Morphine and cannabis: study points to nearly 50% reduction

Pain does not always manifest only in the body: it also affects daily routines, sleep, and quality of life. A clinical trial conducted in Israel brought new data to the investigation into medical cannabis and analgesia. In patients with acute radicular pain, a formulation with tetrahydrocannabinol (THC), cannabidiol (CBD), and terpenes was associated with an almost 50% reduction in morphine consumption over 24 hours.

The study was published in the scientific journal Journal of Cannabis Research and investigated whether a specific combination of cannabis compounds could decrease the need for opioids without compromising pain control.

Morphine: what did the clinical study reveal?

According to a publication by the portal Cañamo, the study included 69 patients treated at Hadassah Hebrew University Medical Center in Jerusalem with acute radicular pain caused by the irritation or compression of a nerve root.

Participants were randomly assigned to three groups: high dose of the cannabis formulation, low dose, or placebo. All had access to intravenous morphine via a patient-controlled analgesia pump.

The results showed significant differences in opioid consumption:

• High dose: average of 17.4 milligrams of morphine in 24 hours.
• Placebo: average of 33.2 milligrams over the same period.
• Low dose: did not show the same reduction observed with the high dose.

The difference between the high-dose group and placebo was statistically significant. In practice, participants who received the higher-concentration formulation used less morphine during the analyzed period.

Medical cannabis, THC, and CBD: how was the formulation tested?

The formulation was administered sublingually and combined three components: THC, CBD, and terpenes.

The high-dose group received 19.8 milligrams of THC, 19.8 milligrams of CBD, and 3 milligrams of terpenes. Meanwhile, the low dose contained 9.9 milligrams of THC and the same amount of CBD, according to the data released about the trial.

The objective was to investigate a possible opioid-sparing effect, that is, the possibility of reducing morphine consumption without increasing pain intensity.

And this was precisely the point that drew attention: despite the difference in medication use, average pain scores remained similar across groups. On the scale used, values were 5.1 in the placebo group, 5.5 in the low-dose group, and 5.4 in the high-dose group.

Does less morphine mean less pain?

Not necessarily. The study observed a reduction in morphine consumption, but did not identify a significant improvement in pain intensity among the groups.

This result suggests that the formulation may have helped participants use less opioid without a noticeable worsening of pain during the 24 hours of follow-up. However, the data do not demonstrate that cannabis can replace morphine in all clinical contexts.

It is also important to consider adverse effects. Three participants experienced transient episodes of hallucinations: one in the high-dose group and two in the low-dose group.

Another relevant aspect is the potential conflict of interest: the company Bazelet Group provided the medications used in the research, and three authors worked for the company, which commercializes these formulations. According to the study report, the statistical analysis was conducted by an external researcher who was blinded to the identity of the treatments.

What remains to be discovered about medical cannabis and opioids?

Despite the promising results, the research has important limitations. The sample size was small, the follow-up lasted only 24 hours, and the study evaluated a specific formulation in people with acute radicular pain.

It is still necessary to investigate whether the effect is maintained over longer periods, in larger populations, and in other types of pain. It is also not possible to extrapolate the results to all cannabis-based products, whose compositions and concentrations may vary.

The research broadens the scientific debate on strategies to reduce the use of opioids, which are important medications in pain management but are associated with risks such as dependence and respiratory depression.

For now, the main contribution of the trial is showing that a specific combination of cannabinoids warrants further investigation as a possible complementary strategy for pain management and reduction of morphine consumption.

The decision to start, adjust, or discontinue any treatment should be made under medical supervision. Morphine should not be discontinued or have its dosage changed on one's own.