Australian patients with chronic pain show improvements in quality of life and fatigue after being prescribed medicinal cannabis, according to an industry sponsored study.

University of Sydney researchers conducted a three-month follow up survey of 2327 Australian patients with chronic health issues who were prescribed medicinal cannabis (THC and CBD dissolved in a medium-chain triglyceride carrier oil) between November 2020 and December 2021.

The most-reported conditions being treated were chronic pain (69%); insomnia (23%); anxiety (22%); and anxiety/depression (11%); half of patients were being treated for more than one condition. Two thirds (63%) of the surveyed patients were female, with an average age of 51 years.

Patients were surveyed about their self-reported health-related quality of life, pain, sleep, anxiety, and depression prior to beginning cannabis therapy, after two weeks of treatment, then once a month for three months.

The survey showed that during the first three months of use of medicinal cannabis, there were significant and ‘clinically meaningful’ improvements in health-related quality of life and fatigue , along with improvements in anxiety, depression and pain.

However, cannabis therapy did not seem to improve reported sleep disturbances, according to a study published in PLOS ONE (link here).

The study investigators reported that health-related quality of life as measured by EQ-5D-5L utility scores and QLQ-C30 summary scores showed clinically meaningful improvement in the overall cohort from baseline to mean follow-up with d = 0.54 (95%CI:0.47 to 0.59) and d = 0.64 (95% CI:0.58 to 0.70) respectively. They noted that there was a suggestion of lesser improvement in quality of life in older patients.

There was also clinically meaningful improvement in fatigue (PROMIS Fatigue T-scores; d = 0.54; 95%CI:0.48 to 0.59) in the overall cohort.

For patients with chronic pain there was clinically meaningful reduction of pain (d = 0.65; 95%CI:0.57 to 0.72); significant improvements for those with moderate to extremely severe anxiety (X2 = 383; df = 4; p<0.001) and depression (X2 = 395; df = 4; p<0.001); and no changes in sleep disturbance.

The study did not assess rates of adverse effects of medicinal cannabis, though 30 patients formally withdrew from the study due to “unwanted side effects”.  Other reasons for withdrawal included  changing treatment (n = 31), treatment too expensive (n = 14) and  treatment not working (n = 52).

The study investigators said they would continue to follow up patients using medicinal cannabis to assess effects at 12 months.

“Our findings suggest that prescribing medicinal cannabis in clinical practice may alleviate symptoms of pain, fatigue, anxiety, and depression in patients with chronic health conditions and improve overall health-related quality of life,” they concluded.

“Current clinical guidelines recommend clinicians consider trialling medicinal cannabis with patients who have chronic conditions not responding to first line treatments, but acknowledge more evidence and education is needed for clinicians to put this into practice. At the very least, prescribing medicinal cannabis may avoid potential risks of cannabis abuse by self-medicating while enabling clinicians to monitor possible adverse effects,” they added.

The study was sponsored by Little Green Pharma of Perth.