Experts call for greater understanding and investment into alternative treatment options for patients living with chronic pain

  • UK medical clinic reports an 114% increase1 rise in the number of patients seeking medical cannabis for relief from chronic pain over the last year alone (8th August 2021-2022)
  • Largest observational study of UK patients prescribed medical cannabis for chronic pain shows overall improvement to general health-related quality of life
  • However, experts warn of patients being left in a ‘pain limbo’ due to lack of investment into randomised trials which prevent the NHS from funding medical cannabis
  • Many patients (estimated 1.4 million people in UK2) self-medicate with illicitly sought cannabis

As Pain Awareness Month approaches this September, a month organised by the World Health Assembly dedicated to raising awareness and understanding of pain, experts from a leading medical cannabis clinic call for greater investment and access into treatment options for those patients living in chronic pain.

Chronic pain is defined by the medical community as ‘persistent or recurrent pain lasting longer than 3 months’ and is estimated to affect around 35-50% of the UK population. A recent BBC investigation (May 20223) into people living with chronic pain, found that patients experience difficulty in accessing specialist services and nearly a quarter (23%) of those living in chronic pain are on waiting lists for surgery or a pain management programme.

The impact of chronic pain is both far reaching and varied. On a patient level it is associated with an increased incidence of anxiety, depression and disability. The socio-economic impact of chronic pain is also hugely significant in terms of increased absenteeism and unemployment, together with reduced productivity. The economic cost of chronic back pain to the UK alone was estimated at £12.3 billion GBP in 2000.

However, there is hope. In the latest review of the literature published on this topic in the British Medical Journal, the use of medical cannabis oils in chronic pain, produce on average, a 10% improvement in pain scores in patients4. For patients where nothing else has helped, this reduction is pain is greatly valued and may enable patients to take part in some day-to-day activities otherwise precluded to them. Additionally, patients also experienced statistically significant improvements in sleep quality and anxiety levels.

Unlike over-the-counter CBD products which have not been studied in a medical setting, medical cannabis is produced to a pharmaceutical standard and can only be prescribed by specialist doctors in their area of expertise where first-line licensed treatment options have failed to provide sufficient relief. Since 2018 doctors in the UK have been prescribing medical cannabis for several conditions, such as chronic pain, anxiety, and post-traumatic stress disorder.

And whilst an increasing number of patients are now in receipt of medical cannabis prescription, with Sapphire Clinics seeing an 114% increase in patients in the last year alone for chronic pain, one of the main barriers to people being able to access it through the NHS is a lack of the right evidence to enable the NHS to fund it.

Doctors and scientists from Sapphire Clinics say the UK is leading the way in medical cannabis research. They have recently completed twenty individual pieces of new research, in addition to 6 previously published results in internationally peer reviewed journals. These papers were presented at the annual International Cannabinoid Research Society (ICRS) Conference in June 2022. Yet whilst results are promising, more randomised controlled trials are needed.

Consultant rheumatologist Dr Wendy Holden at Sapphire Clinics gives her expert insight into patients living with chronic pain and the use of medical cannabis for some common symptoms; “The management for chronic pain is challenging and there is always a pressing need to identify and develop novel therapeutics. One emerging option for those with chronic pain refractory to first-line treatments is medical cannabis, which was rescheduled to be prescribed by specialist medical consultants under regulations published in the UK in November 2018.

“Medical cannabis is only available for patients who haven’t experienced sufficient relief of symptoms from conventional treatments, but my experience, for eligible patients living with chronic pain whether it be undefined, neuropathic, fibromyalgia or from endometriosis is backed up by the research from the UK Medical Cannabis Registry.

“Insomnia for patients living with chronic pain can be hugely challenging. A lack of sleep can in fact, heighten the awareness of pain making it more unbearable. So, it is incredibly important for those patients to try and get on top of sleeping patterns as part of their treatment pathway.”

Dr Simon Erridge, Head of Research and Access at Sapphire Medical Clinics comments; “Whilst observational studies have found associations between chronic pain patients on cannabis-based medicinal product (CBMP) therapy with significant reductions in pain severity and interference, randomised controlled trials have largely been of indifferent quality, leading to conflicting conclusions. To help support patients and indeed for the UK to remain at the forefront of research, it is important that funding bodies, such as the National Institute for Health Research, recognise the initial promising signals and commit funding further randomised controlled trials.”

References

1 & 4. https://www.tandfonline.com/doi/full/10.1080/17512433.2022.2017771

2. https://thecmcuk.org/wp-content/uploads/2022/02/Left-Behind012020.pdf 

3. https://www.bbc.co.uk/news/health-61309962