2015): 293-301.
[2] Noyes, R., et al. “The analgesic properties of delta-9-tetrahydrocannabinol.” Clin Pharmacol Ther 18.1 (1975): 84-89.
[3] Portenoy, Russell K., et al. “Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: a randomized, placebo-controlled, graded-dose trial.” The Journal of Pain 13.5 (2012): 438-449.
[4] Koppel, Barbara S., et al. “Systematic review: Efficacy and safety of medical marijuana in selected neurologic disorders Report of the Guideline Development Subcommittee of the American Academy of Neurology.” Neurology 82.17 (2014): 1556-1563.
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