Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study
Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study
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DOI：
10.1080/00325481.2019.1685298
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发表时间：
2019-11-14
影响因子：
4.2
通讯作者：
Burkman, Elisa
中科院分区：
文献类型：
--
作者：
Capano, Alex;Weaver, Richard;Burkman, Elisa
背景：慢性疼痛在世界上大多数工业化国家都非常普遍。尽管有记录的不良反应，阿片类药物被广泛用于疼痛管理。大麻素，特别是大麻二酚，被提议作为阿片类药物的替代品，具有相当的疗效和更好的安全性。目的：我们的目的是调查大麻提取物大麻二酚（CBD）对慢性疼痛患者阿片类药物使用和生活质量指标的影响。方法：从一家私人疼痛管理中心的调查人群中招募了131名患者作为初始样本。97例患者完成了为期8周的研究。主要入选标准包括30至65岁的慢性疼痛患者，这些患者已服用阿片类药物至少1年。在三个不同的时间点收集数据：基线、4周和8周。通过药物和精神病治疗收据评价阿片类药物和其他药物的使用情况。使用四个指数评估改善：疼痛残疾指数（PDI-4）;匹兹堡睡眠质量指数（PSQI），疼痛强度和干扰（PEG）;和患者健康问卷（PHQ-4）。结果如下：超过一半的慢性疼痛患者（53%）在将富含CBD的大麻提取物添加到他们的治疗方案后的8周内减少或消除了他们的阿片类药物。几乎所有CBD用户（94%）都报告生活质量有所改善。结果表明CBD和PSQI（p = 0.003）和PEG（p = 0.006）之间存在显著相关性。有改善的趋势，但CBD的使用与PHQ和PDI之间没有显着的关系。结论：CBD可以显着减少阿片类药物的使用，改善目前使用阿片类药物进行疼痛管理的患者的慢性疼痛和睡眠质量。关键信息：这是一项前瞻性单臂队列研究，旨在研究大麻素作为阿片类药物替代品的潜在作用。结果表明，使用富含CBD的提取物使我们的患者能够减少或消除阿片类药物，并显着改善其生活质量指数。
Context: Chronic pain is highly prevalent in most of the industrialized nations around the world. Despite the documented adverse effects, opioids are widely used for pain management. Cannabinoids, and specifically Cannabidiol, is proposed as an opioid alternative, having comparable efficacy with better safety profile. Objectives: We aim to investigate the impact of full hemp extract cannabidiol (CBD) on opioid use and quality of life indicators among chronic pain patients. Methods: An initial sample of 131 patients was recruited from a private pain management center's investigative population. Ninety-seven patients completed the 8-week study. The primary inclusion criteria included patients between 30 and 65 years old with chronic pain who have been on opioids for at least 1 year. Data were collected at three different time points: baseline, 4, and 8 weeks. Opioid and other medication use were evaluated via the medication and psychiatric treatment receipt. Improvement was evaluated using four indices: Pain Disability Index (PDI-4); Pittsburgh Sleep Quality Index (PSQI), Pain Intensity and Interference (PEG); and Patient Health Questionnaire (PHQ-4). Results: Over half of chronic pain patients (53%) reduced or eliminated their opioids within 8 weeks after adding CBD-rich hemp extract to their regimens. Almost all CBD users (94%) reported quality of life improvements. The results indicated a significant relationship between CBD and PSQI (p = 0.003), and PEG (p = 0.006). There was a trend toward improvement but no significant relationship between CBD use and PHQ and PDI. Conclusion: CBD could significantly reduce opioid use and improve chronic pain and sleep quality among patients who are currently using opioids for pain management. Key Message: This is a prospective, single-arm cohort study for the potential role of cannabinoids as an alternative for opioids. The results indicate that using the CBD-rich extract enabled our patients to reduce or eliminate opioids with significant improvement in their quality of life indices.