Impact of Repeatedly-Administered THC-cannabis on Experimental Pain and Abuse Liability in Humans
Chronic pain is a significant public health concern in the U.S., for which prescription opioids have historically been the standard treatment. This has resulted in striking rates of opioid use disorders and fatal overdoses. Identifying non-opioid medications for the management of chronic pain with minimal abuse liability is a public health necessity, and cannabinoids are a promising drug class for this purpose. More than 80% of medicinal cannabis users report pain as their primary medical indication, and they report experiencing minimal psychoactive effects. However, there are few well-controlled human laboratory studies assessing cannabis' efficacy for pain in the context of abuse, and even less is known regarding the effects of daily repeated use of cannabis on pain and its relationship to abuse liability. Carefully controlled research is needed.
The proposed randomized, within-subjects, placebo-controlled 16-day crossover inpatient human laboratory study (N = 20 healthy cannabis users; 10 men, 10 women) will address three important gaps in our understanding of the potential therapeutic utility of cannabis for pain: 1) Does tolerance develop to repeated, daily smoked cannabis administration on measures of experimental pain and abuse liability; 2) If so, is tolerance reversed during the 7 days of abstinence from active-THC cannabis; 3) Does abrupt abstinence from active cannabis increase experimental pain sensitivity, i.e. hyperalgesia, relative to baseline, and do these effects parallel measures of cannabis withdrawal such as disrupted mood and sleep?
Two distinct modalities of experimental pain will be assessed: The Cold Pressor Test (CPT) and Quantitative Sensory Testing Thermal Temporal Summation (QST-TTS). Throughout the study, experimental pain and abuse-related effects will be assessed, as will sleep and subjective mood assessments.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Caroline A Arout, PhD
- Phone Number: 646-774-7777
- Email: caroline.arout@nyspi.columbia.edu
Study Locations
-
-
New York
-
New York, New York, United States, 10032
- New York State Psychiatric Institute
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Males/non-pregnant females, 21-60 years old
- Current cannabis user
- Able to perform all study procedures
Exclusion Criteria:
- Use of other illicit drugs
- If medical history, physical and psychiatric examination, or laboratory tests performed during the screening process reveal any significant illness that the study physician deems contraindicated for study participation
- Insensitivity to the cold-water stimulus of the Cold Pressor Test or the heat stimulus of Quantitative Sensory Testing
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Dose A: Standardization Phase
On the first full inpatient day (Day 1), participants smoke one specified strength (Dose A; 75% of two 6.58% cannabis cigarettes) of cannabis at three timepoints.
|
6.58% THC + <0.01%
CBD cannabis (in one cigarette)
|
|
Placebo Comparator: Dose B: Placebo Phase
On Days 2-8, participants smoke a second strength (Dose B; 75% of two < 0.01%THC:CBD cannabis cigarettes) of cannabis will be administered 3x/day.
|
<0.01% THC:CBD cannabis.
|
|
Experimental: Dose A: Active Phase
On Days 9-15, cannabis Dose A will be administered again (75% of two 6.58% cannabis cigarettes) at three timepoints each day.
|
6.58% THC + <0.01%
CBD cannabis (in one cigarette)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Cold Pressor Test (CPT) latency
Time Frame: Up to 15 days
|
The CPT apparatus consists of two refrigerated circulators, filled with warm (36.5-37.5°C).
participants will complete the CPT 30 minutes before the 1000h cannabis administration (baseline), and 0, 15, 30, 45, 60, and 90 minutes post-cannabis administration.
and cold (3.5 - 4.5°C) water.
Participants will insert their non-dominant hand into the warm water and remove it after 3 minutes; skin temperature of the thumb pad will be measured.
Participants will then insert their hand in the cold water and will be instructed to report when they first experience pain (pain threshold) and remove their hand when the cold water can no longer be tolerated (pain tolerance).
Maximum immersion time will be 3 minutes.
Repeats on days 1, 2, 5, 8, 9, 12, and 15.
|
Up to 15 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Quantitative Sensory Testing-Thermal Temporal Summation (QST-TTS) ratings
Time Frame: Up to 15 days
|
The QST-TTS apparatus is a thermal testing analyzer with a 30 x 30 mm Peltier thermode, which will use repetitive nociceptive heat stimulation of a fixed frequency and intensity.
At the beginning of the procedure, a research assistant (same gender as the participant) will read a script describing the procedure to the participant.
Tonic noxious heat stimulation will be applied to the palm using a ramp-and-hold method, in which the baseline temperature will be set at 32.0°C, and will increase at a rate of 1°C/s up to 46.5°C, remaining constant for 120 sec.
During the total duration of stimulation (135 seconds), participants will continuously rate the magnitude of perceived pain using a visual analog scale.
participants will complete the CPT 30 minutes before the 1000h cannabis administration (baseline), and 0, 15, 30, 45, 60, and 90 minutes post-cannabis administration.
Repeats on days 1, 2, 5, 8, 9, 12, and 15.
|
Up to 15 days
|
|
Change in Cannabis Rating Form (CRF) ratings
Time Frame: Up to 15 days
|
Participants rate the strength, liking, desire to take again, good drug effect and bad.
7x on each of drug effect of cannabis on a 100mm visual analog scale.
Repeats on days 1, 2, 5, 8, 9, 12, and 15.
|
Up to 15 days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 8058
- R21DA050752 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Pain
-
NCT00866164Approved for marketingBack Pain | Leg Pain | Trunk Pain | Intractable Pain | Arm Pain
-
NCT07190807RecruitingLow Back Pain | Chronic Pain | Chronic Low-back Pain | Leg Pain | Intractable Pain | Chronic Leg Pain
-
NCT03727373CompletedPain, Acute | Pain, Chronic | Pain Measurement | Pain, Cancer
-
NCT03597737CompletedPain, Acute | Pain, Chronic | Oncology
-
NCT07454083Not yet recruitingNon-Cancer Pain,Musculoskeletal Pain,Chronic Pain,Acute Pain
-
NCT01576978CompletedPREGNANCY | LUMBAR BACK PAIN | PELVIC PAIN
-
NCT07274293CompletedCervical Pain | Pain Management | Lumbar Pain | Muscular | Chronic Pain (Back / Neck)
-
NCT07144033Not yet recruitingPain, Acute | Chronic Post Operative Pain | Pain, Chronic
-
NCT05616702RecruitingLow Back Pain | Chronic Low-back Pain | Low Back Pain, Mechanical | Mechanical Low Back Pain | Pain, Chronic | Pain, Back | Lower Back Pain Chronic | CLBP - Chronic Low Back Pain
-
NCT04727749CompletedPain | Pain, Acute | Pain, Chronic | Pain, Intractable
Clinical Trials on Placebo Cannabis
-
NCT02177513Completed
-
NCT04576507CompletedPain | Cannabis | Hyperalgesia | Tolerance
-
NCT04982965RecruitingLower Back Pain | Back Pain | Sciatica | Degenerative Disc Disease | Lumbar Radiculopathy | Chronic Low-back Pain (cLBP) | Chronic Low Back and Leg Pain
-
NCT06059677RecruitingDriving Impaired | Cannabis Smoking
-
NCT06190470Enrolling by invitation
-
NCT07224698Not yet recruitingPost Traumatic Stress Disorder PTSD
-
NCT03656029CompletedCognitive Impairment | Driving Impaired | Abuse Cannabis