PAIN RELIEF WITH ORAL CANNABINOIDS IN FAMILIAL MEDITERRANEAN FEVER

Cannabinoids have analgesic and, possibly, anti-inflammatory propertie s but their clinical use has been restricted by legislation. This is t he first United Kingdom report of the controlled use of a standardised pharmaceutical preparation of cannabinoids in capsular form. The ther apy was assessed in a patient with familial Mediterranean fever, who p resented with chronic relapsing pain and inflammation of gastrointesti nal origin. After determining a suitable analgesic dosage, a double-bl ind placebo-controlled cross-over trial was conducted using 50 mg tetr ahydrocannabinol daily in five doses in the active weeks and measuring effects on parameters of inflammation and pain. Although no anti-infl ammatory effects of tetrahydrocannabinol were detected during the tria l, a highly significant reduction (p < 0.001) in additional analgesic requirements was achieved. Future study designs can now incorporate pr escribable forms of cannabinoids but the choice of previous cannabis u sers only as patients has clinical limitations. Cannabis naive patient s would tolerate controlled investigations but may generate medicolega l problems.