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Trial record 39 of 152 for:    cannabis | Recruiting, Enrolling by invitation Studies

Pain Research: Innovative Strategies With Marijuana (PRISM)

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ClinicalTrials.gov Identifier: NCT03522324
Recruitment Status : Recruiting
First Posted : May 11, 2018
Last Update Posted : October 10, 2018
Sponsor:
Collaborators:
University of Colorado, Denver
Colorado State University
Information provided by (Responsible Party):
L. Cinnamon Bidwell, University of Colorado, Boulder

Brief Summary:
This study tests the effects of cannabinoid levels in blood on pain relief, inflammation, and cognitive dysfunction in chronic pain patients who choose to use edible cannabis. Over a two-week period, participants use an edible product of their choice. Blood levels of 9-delta-tetrahydrocannabinol (THC) and cannabidiol (CBD) will be measured before, during, and after the two-week exposure period to determine whether there are associations with pain, inflammation, sleep, physical activity, anxiety/depression, and cognitive dysfunction. After the two-week self-administration period, participants will be followed for six months to collect self-report data on cannabis use, pain levels, sleep quality, and mental health symptoms.

Condition or disease Intervention/treatment
Chronic Pain Chronic Low Back Pain Cannabis Use Drug: Cannabis Edible

Detailed Description:

The National Center for Health Statistics reports that approximately 76 million Americans suffer from chronic pain, affecting the lives of more Americans than cancer, diabetes, and heart disease combined. Perhaps because of its ubiquity and the challenge to its treatment, relief from chronic pain is by far the most commonly cited condition by patients for use of marijuana, with 87%-94% of medical marijuana users reporting using for relief of a pain condition.

Although the mechanisms are still unclear, marijuana and its constituent cannabinoids, including 9-delta-tetrahydrocannabinol (THC), are thought to be involved in reducing pain and associated inflammation. However, THC is also associated with harm in the form of cognitive dysfunction. Synergistic interactions of multiple cannabinoids are believed to produce different effects on both pain relief and cognitive function as compared to THC alone. For example, cannabidiol (CBD) is another primary cannabinoid that may work synergistically with THC in a multi-target analgesic approach.

This study examines the effects of cannabinoids in edible form on pain relief, inflammation, and cognitive dysfunction in chronic pain patients who choose to use marijuana in the context of a short-term (2 weeks), patient-oriented, observational design and a mobile pharmacology and phlebotomy lab.


Study Type : Observational
Estimated Enrollment : 283 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: An Observational Study of the Effects of Edible Cannabis and Its Constituent Cannabinoids on Pain, Inflammation, and Cognition
Actual Study Start Date : June 1, 2018
Estimated Primary Completion Date : October 31, 2021
Estimated Study Completion Date : March 31, 2022

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Marijuana


Intervention Details:
  • Drug: Cannabis Edible
    Self-Directed Use (ad-libitum)


Primary Outcome Measures :
  1. Pain Interference: Roland Morris Disability Questionnaire (RMDQ) [ Time Frame: Change over two time points over 2 weeks: Baseline (before 2 weeks of edible use), Pre-Administration (after 2 weeks of use and before acute administration). ]
    Measure of pain interference (RMDQ), using the total RMDQ score (0-24). THC and CBD blood levels will be tested in relation to all outcomes.

  2. Inflammation: Circulating Levels of Cytokines [ Time Frame: Change over two time points over 2 weeks: Baseline (before 2 weeks of edible use), Pre-Administration (after 2 weeks of use and before acute administration). ]
    Tests levels of recent inflammation (panel of inflammatory markers) before and after cannabis use. THC and CBD blood levels will be tested in relation to all outcomes.

  3. Flanker Inhibitory Control Attention task (FICA) & International Shopping List Task (ISLT) [ Time Frame: Change over two time points over 2 weeks: Baseline (before 2 weeks of edible use), Pre-Administration (after 2 weeks of use and before acute administration). ]
    Co-outcomes testing cognitive impairment in the domains of immediate and delayed recall (ISLT) and attention and inhibitory control (FICA). Cognitive outcomes are measured in standard scores (e.g. Range of >70 to >140 (Mean of 100 and SD of 15) with higher scores indicating better performance) and can be averaged to reflect a Standard score of overall cognitive function.

  4. Functional Assessment of Cancer Therapy Cognitive Scale (FACT-Cog) [ Time Frame: Change over two time points over 2 weeks: Baseline (before 2 weeks of edible use), Pre-Administration (after 2 weeks of use and before acute administration). ]
    Subjective report of cognitive function


Secondary Outcome Measures :
  1. Pain Intensity: Current, Average and Worst pain using NIH Pain intensity scale. [ Time Frame: Change over four time points over 2 weeks: Baseline (before start of edible use), Pre-Administration (after 2 weeks of edible use and post-acute administration), and Post-Administration (1 and 2 hours post-use. acute measure of edible cannabis effects). ]
    Test effects of cannabinoids on pain using the "current pain", "average pain", and "worst pain" versions of the Pain Intensity scale (on a scale from 0-10). THC and CBD blood levels will be tested in relation to all outcomes.

  2. Health & Wellbeing [ Time Frame: Change over four time points over 2 weeks: Baseline (before start of edible use), Pre-Administration (after 2 weeks of edible use and post-acute administration), and Post-Administration (1 and 2 hours post-use. acute measure of edible cannabis effects). ]
    Self-report measure across primary domains of health-related well-being (e.g. exercise and diet).

  3. Pittsburgh Sleep Quality Assessment (PSQI) [ Time Frame: Change over four time points over 2 weeks: Baseline (before start of edible use), Pre-Administration (after 2 weeks of edible use and post-acute administration), and Post-Administration (1 and 2 hours post-use. acute measure of edible cannabis effects). ]
    Self-report assessment of sleep quality.

  4. Motor function [ Time Frame: Change over four time points over 2 weeks: Baseline (before start of edible use), Pre-Administration (after 2 weeks of edible use and post-acute administration), and Post-Administration (1 and 2 hours post-use. acute measure of edible cannabis effects). ]
    Physical function assessment of motor flexibility and control. Motor outcomes can be aggregated via Z-score to reflect a Z-score of overall motor function.

  5. Depression and Mood [ Time Frame: Change over four time points over 2 weeks: Baseline (before start of edible use), Pre-Administration (after 2 weeks of edible use and post-acute administration), and Post-Administration (1 and 2 hours post-use. acute measure of edible cannabis effects). ]
    Self-report measures of depression, anxiety, and stress. Given the observational nature of the study, co-outcomes are appropriate to comprehensively assess change in depression/negative affect over the course of the study.

  6. Acute Cognitive impairment: Flanker Inhibitory Control Attention task (FICA) and International Shopping List Task (ISLT). [ Time Frame: Acute changes in three time points over 2 hours: Pre-Administration (after 2 weeks of use, before acute administration), Post-Administration 1-hr & 2-hr (after 2 weeks of use, 1 and 2 hours after acute administration). ]
    Co-outcomes testing cognitive impairment after acute use of cannabis in the domains of immediate and delayed recall (ISLT) and and attention and inhibitory control (FICA). Cognitive outcomes are measured in standard scores (e.g. Range of >70 to >140 (Mean of 100 and SD of 15) with higher scores indicating better performance) and can be averaged to reflect a Standard score of overall cognitive function.

  7. Inflammation: Circulating Levels of Cytokines [ Time Frame: Acute changes in three time points over 2 hours: Pre-Administration (after 2 weeks of use, before acute administration), Post-Administration 1-hr & 2-hr (after 2 weeks of use, 1 and 2 hours after acute administration). ]
    Acute changes in inflammation (panel of inflammatory markers) immediately before and after cannabis use. THC and CBD blood levels will be tested in relation to all outcomes.

  8. Patient Global Impression of Change: Global Impression of Change Scale (PGIC). [ Time Frame: Change over six month study, including after 2 week primary exposure period. ]
    Patient Global Impression of Change Scale (PGIC) measures self-reported change on a 1-7 scale (i.e. from 1 (very much worse) to 7 (very much improved)) in anxiety. Changes in this measure will be tested in relation to THC and CBD blood levels.


Other Outcome Measures:
  1. Exploratory: Daily Follow-up Messages [ Time Frame: 2 weeks (daily) ]
    Brief self-report from participants on cannabis use, pain, and sleep in the past 24 hours.

  2. Exploratory: Monthly Follow-up Surveys [ Time Frame: 6 months (monthly) ]
    Self-report from participants on all drug use, subjective cognitive function, pain, sleep, and mental health

  3. Objective physical activity/exercise [ Time Frame: 2 weeks ]
    Physical activity and sleep via objective daily data on wearable watch.

  4. Physical activity/exercise [ Time Frame: 2 weeks ]
    Physical activity via subjective self-report data


Biospecimen Retention:   Samples Without DNA
Blood samples collected for cytokine and cannabinoid quantitation.


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Ages Eligible for Study:   21 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Community Sample
Criteria

Inclusion Criteria:

  • Intent to initiate use of marijuana to treat chronic pain
  • At least one episode of lifetime marijuana use, but less than weekly marijuana use for prior six months
  • Self-reported non-specific chronic low back pain for at least three months
  • Health eligibility approved by study physician
  • Pain intensity at 4 or greater on 10-point scales
  • Pain interference with activities at 3 or greater on 10-point scales

Exclusion Criteria:

  • Other drug use (cocaine, methamphetamine, etc.) in the past 3 days and/or actively seeking or in treatment for any substance use disorder
  • Use of marijuana to treat pain at any time in lives
  • Current use of psychotropic medications (other than SSRIs and ADHD meds), or use of antivirals, steroids, or regular use of maximal doses of NSAIDS
  • A daily tobacco user
  • Are currently pregnant or trying to become pregnant
  • Acute illness (other than chronic pain) or any immune-related disease (e.g., HIV)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03522324


Contacts
Contact: Leah Hitchcock, PhD 303-492-0288 prism.custudy@gmail.com

Locations
United States, Colorado
Center for Innovation and Creativity Recruiting
Boulder, Colorado, United States, 80304
Contact: Leah Hitchcock, PhD         
Sponsors and Collaborators
University of Colorado, Boulder
University of Colorado, Denver
Colorado State University
Investigators
Principal Investigator: Cinnamon Bidwell, PhD Institute of Cognitive Science, University of Colorado, Boulder

Additional Information:
Responsible Party: L. Cinnamon Bidwell, Assistant Research Professor, University of Colorado, Boulder
ClinicalTrials.gov Identifier: NCT03522324     History of Changes
Other Study ID Numbers: R01AT009541 ( U.S. NIH Grant/Contract )
First Posted: May 11, 2018    Key Record Dates
Last Update Posted: October 10, 2018
Last Verified: October 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by L. Cinnamon Bidwell, University of Colorado, Boulder:
Cannabis
Pain
Cytokines
Inflammation
Cognition

Additional relevant MeSH terms:
Marijuana Abuse
Back Pain
Low Back Pain
Chronic Pain
Pain
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Substance-Related Disorders
Chemically-Induced Disorders
Mental Disorders