6 ms·

Cannabis extract found to be effective for lower back pain

15 points by Brajeshwar 1y ago

ipnon 1y ago
A high-quality study has finally come to a daring conclusion: Weed makes you feel better but it makes you confused and sleepy.
- timschmidt 1y ago
  Careful making generalizations. Cannabis has been cultivated since before recorded history, and exhibits similar levels of phenotypic variation to other long-domesticated organisms like dogs or brassicas. Observations about one cultivar or sport may not apply to others. Cannabinoids bind to https://en.wikipedia.org/wiki/G_protein-coupled_receptor https://en.wikipedia.org/wiki/G_protein-coupled_receptor at a minimum, which exist in every tissue of the body, and of which there are at least a half dozen varieties, probably more. Ancient humans all the way to modern growers have bred plants to achieve specific desirable effects beyond intoxication, in a tight feedback loop, testing against their own physiology. Cannabis isn't a single drug, it's a factory for a complex family of metabolically related phytohormones.
  - reactordev 1y ago
    I wish more people would say this. There are so many varieties, strains, mutations, some good, some bad. Then there’s 2018 farm bill cannabis… THCA, THCP, THC-D9, THC-D8, CBD, etc. I use it for pain as well but started using it for creativity during college. It’s never presented a problem other than having the feeling of fuzzy teeth (brushing after eliminates this). My friends that use alcohol all have issues from consuming it where as I don’t have any issues with my liver or anything. The issue is the stigma and propaganda has been so strong for 120 years that people have forgotten it was one of the first medicines.
    - timschmidt 1y ago
      I ran support groups for a while, and met folks of all walks of life. One of them told me that when they smoked a specific strain of cannabis, they found that they needed far less insulin than normal to maintain their blood sugar levels. My aunt was a life long diabetic, so I have some idea of how much testing is involved, and so this meant more to me than most anecdotes. I decided to look up the gene regulatory network of the pancreatic islet cells involved in manufacturing insulin. Sure enough, smack in the middle, a G-protein-coupled receptor. The Mythbusters "PLAUSIBLE" sequence played in my mind. I'm of the opinion that we should probably be paying special attention to any substance with known activity on human cell signalling pathways. Cannabis is capable of targeting so many, spread across such a variety of organ systems, that it seems obviously useful. Wild how we've avoided studying all but the least useful strains.
      - reactordev 1y ago
        Absolutely. I'm definitely not advocating for it to just get a pass because it's ancient "medicine". Understanding it's effects on cells is good science. I'm not dismissing that at all. What I am saying is, I've had chronic pain for a long time. Side effect of skateboarding injuries, snowboarding injuries, a one-wheel injury, sailing injuries. I've broken dozens of bones. Etc etc. Cannabis is the only thing that consistently alleviates the pain. Not saying it's not damaging, it totally is. The inside of your lungs, if smoked for long periods, turns into tar pits. It can cause COPD, among other smoking related issues. However, I do think that legalizing it here in the US opens up the doors for further research and medicinal advancements. So I'm all for that. However, keeping laws around operating a vehicle, heavy machinery, etc should still stand. I think those that dismiss it are closed minded and those that fully embrace it without protection from side effects or long term use issues are also closed minded. There's some sort of healthy medium I'm sure of. Edibles or topicals.
  - mapontosevenths 1y ago
    > which exist in every tissue of the body, and of which there are at least a half dozen varieties, probably more This is exactly the reason it's often a less than ideal solution. When you need a safe, reliable, and predictable medication, you don't want something that interacts with every cell in the body. Let alone something that might be interacting with those cells in multiple conflicting ways. Don't get me wrong, if it helps you and doesnt negatively impact your health I'm in favor of it. However, it would be nice to see more research done to develop synthetics and extracts that work in a more targeted, predictable, and well understood manor.
    - timschmidt 1y ago
      What makes you think that selective breeding results in a less targeted therapeutic than synthetics? Reportedly, pure THC as administered to cancer patients to treat nausea results in much less favorable results than the compounds naturally produced by plants selectively bred for the purpose. This is why I pointed to the tight feedback loop between plant and grower. Evolution, coupled with a good fitness function, outperforms most other methods available to us on hard problems. Targeting specific receptors for therapeutic benefit certainly qualifies as one.
      - mapontosevenths 1y ago
        > What makes you think that selective breeding results in a less targeted therapeutic than synthetics? Your own quote. It literally inetarcts with every system of the body. Seldom do we need or want that in a therapeutic drug.
        timschmidt 1y ago
        I see. You need to read more, then. Just because G coupled protein receptors exist in every tissue does not mean they are all identical. As I said there are many varieties, each with unique binding affinity, local physiology, cell differentiation, etc. And each type is expressed preferentially in different areas and ratios. We are very complex systems. How a molecule binds to specific receptors can operate as a targeting mechanism in and of itself. And can also be modified by other molecules produced by the same plant. Synthetics also permeate and interact with the entire body, typically, btw.
  - ipnon 1y ago
    It's true, but the main ingredient of the extract is THC at 5%. You could add 5% THC to acetaminophen, aspirin, or multivitamins, and you'll get the same therapeutic profile and same side effects.
meindnoch 1y ago
Unpopular opinion: opioids are the gold standard for pain management, and denying them from people in pain is simply cruel.
- gchamonlive 1y ago
  Yes, but https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html https://www.cdc.gov/overdose-prevention/about/understanding-...
- mapontosevenths 1y ago
  Robert Anton Wilson once essentially said that any society that hasn't yet found a cure for pain is still barbaric. Right now, opiods are the closest thing we have to that, but they are like Cannabis in that they also have many less useful/safe side effects. One day someone will find a drug that obliterates pain without damaging consciousness, and I suspect that society will become a more evolved place.
  - timschmidt 1y ago
    > One day someone will find a drug that obliterates pain without damaging consciousness That has side effects too: https://en.wikipedia.org/wiki/Congenital_insensitivity_to_pain#Signs_and_symptoms https://en.wikipedia.org/wiki/Congenital_insensitivity_to_pa...
    - mapontosevenths 1y ago
      I once knew a man who was one of the "Frozen Chosin" of the Korean war. He couldn't feel anything in his feet due to the frostbite. It was a constant source of injury and infection for him. I suspect that whatever a "cure for pain" looks like it will involve modulating those signals to be lower, rather than eliminating them.
- antisthenes 1y ago
  It's more of an uninformed opinion than unpopular.
Molitor5901 1y ago
This is only my opinion, but in my experience with marijuana it doesn't seem to relieve pain so much as it makes you forget, or ignore for a bit, that the pain is there.
- ipnon 1y ago
  Pain relief seems to require some lowering of consciousness generally. For example, we daydream to relieve the pain of boring experiences. And when we undergo general anesthesia we lose all ability to perceive the moment or form memories.
- UI_at_80x24 1y ago
  I will agree and disagree with this comment. In my experience, I find that it depends on the 'type/cause' of the pain. For soft-tissue related I find it helpful, while for hard-tissue related it does not. Here are my anecdotes. I've got 3 different types of back problems. (a) deteriorating cartilage between vertebrae causes bone-on-bone grinding -Cannabis does not help with that (b) muscle spasms in 'other parts' of back from another cause. -Cannabis does help (c) neuropathy -Cannabis helps quiet the nerves too IMHO b & c are related, it's a sedative-like effect. AND related to the points in TFA; it helps me to sleep when B & C are active.
hackingonempty 1y ago
> The study met its primary endpoint in phase A, with a mean pain reduction of −1.9 NRS points in the VER-01 group (mean difference (MD) versus placebo = −0.6, 95% confidence interval (CI) = −0.9 to −0.3; P < 0.001). That's not very good considering this meta-analysis[0] found that exercise had a mean difference of "−7.9 (−13.6 to −2.2)" compared to placebo for chronic low back pain. ...and the authors say that is a small effect. 0: https://doi.org/10.1136/bmjebm-2024-112974 https://doi.org/10.1136/bmjebm-2024-112974

15 points by Brajeshwar 1y ago

A high-quality study has finally come to a daring conclusion: Weed makes you feel better but it makes you confused and sleepy.

timschmidt 1y ago
Careful making generalizations. Cannabis has been cultivated since before recorded history, and exhibits similar levels of phenotypic variation to other long-domesticated organisms like dogs or brassicas. Observations about one cultivar or sport may not apply to others. Cannabinoids bind to https://en.wikipedia.org/wiki/G_protein-coupled_receptor https://en.wikipedia.org/wiki/G_protein-coupled_receptor at a minimum, which exist in every tissue of the body, and of which there are at least a half dozen varieties, probably more. Ancient humans all the way to modern growers have bred plants to achieve specific desirable effects beyond intoxication, in a tight feedback loop, testing against their own physiology. Cannabis isn't a single drug, it's a factory for a complex family of metabolically related phytohormones.
- reactordev 1y ago
  I wish more people would say this. There are so many varieties, strains, mutations, some good, some bad. Then there’s 2018 farm bill cannabis… THCA, THCP, THC-D9, THC-D8, CBD, etc. I use it for pain as well but started using it for creativity during college. It’s never presented a problem other than having the feeling of fuzzy teeth (brushing after eliminates this). My friends that use alcohol all have issues from consuming it where as I don’t have any issues with my liver or anything. The issue is the stigma and propaganda has been so strong for 120 years that people have forgotten it was one of the first medicines.
  - timschmidt 1y ago
    I ran support groups for a while, and met folks of all walks of life. One of them told me that when they smoked a specific strain of cannabis, they found that they needed far less insulin than normal to maintain their blood sugar levels. My aunt was a life long diabetic, so I have some idea of how much testing is involved, and so this meant more to me than most anecdotes. I decided to look up the gene regulatory network of the pancreatic islet cells involved in manufacturing insulin. Sure enough, smack in the middle, a G-protein-coupled receptor. The Mythbusters "PLAUSIBLE" sequence played in my mind. I'm of the opinion that we should probably be paying special attention to any substance with known activity on human cell signalling pathways. Cannabis is capable of targeting so many, spread across such a variety of organ systems, that it seems obviously useful. Wild how we've avoided studying all but the least useful strains.
    - reactordev 1y ago
      Absolutely. I'm definitely not advocating for it to just get a pass because it's ancient "medicine". Understanding it's effects on cells is good science. I'm not dismissing that at all. What I am saying is, I've had chronic pain for a long time. Side effect of skateboarding injuries, snowboarding injuries, a one-wheel injury, sailing injuries. I've broken dozens of bones. Etc etc. Cannabis is the only thing that consistently alleviates the pain. Not saying it's not damaging, it totally is. The inside of your lungs, if smoked for long periods, turns into tar pits. It can cause COPD, among other smoking related issues. However, I do think that legalizing it here in the US opens up the doors for further research and medicinal advancements. So I'm all for that. However, keeping laws around operating a vehicle, heavy machinery, etc should still stand. I think those that dismiss it are closed minded and those that fully embrace it without protection from side effects or long term use issues are also closed minded. There's some sort of healthy medium I'm sure of. Edibles or topicals.
- mapontosevenths 1y ago
  > which exist in every tissue of the body, and of which there are at least a half dozen varieties, probably more This is exactly the reason it's often a less than ideal solution. When you need a safe, reliable, and predictable medication, you don't want something that interacts with every cell in the body. Let alone something that might be interacting with those cells in multiple conflicting ways. Don't get me wrong, if it helps you and doesnt negatively impact your health I'm in favor of it. However, it would be nice to see more research done to develop synthetics and extracts that work in a more targeted, predictable, and well understood manor.
  - timschmidt 1y ago
    What makes you think that selective breeding results in a less targeted therapeutic than synthetics? Reportedly, pure THC as administered to cancer patients to treat nausea results in much less favorable results than the compounds naturally produced by plants selectively bred for the purpose. This is why I pointed to the tight feedback loop between plant and grower. Evolution, coupled with a good fitness function, outperforms most other methods available to us on hard problems. Targeting specific receptors for therapeutic benefit certainly qualifies as one.
    - mapontosevenths 1y ago
      > What makes you think that selective breeding results in a less targeted therapeutic than synthetics? Your own quote. It literally inetarcts with every system of the body. Seldom do we need or want that in a therapeutic drug.
      - timschmidt 1y ago
        I see. You need to read more, then. Just because G coupled protein receptors exist in every tissue does not mean they are all identical. As I said there are many varieties, each with unique binding affinity, local physiology, cell differentiation, etc. And each type is expressed preferentially in different areas and ratios. We are very complex systems. How a molecule binds to specific receptors can operate as a targeting mechanism in and of itself. And can also be modified by other molecules produced by the same plant. Synthetics also permeate and interact with the entire body, typically, btw.
- ipnon 1y ago
  It's true, but the main ingredient of the extract is THC at 5%. You could add 5% THC to acetaminophen, aspirin, or multivitamins, and you'll get the same therapeutic profile and same side effects.

meindnoch 1y ago

Unpopular opinion: opioids are the gold standard for pain management, and denying them from people in pain is simply cruel.

gchamonlive 1y ago
Yes, but https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html https://www.cdc.gov/overdose-prevention/about/understanding-...
mapontosevenths 1y ago
Robert Anton Wilson once essentially said that any society that hasn't yet found a cure for pain is still barbaric. Right now, opiods are the closest thing we have to that, but they are like Cannabis in that they also have many less useful/safe side effects. One day someone will find a drug that obliterates pain without damaging consciousness, and I suspect that society will become a more evolved place.
- timschmidt 1y ago
  > One day someone will find a drug that obliterates pain without damaging consciousness That has side effects too: https://en.wikipedia.org/wiki/Congenital_insensitivity_to_pain#Signs_and_symptoms https://en.wikipedia.org/wiki/Congenital_insensitivity_to_pa...
  - mapontosevenths 1y ago
    I once knew a man who was one of the "Frozen Chosin" of the Korean war. He couldn't feel anything in his feet due to the frostbite. It was a constant source of injury and infection for him. I suspect that whatever a "cure for pain" looks like it will involve modulating those signals to be lower, rather than eliminating them.
antisthenes 1y ago
It's more of an uninformed opinion than unpopular.

Molitor5901 1y ago

This is only my opinion, but in my experience with marijuana it doesn't seem to relieve pain so much as it makes you forget, or ignore for a bit, that the pain is there.

ipnon 1y ago
Pain relief seems to require some lowering of consciousness generally. For example, we daydream to relieve the pain of boring experiences. And when we undergo general anesthesia we lose all ability to perceive the moment or form memories.
UI_at_80x24 1y ago
I will agree and disagree with this comment. In my experience, I find that it depends on the 'type/cause' of the pain. For soft-tissue related I find it helpful, while for hard-tissue related it does not. Here are my anecdotes. I've got 3 different types of back problems. (a) deteriorating cartilage between vertebrae causes bone-on-bone grinding -Cannabis does not help with that (b) muscle spasms in 'other parts' of back from another cause. -Cannabis does help (c) neuropathy -Cannabis helps quiet the nerves too IMHO b & c are related, it's a sedative-like effect. AND related to the points in TFA; it helps me to sleep when B & C are active.

hackingonempty 1y ago

> The study met its primary endpoint in phase A, with a mean pain reduction of −1.9 NRS points in the VER-01 group (mean difference (MD) versus placebo = −0.6, 95% confidence interval (CI) = −0.9 to −0.3; P < 0.001). That's not very good considering this meta-analysis[0] found that exercise had a mean difference of "−7.9 (−13.6 to −2.2)" compared to placebo for chronic low back pain. ...and the authors say that is a small effect. 0: https://doi.org/10.1136/bmjebm-2024-112974 https://doi.org/10.1136/bmjebm-2024-112974