Cannabinoid Use in SCI
Cannabinoids are a potential new treatment for post-SCI pain in need of further study. Preliminary results from a pilot (N=5) randomized controlled trial on dronabinol (synthetic THC) suggest that it is not effective in reducing neuropathic pain post-SCI (Rintala et al. 2010). Ultramicronized palmitoylethanolamide (Normast), a laboratory made form of an endocannabinoid that occurs naturally in the human body, was shown to not be effective in reducing chronic pain post-SCI (Andresen et al. 2016). Nabilone (a standardized synthetic THC cannabis plant product in tablet form) and 2.9% THC vapor have been shown to be effective in reducing spasticity, and dronabinol may help reduce spasticity (Pooyania et al. 2010).
People with SCI report using cannabis for pain, spasticity, and pleasure, feelings of anxiety, stress, and depression, bowel and bladder impairment, nausea, loss of appetite, sleep disturbance; and to decrease use of other prescription medications, as well as using cannabis for pleasure, recreation and relaxation (Nabata et al. 2020; Cardenas & Jensen 2006; Shroff 2015; Drossel et al. 2016; Andresen et al. 2017, Bruce et al. 2018, Hawley et al. 2018). However, observational studies have only demonstrated effects on pain and spasticity and results to date are preliminary and only demonstrate the potential of its effectiveness. No meta-analyses could be performed and there are no best practice recommendations for dose because all studies found used different cannabis products and dose regimens.