Research into side effects of opioids versus cannabis

A recent study conducted by the Leiden University Medical Center (LUMC) examined the side effect profiles of the opioid oxycodone and cannabis product Bediol®. The outcomes of the study were published in the scientific journal Frontiers in Pain Research under the title Cannabis Combined with Oxycodone for Pain Relief in Fibromyalgia Pain: A Randomized Clinical Self-titration Trial with a focus on Adverse Events.

The results showed that (i) around one in four participants dropped out of the study, mainly due to the severity of adverse effects experienced from inhaled cannabis; (ii) there were no significant differences in pain scores between treatments; (iii) the drug load increased in patients treated with the combination of oxycodone and cannabis relative to either treatment alone; and (iv) patients titrated their dosing based on adverse effects and pain relief.

Bedrocan’s Chief Scientific Officer, Mikael Kowal, briefly commented on the results: “Unfortunately, the results are not entirely as expected. We hoped that Bediol® would provide clear advantage over oxycodone in terms of the side effect profile and treatment efficacy for fibromyalgia-induced pain. However, due to many patients not tolerating inhaled cannabis well, the study results do not clearly point to a beneficial effect of Bediol®. To be precise, 31% of patients that received cannabis dropped out from the study due to various adverse effects, most notably headaches.”

Cannabis or opioids for pain relief

“On the other hand, the study also demonstrated that Bediol® worked just as well as the opioid oxycodone for pain relief in some patients, despite the many dropouts during the study. Although the study design and findings do not allow us to draw conclusions that the side effect profile of Bediol® is better than that of oxycodone, it is clear that the use of opioids is more dangerous than the use of cannabis. Using opioids can cause respiratory depression, which can lead to death. That is not the case with cannabis.”, Kowal says.

Kowal: “In sum, I think that the most important conclusion from this study is that cannabis may be an effective pain treatment for some patients, but that it is certainly not for everyone. It is therefore crucial to determine which factors contribute to a good response to cannabis treatment.”