Using Marijuana to Treat Pain? A Pill May Outlast a Puff

Study shows a pill containing THC lasts longer and may be safer than smoking pot

By Brenda Goodman

HealthDay Reporter

MONDAY, April 22 (HealthDay News) -- A pill may work as well as a puff when it comes to using marijuana to treat pain, according to a small but carefully controlled new study. Pain relief from pills may last longer, however, and may not leave people feeling as high as they do after they smoke the drug.

Medical marijuana is now legal in 18 states and the District of Columbia, according to the nonprofit group ProCon.org. Surveys show pain is one of the main reasons doctors prescribe it. But studies testing marijuana as a pain reliever have had mixed results. Some have shown that it works as well as mild opioid (narcotic) pain relievers like codeine, while others have indicated that the drug might actually make pain worse.

To learn more, researchers at the Substance Use Research Center of the New York State Psychiatric Institute pitted two strengths of smoked marijuana against two strengths of the drug dronabinol, which contains tetrahydrocannabinol, or THC, the same active ingredient as in marijuana plants.

Dronabinol has been FDA-approved since 1985 to treat the nausea and loss of appetite that commonly afflict patients with cancer and AIDS. Less is known about its effects on pain.

For the government-sponsored study, researchers recruited 30 healthy, pain-free men and women who were already regular marijuana smokers.

During five experimental sessions, participants took a capsule and then 45 minutes later smoked a marijuana cigarette. The capsules contained either an inactive placebo, or 10 milligrams or 20 milligrams of dronabinol. The cigarettes were specially made by the U.S. National Institute on Drug Abuse, which funded the study. Cigarettes were standardized to contain marijuana with no THC, a low dose of the drug or a higher dose.

People in the study never knew whether they were smoking or swallowing the drug or how strong the dose was. Researchers made sure they never got a double hit of the drug during the same session.

The testing days were spaced at least two days apart, and participants were asked to refrain from smoking the night before their lab visits.

Several times during the sessions, researchers had each person place their hands in a water bath kept just above freezing temperatures. They measured how long it took study participants to feel pain and then how long they were able to tolerate the pain before they yanked their hand out of the water. Participants also answered questions about how intensely they felt the pain during the experiments and how high they felt.

When researchers tallied their data, they found that both the smoked drug and the pill were about equally effective at controlling pain.

After smoking the strongest cigarettes or taking the highest strength of the pill, it took people an average of about 12 to 13 seconds longer to report feeling pain from the cold water compared to when they took the placebos. Both forms of the drug also significantly increased pain tolerance, the amount of time a person was able to stand the pain before they pulled their hand out of the cold water.

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Mini-Organ Would Mimic Pancreas to Treat Type 1 Diabetes

By Serena Gordon

HealthDay Reporter

TUESDAY, March 5 (HealthDay News) -- A new bioengineered, miniature organ dubbed the BioHub might one day offer people with type 1 diabetes freedom from their disease.

In its final stages, the BioHub would mimic a pancreas and act as a home for transplanted islet cells, providing them with oxygen until they could establish their own blood supply. Islet cells contain beta cells, which are the cells that produce the hormone insulin. Insulin helps the body metabolize the carbohydrates found in foods so they can be used as fuel for the body's cells.

The BioHub also would provide suppression of the immune system that would be confined to the area around the islet cells, or it's possible each islet cell might be encapsulated to protect it against the autoimmune attack that causes type 1 diabetes.

The first step, however, is to load islet cells into the BioHub and transplant it into an area of the abdomen known as the omentum. These trials are expected to begin within the next year or year and a half, said Dr. Luca Inverardi, deputy director of translational research at the Diabetes Research Institute at the University of Miami, where the BioHub is being developed.

Dr. Camillo Ricordi, the director of the institute, said the project is very exciting. "We're assembling all the pieces of the puzzle to replace the pancreas," he said.

"Initially, we have to go in stages, and clinically test the components of the BioHub," he said. "The first step is to test the scaffold assembly that will work like a regular islet cell transplant."

The Diabetes Research Institute already successfully treats type 1 diabetes with islet cell transplants into the liver.

In type 1 diabetes, an autoimmune disease, the body's immune system mistakenly attacks and destroys the beta cells contained within islet cells. This means someone with type 1 diabetes can no longer produce the insulin they need to get sugar (glucose) to the body's cells, so they must replace the lost insulin. This can be done only through multiple daily injections or with an insulin pump via a tiny tube inserted under the skin and changed every few days.

Although islet cell transplantation has been very successful in treating type 1 diabetes, the underlying autoimmune condition is still there. Because transplanted cells come from cadaver donors, people who have islet cell transplants must take immune-suppressing drugs to prevent rejection of the new cells. This puts people at risk of developing complications from the medication, and, over time, the immune system destroys the new islet cells.

Because of these issues, islet cell transplantation is generally reserved for people whose diabetes is very difficult to control or who no longer have an awareness of potentially dangerous low blood-sugar levels.

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Brain May Treat Wheelchair as Part of the Body

By Randy Dotinga

HealthDay Reporter

WEDNESDAY, March 6 (HealthDay News) -- The brains of disabled people adjust to a wheelchair and treat it as an extension of their body, essentially replacing limbs that don't function properly anymore, new research suggests.

The findings provide more insight into how the brain compensates when it uses tools like a wheelchair, or even something as simple as a hammer or toothbrush, said study lead author Mariella Pazzaglia, an assistant professor at the Sapienza University of Rome, in Italy.

In the future, Pazzaglia said, this kind of research could lead to ways to enhance the body in people who are physically impaired. "Bodily representations can be extended to include exoskeletons, prostheses, robots and virtual avatars," she said.

At issue is what scientists call "brain plasticity," which describes the brain's ability to learn and adjust, something people do quite often when young and continue to do as they get older.

"If we learn how to play a piano or drive somewhere, that's plasticity in action," said Dr. Alexander Dromerick, chief of rehabilitation medicine at Georgetown University Medical Center in Washington, D.C.

Human brains also can compensate for bodily changes such as the loss of a limb by adjusting what's known as the internal body map. The new study sought to understand how the brains of disabled people change their body maps to include wheelchairs.

The researchers surveyed 55 people in wheelchairs with spinal cord injuries about their lives, and then analyzed their responses. The study authors determined that the participants treated wheelchairs as part of their bodies, not simply as extensions of their limbs.

The study also found that people who had more movement in their upper limbs could interact more with wheelchairs, and this improved their ability to incorporate them into their body images.

Essentially, the participants' brains go into an automatic mode when it comes to using the wheelchairs. This leads to "more efficient and safer use, with lower costs, risks and dangers to the body," Pazzaglia said.

"To elude dangerous objects in the environment and the collisions that may occur during wheelchair use, the brain needs to encode an internal representation of the body that includes the wheelchair," she said.

"Moreover, the simple action of picking objects up from the floor without tipping out of the wheelchair implies a change in the representation of the body to enable this to happen successfully and without the risk of possible damage to the individual due to a fall," she added. "All daily activities become an automatic way of thinking, not merely a mechanical or practical process."

Automatic thinking -- based on body maps that encompass inanimate objects -- plays plenty of other roles in people's lives, Georgetown's Dromerick said. For example, people who can wield a hammer effectively or parallel park with ease have learned to treat hammers and cars as extensions of themselves, he said.

The study appeared March 6 in the journal PLoS One.

More information

For more on disabilities, visit the U.S. National Library of Medicine.

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