Michigan's Major Clinical Trial to Explore CBD as an Opioid-Sparing Strategy in Surgery

February 22nd, 2024 Medical Marijuana
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In a landmark initiative aimed at combating the opioid crisis through innovative pain management strategies, Michigan Medicine and Henry Ford Health have announced a collaboration on what is poised to be the largest clinical trial ever conducted to evaluate the efficacy of cannabidiol (CBD) in reducing opioid dependence after surgery. Specifically, the study will focus on patients undergoing total knee arthroplasty, with the broader goal of exploring CBD's potential as a perioperative medication across a spectrum of elective surgeries.

Funded by a generous $6 million, 5-year grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of the National Institutes of Health, this multi-site clinical trial seeks to address the critical issue of postoperative pain management—a domain traditionally dominated by opioids. Despite their effectiveness in pain relief, opioids carry a high risk of addiction and a host of side effects, including nausea, dizziness, and constipation, prompting the search for safer alternatives.

The trial will be spearheaded by a team of distinguished researchers: Chad Brummett, M.D., the Bert N LaDu Professor of Anesthesiology and co-director of the Opioid Research Institute at the University of Michigan; Kevin Boehnke, Ph.D., research assistant professor within the Michigan Medicine Department of Anesthesiology; and Joel Gagnier, Ph.D., from Western University Ontario. Together, they will oversee the recruitment of 380 adult patients undergoing primary total knee arthroplasty at Michigan Medicine and Henry Ford Health.

Participants in this double-blind randomized controlled trial will be assigned to one of four groups, receiving a combination of placebo or 300 mg/day of CBD for one week prior to their surgery and for four weeks afterward. This regimen will be complemented by a standard pain treatment pathway, which includes an opioid prescription post-discharge and refills as necessary, thus maintaining a controlled environment to accurately assess CBD's effects on post-surgical opioid consumption.

This trial is significant, not only for its scale but also for its comprehensive approach to understanding CBD's potential benefits. Beyond merely measuring opioid intake, the study aims to provide insights into CBD's impact on pain intensity, anxiety, inflammation, and sleep quality post-surgery. Such data is crucial, given the increasing popularity of CBD among the general public, with an estimated 14% of Americans using CBD, primarily for chronic pain and related symptoms, despite a lack of substantial clinical research validating its effectiveness.

The move to investigate CBD as a viable alternative to opioids is motivated by the urgent need to offer patients safer pain management options. Opioids, while effective, present a slippery slope to dependence and addiction, a scenario the medical community is keen to avoid. By potentially establishing CBD as an effective perioperative pain management tool, Michigan Medicine and Henry Ford Health aim to set a new standard in surgical care, reducing reliance on opioids and mitigating the risk of addiction.

This clinical trial represents a crucial step forward in the quest to redefine postoperative pain management. Lara Zador, M.D., a specialist in anesthesiology and pain medicine at Henry Ford Health, emphasized the significance of this research in assessing CBD's capacity to curtail opioid use after surgery. Given the widespread prevalence of surgeries requiring pain management, the implications of this study extend far beyond knee arthroplasty, offering hope for a future where elective surgeries are associated with less risk and better outcomes.

In sum, this pioneering clinical trial by Michigan Medicine and Henry Ford Health not only highlights the institutions' commitment to advancing medical research but also underscores the broader medical community's dedication to finding safer, more effective pain management solutions. As the study progresses, it promises to shed light on CBD's role in post-surgical care, potentially revolutionizing the way pain is managed and offering a beacon of hope for millions of patients worldwide.

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