Cannabis Extracts Helped Neurological Pain and Symptoms That Standard Treatments Could Not
A controlled trial found that sublingual cannabis extracts containing THC and CBD significantly improved pain and bladder control in patients with intractable neurological symptoms from MS and spinal cord injury.
Quick Facts
What This Study Found
In 24 patients with neurological conditions (18 MS, 4 spinal cord injury, 2 other) whose symptoms had not responded to standard treatments, sublingual cannabis extracts produced significant pain relief. Both THC-containing and CBD-containing extracts improved pain significantly compared to placebo. Some patients also experienced improvements in bladder control, muscle spasms, and spasticity.
The extracts were self-administered by sublingual spray at doses patients titrated based on symptom relief, ranging from 2.5 to 120 mg per 24 hours. Three patients experienced transient hypotension and intoxication with rapid initial dosing, but unwanted effects were generally predictable and well tolerated.
Key Numbers
Twenty-four patients enrolled. Doses ranged from 2.5 to 120 mg per 24 hours via sublingual spray. Two-week treatment periods for each condition. Three patients experienced transient hypotension.
How They Did This
This was a series of double-blind, randomized, placebo-controlled, single-patient crossover trials with two-week treatment periods. Twenty-four patients received whole-plant extracts of THC, CBD, 1:1 CBD:THC, or placebo via sublingual spray. Patients recorded daily symptom, well-being, and intoxication scores using visual analogue scales.
Why This Research Matters
This was one of the early clinical trials of what would become Sativex, testing sublingual delivery of standardized cannabis extracts. The finding that both THC and CBD provided significant pain relief in treatment-resistant neurological conditions helped build the evidence base for subsequent approval of Sativex.
The Bigger Picture
This study was part of GW Pharmaceuticals' clinical development program that led to the eventual approval of Sativex for MS spasticity. The sublingual spray delivery method tested here became the standard delivery for the approved product.
What This Study Doesn't Tell Us
The sample was small (24 patients) and heterogeneous in terms of underlying conditions. The single-patient crossover design, while appropriate for early-stage investigation, limits generalizability. The wide dose range (2.5-120 mg) suggests substantial individual variation that requires further characterization.
Questions This Raises
- ?How does the dose-response relationship for sublingual cannabis extracts compare to other delivery methods?
- ?Which specific symptoms are most responsive to THC versus CBD versus combination extracts?
Trust & Context
- Key Stat:
- Both THC and CBD extracts significantly superior to placebo for pain relief
- Evidence Grade:
- This is a randomized, double-blind, placebo-controlled crossover trial, though with a small sample of 24 patients.
- Study Age:
- Published in 2003. This trial contributed to the development of Sativex, which was subsequently approved in multiple countries.
- Original Title:
- A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms.
- Published In:
- Clinical rehabilitation, 17(1), 21-9 (2003)
- Authors:
- Wade, Derick T(2), Robson, Philip(4), House, Heather(3), Makela, Petra, Aram, Julia
- Database ID:
- RTHC-00150
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
What is sublingual cannabis spray?
A spray applied under the tongue that delivers measured doses of cannabis extracts. This delivery method avoids smoking and provides more consistent dosing than edibles. The product tested here became Sativex.
Did CBD help with pain in this study?
Yes. Pain relief was significantly better than placebo for both THC and CBD extracts, suggesting both cannabinoids have analgesic properties, though they may work through different mechanisms.
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Cite This Study
https://rethinkthc.com/research/RTHC-00150APA
Wade, Derick T; Robson, Philip; House, Heather; Makela, Petra; Aram, Julia. (2003). A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms.. Clinical rehabilitation, 17(1), 21-9.
MLA
Wade, Derick T, et al. "A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms.." Clinical rehabilitation, 2003.
RethinkTHC
RethinkTHC Research Database. "A preliminary controlled study to determine whether whole-pl..." RTHC-00150. Retrieved from https://rethinkthc.com/research/wade-2003-a-preliminary-controlled-study
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.