Researchers Study THC Microdosing For Chronic Pain

August 4, 2020 / Thomas Cohn, MD

If you’ve been following our blog for a while now, you probably know that we’re interested in how cannabis or medical marijuana can be used to help with some chronic pain conditions. Recently, we came across a new study published in the European Journal of Pain that explored how microdosing THC could be used to treat chronic pain. Below, we take a closer look at the findings of that study.

Microdosing For Chronic Pain

Microdosing is the term used to describe the act of taking a subtherapeutic dosage of a drug. More recently, the term has become synonymous with regularly taking small doses of psychedelic drugs like LSD. Some artists and authors say microdosing on these agents can unlock the creativity inside of them, but the study out of Europe wanted to see if microdosing other types of drugs could prove to be a successful treatment option for some health conditions. Considering that cannabis has already been used to treat some types of chronic pain, researchers were interested to see if a THC microdose could offer similar benefits.

The randomized, double-blind study separated 27 patients into three different groups. There were:

One inhaled microdose of 500 micrograms (0.5mg) of THC
One inhaled microdose of 1,000 micrograms (1.0mg) of THC
A placebo group

Participants with neuropathic chronic pain were given the doses on three separate test days and asked about their pain scores throughout the study. Researchers found that both microdose groups experienced some short-term reductions in chronic pain.

“Both doses, but not the placebo, demonstrated a significant reduction in pain intensity compared with baseline and remained stable for 150-minutes,” the researchers wrote in the published study. “The 1-mg dose showed a significant pain decrease compared to the placebo.”

Other findings from the study include:

No signs of cognitive impairment in either active dose group.
Reports of a psychoactive “high” sensation were significantly higher in the 1-mg group compared to the 0.5-mg group.
The 1-mg dose used in the trial is about about 5-10x less than what many consider to be the low-end of a psychoactive dose of THC.

“We can concluded from the study results that low doses of cannabis may provide desirable effects while avoiding cognitive debilitations, significantly contributing to daily functioning, quality of life, and safety of the patient,” says Elon Eisenberg, lead research on the project, from the Technion-Israel Institute of Technology. “The doses given in this study, being so low, mandate very high precision in the treatment modality.”

However, the study did have some limitations. The study was conducted and funded primarily by Syqe Medical, which produces the single microdose inhalers used in the trial, but the study was independently peer-reviewed and published. Also, the trial only involved 27 people, so we’ll need more research on a much larger scale before considering this an option for the right chronic pain patient. That being said, it’s certainly an avenue we’ll be keeping an eye on in the coming months and years!

How A Positive Attitude Can Affect Chronic Pain Treatment

July 21, 2020 / Thomas Cohn, MD

When it comes to treating chronic pain patients, we always hope to find patients who are willing to put in the work and have a positive attitude about working towards a solution. And according to a new study out of Boston Medical University, those patients with positive attitudes may actually have a better chance of experiencing positive results from treatment.

For the study, researchers at BMU tracked the progress of nearly 300 individuals who had been diagnosed with chronic low back pain. Individuals were either placed in a therapy group, where they received 12 weeks of physical therapy or yoga, or they were placed in self-care group which involved being given a handbook on self-management strategies for their pain. Not surprisingly, the individuals who pursued active treatment strategies like yoga or physical therapy were more likely to see a decrease in back pain and an increase in function compared to the self care group (42% vs. 23%, respectively).

Looking Forward To Exercise

However, likely the most interesting finding from the study was uncovered when researchers looked into patient motivations. Researchers also tracked a patient’s desire to complete their specific treatment course, and they found that those who looked forward to exercise, or at a minimum, did not fear the activity, generally had a much higher physical response to the treatment.

Of those with less fear of exercise, 53 percent of those in the yoga group had pain decreases and function increases, 42 percent in the physical therapy group responded the same, as did 13 percent in the self care group. Researchers uncovered that regardless of what group they were placed in, those individuals who had a fear of exercise typically had a poor response to pain and function changes.

We understand that exercise or your physical therapy routine may not be something that you look forward to with anticipation, but at the same time, if you generally dislike the activity or are afraid of giving it your all, it can actually have negative effects on your recovery.

It’s obviously easier said than done to change your attitude about therapy, especially when you’re dealing with a chronic condition, but know that your attitude plays a bigger role in your outcomes than you may expect. Focus on your goals and what you hope to gain by working towards a recovery instead of focusing on the discomfort caused by your pain condition. Focusing on your goals instead of your pain can make it easier for you to attack the day and have a positive mindset about your treatment, and that can help you make success a reality!

So if you are struggling to find the motivation or desire to follow through on a chronic pain treatment plan, or if you feel lost and in need of professional guidance, reach out to Dr. Cohn and his experienced medical team today for more information and assistance.

Tips For Safely Managing Your Prescriptions

June 25, 2020 / Thomas Cohn, MD

Whether you’re dealing with a chronic pain condition or recovering after a surgical operation, there’s a decent chance that you’ve been prescribed some form of medication to help mange the discomfort. If you need to take medication for your ailment, be it for the next seven days or the rest of your life, managing these painkillers so they are taken safely is the utmost priority. In today’s blog, we share some tips for helping you safely manage your prescription medication.

How To Manage Your Meds Safely

Your ability to safely manage your prescription medication begins the moment your physician tells you that they are starting you on a prescription regimen. From that moment until your last dose, you’ll want to:

Ensure You Understand – Before you leave the office, make sure you understand how your medication should be taken, how often you should take it, and the potential side effects of the medication. When you pick up the prescription from the pharmacist, have them run through the instructions once again. Don’t abuse your medications because you took them incorrectly on accident. Before you take your first pill, make sure you completely understand how to properly administer them.

Set Reminders – Even if you don’t think that you’ll forget to take your medication, it may be worthwhile to get set up with a daily reminder. Some people do this by attaching a sticky note to their toothbrush, while others prefer more modern solutions. There are a number of smartphone apps that can send you notifications or text messages at regular intervals to ensure you take your medications at the right time every day. Find a reminder that works best for you.

Safe Storage – Always be sure to store your medications is a safe location that is out of reach for children. If you have teens or young adults in the household, store your painkillers in a discreet location. You may think that’d they’d never try your painkillers, but it’s always better to be safe than sorry. Lock boxes are a great place for medications if you’re even the slightest bit concerned that someone in your household could abuse or steal them to sell.

Never Mix – Never mix medications unless your doctor has told you that doing so is safe, and even then you’ll want to avoid driving or doing physical tasks until you know how the medication will affect you. Similarly, don’t mix medications and alcohol, because it can cause significant health issues.

Follow Instructions – If you feel a bad flareup coming on or you’re concerned that your medication isn’t working, don’t take this as a sign to take more of your medication. Follow the instructions and talk to your doctor about whether or not it is safe to adjust your dosage. Taking more than directed can lead to addiction or overdose.

Safely Separate – If you take more than one medication, consider separating them into a daily container like the one in the above picture. Some pills will be taken four times a day, others every 24 hours, and others every few days. It can be tough to keep track of everything, which is why a medication sorter can help ensure you take everything safely.

Stop Smart – Finally, there are health risks associated with abruptly stopping your medication. Talk to your doctor about the best ways to wean off your medication, and if you believe healing has run its course before you run out of painkillers, make sure you dispose of them the right way. You can turn them into a pharmacy or grind them up into coffee grounds and throw them away, but avoid flushing them down the toilet or holding onto them. Safely stop and dispose of your medication.

For help with your medication management, or to look at other solutions to your pain, reach out to Dr. Cohn’s office today.

Managing Chronic Pain During These Challenging Times

March 18, 2020 / Thomas Cohn, MD

Needless to say, we’re in unprecedented times in America and across the globe in terms of how we’re reacting to the COVID-19 outbreak. COVID-19, also termed the coronavirus, is a virus that spreading like wildfire and can have significant health impacts on anyone who comes down the the virus.

Specifically, older individuals and those with immunodeficiency disorders are at the highest risk of severe complications from the virus, and in our experience, individuals with chronic pain tend to be more likely to have an immunodeficiency disorder than the general population.

Now more than ever, we need to be diligent in how we manage our chronic pain. Even if you don’t have an immunodeficiency disorder and consider yourself young and healthy outside of your chronic pain, you need to make some conscious changes to how you manage your chronic pain in the coming days and weeks. We share some tips and situation updates below.

Managing Chronic Pain During The Coronavirus Outbreak

As we’ve stated on the blog in the past, exercise is one of the best things you can do to help manage your chronic pain condition. Exercise helps to strengthen key muscle groups and releases endorphins that can help mask some pain signals. However, gyms are closing because of the virus, so you may need to find a new way to work out. Going for a walk or a run is still fine so long as you avoid group running, and we encourage chronic pain patients to look for ways to stay active inside their home. Dust off that old exercise equipment, or do some home-based exercise routines like yoga or balance board training. Find ways to stay active without going to the gym.

If you need to have a consultation with a physician, whether it’s for a new sickness or because of your current chronic pain situation, you can take solace in knowing that the U.S. Department of Health and Human Services is making it easier for physicians to connect with patients through telemedicine. As long as the provider is acting in good faith, they can consult with patients over electronic means like Skype, Google Hangout and Facetime. Doctors can even do this across state borders, an action that was announced during a White House press briefing this morning. We’re still sifting through all these changes, but know that we’re working as diligently as we can to make it easier for patients to connect with physicians while still following smart social distancing guidelines.

Lastly, remember to take some time to focus on your mental health during these trying times. Your mental health plays a significant role in how your physical condition responds to treatment, so you need to take care of your physical and mental health. This may be easier said than done, but find ways to give yourself a mental break and to safely alleviate stress. Call friends and family members, organize a game night with your family, or dive into a book series you’ve been meaning to read. Taking your mind off other stressors can help with your physical condition, so keep that in mind over the next few weeks.

We’ll get through this together. If you need anything during this time, please don’t hesitate to reach out to Dr. Cohn’s office for answers or information.

Could Deep Brain Stimulation Help Treat Chronic Pain?

February 4, 2020 / Thomas Cohn, MD

Nearly one in three adults in the US suffers from some form of chronic pain, and despite everyone’s best efforts, it’s not always easy to treat. We’re always looking for new ways to best help our patients decrease and eliminate their chronic pain, and one new treatment that is being closely monitored and tested is deep brain stimulation.

Deep brain stimulation (DBS) may sound like some futuristic medical experiment, but it’s already being used to treat some cognitive impairments. It has been successful in helping limit symptoms in conditions like Parkinson’s disease, dystonia and tremors, and now doctors are wondering if it could be useful in managing some types of chronic pain.

DBS works by implanting electrodes deep into a person’s brain in the areas that help control movement. A stimulator is also implanted in the chest, and the stimulator can help drown out problematic brain signals. The only issue is that it’s not a perfect science, and you’d like it to be perfect when you’re implanting a device in a person’s head. The electrical current relayed through the stimulators is constant, meaning it can’t adjust to what’s going on in the brain, it simply operates as a way to drown out problematic signals.

Because of this, some patients have experienced changes in personality or problems speaking, and like many treatments, the brain can get used to the stimulation and find ways to drown out the signal that is supposed to be drowning out the problematic signals. So while it’s not a perfect system, medical experts are always trying to improve it, and now they are researching whether it could be a viable option for chronic pain patients.

Deep Brain Stimulation For Chronic Pain

Researchers at the UCSF Weill Institute for Neurosciences recently received a $7.56 million, five-year grant to see if DBS could be used as a treatment for some forms of chronic pain. However, their goal is to develop the technology so that the current can be harnessed and used based on signals from the brain in real-time, instead of as a constant current.

Researchers likened the system to a space heater and a thermostat. The space heater provides constant heat, whereas a thermostat can turn the heating system on and off based on the current temperature and a desired setting. Right now DBS is a space heater, but researchers say they hope to use the grant to help develop a more thermostat-style model.

“We are trying to build a model to serve as a thermostat to control electronic stimulation to provide pain relief,” said Dr. Prasad Shirvalker, assistant professor of Anesthesiology at UC San Francisco. “We’re at the front edge of trying to open up new indications for DBS.”

Hopefully researchers can figure out how to control DBS in the most complex system in our body so that chronic pain patients can have another avenue to pursue relief. We’ll keep tabs on this research as it progresses.