Jessica Nye, PhD  February 8, 2023
Study authors did not identify clear pain-relieving effects from CBD and/or THC among patients with peripheral neuropathic pain and prior treatment failure.
Oral cannabidiol (CBD), tetrahydrocannabinol (THC), or their combination did not decrease pain among patients with peripheral neuropathic pain who had a history of treatment failure. These findings, from a randomized, double-blind trial, were published in the European Journal of Pain.
The median age of the study population was 65 (range, 22-95) years, the median duration of pain was 60 (range, 10-2017) months, mean NRS score was 6.5 (standard deviation [SD], 1.3) points, and the most common prior therapy was gabapentin or pregabalin (n=115). Neuropathic etiologies included polyneuropathy (n=95), diabetic polyneuropathy
“In the PPP, CBD reduced pain less than placebo, and less effect of CBD than of placebo was also seen with some secondary pain outcomes.”
Neither CBD, THC, nor CBD/THC were superior to placebo for symptoms of burning pain, pressing and squeezing, pain paroxysms, or evoked pain as evaluated using the Neuropathic Pain Symptom Inventory (NPSI).  The study authors report that CBD was actually less effective than placebo in reducing evoked pain.
No effects on paracetamol consumption, quality of life, or psychomotor function were reported with active treatment.
In subgroup analyses, active treatment was not superior to placebo for pain, quality of life, mood, or pain-related sleep disturbance.
Nausea and diarrhea were reported more frequently among recipients of CBD/THC compared with prior to treatment (11% vs 1% and 11% vs 3%, respectively).

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