Most Dutch-Smarters know that cannabis is a wonderful herb. But in addition to recreational use, many people also use it for medical reasons. In the Netherlands, cannabis is sometimes prescribed by doctors, for example because it can reduce muscle spasms and nausea. Now, the Ministry of Health has decided to invest 1.9 million euros in research on medical cannabis for patients with nerve pain—a condition currently treated (often unsuccessfully) with antidepressants.
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New method
Leiden University Medical Center (LUMC) will be the recipient of this large sum of money. “The focus of this research is on patients with nerve pain caused by various factors, such as diabetes, herpes, or an accident,” says Albert Dahan, professor of Anesthesiology. “These patients are currently treated with antidepressants or even opioids, but for a large proportion of patients, these medications do not work,” the expert continues in an interview with Sleutelstad.
“We will first conduct a comprehensive characterization of the patients. We’ll examine how they respond to stimuli such as cold and pain. Even the tiny nerves in their corneas will be examined,” says Dahan. “We hope to use this data to determine which patient groups will benefit from this treatment and which will not,” explains Geert Jan Groeneveld, a neurologist in the Department of Anesthesiology.
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Unique study
“Much clinical research on cannabis is conducted using the whole plant, which contains all kinds of active compounds,” says Groeneveld. “In this study, we’re going to investigate in a highly controlled manner whether two components of cannabis, tetrahydrocannabinol (THC) and cannabidiol (CBD), can help patients with chronic nerve pain. This has never been done before, so it’s a unique study.”
THC has a pain-relieving effect, but it also causes people to get high and sometimes anxious. CBD may potentially reduce some of THC’s side effects. Groeneveld: “We will determine the optimal combination of THC and CBD to administer based on a study involving healthy individuals. In this study, they will be treated with a THC-CBD combination or a placebo. We hope to start this in early 2021.” The results will be used for a subsequent study, in which 200 patients with nerve pain will be treated for five weeks with the THC-CBD combination and five weeks with a placebo.
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How does it work?
But exactly how cannabis works in the body remains something of a mystery. “We know that cannabis has an effect when pain is caused by nerve damage,” says Groeneveld on the radio program West Wordt Wakker. “We just don’t know who it works for. Nerve pain is very diverse. One patient benefits greatly from it, while another does not. It would be good if we could figure that out better. If it relieves someone’s pain, it’s a fluke.”
“Pain caused by nerve damage is extremely difficult to treat,” Groeneveld continues. “A paracetamol doesn’t work. Most of the medications we prescribe only work for half of the patients. And if it does work, the pain is reduced by half. That’s not very good. We need new medications.”
