A Novel Non-Opioid Topical Therapy for Chronic Musculoskeletal Pain
Abstract
Our research proposal addresses the FY21 Focus Area of studying the effectiveness of novel, untested, non-opioid approaches to chronic pain management. Joint pain (knee, shoulder, ankle, etc.) is a common source of chronic pain in the general population, military Service Members, and Veterans. Opioids have been used to treat chronic joint pain, but increased awareness of the risks of opioid dependence and overdose has led patients and clinicians alike to seek alternative non-opioid pain medications. This has resulted in a surge of interest in cannabis-based therapies for chronic pain treatment. Unlike opioids, cannabis overdoses in adults are rarely fatal. Many states have legalized cannabis for medical purposes, leading to an expansion in the variety of cannabis products available to patients in those retail markets. Cannabinoids are a family of chemicals found in the cannabis plant. Tetrahydrocannabinol (THC) causes the intoxicating effects of cannabis, while other cannabinoids like cannabidiol (CBD) do not impair mental or motor function and may reduce inflammation and relieve nerve pain. Traditionally, medical cannabis products were consumed via inhalation or oral routes. However, topical cannabis products (creams, salves, and balms) are now widely available and are popular choices for treating chronic joint pain, particularly those products predominantly containing CBD. Topical medications are applied to the skin over the affected area with the intent of providing pain relief to the underlying tissue without significant absorption of the drug into the bloodstream. This reduces the risk of negative effects on other organs, such as the brain, liver, and heart. Thus, topical cannabinoid preparations are appealing pain relief therapies, as they potentially provide local joint and muscle pain relief with fewer side effects, including the cognitive or motor impairments associated with other routes of cannabis administration. However, despite their popularity, these commonly used products have not been studied in clinical trials to determine their efficacy or safety. Our proposal objective is to evaluate if state-regulated topical CBD-based products relieve chronic musculoskeletal pain and/or absorb into the bloodstream. If we find that topical cannabinoid products provide significant pain relief without causing intoxication or substantial cannabinoid accumulation in the bloodstream, it will provide groundbreaking evidence for the safe use of these products as opioid alternatives without the risk of impairment or abuse. Conversely, if we find no effects on pain relief and/or evidence of substantial absorption into the bloodstream, this will also provide clinicians and patients with important data on the lack of efficacy and/or risks of these commonly used products. The results of this proposal will have an immediate and direct benefit to Veterans, military beneficiaries, and civilian patients with chronic joint and muscle pain. Patients with chronic musculoskeletal pain, as well as their healthcare providers, will have access to scientific evidence to reach an informed decision regarding the use of topical cannabinoid preparations for pain management instead of relying on recommendations from friends, family, or online media. Long term, our project will advance the field of chronic pain research by guiding the design of large clinical trials and supporting the development of new topical cannabinoid therapeutics that meet federal requirements to become approved drugs for the treatment of chronic musculoskeletal pain.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210837
Entities
People
- Emily Lindley
Organizations
- United States Army
- University of Colorado Denver