(Photo provided by: BLACKDAY)
Written by Cam Buchan
In what is being called the Definitive Trial of the Perioperative Use of Cannabidiol (CBD), a team from Schulich Medicine and Dentistry and the University of Michigan investigated how CBD treatment affected the need for opioid painkillers after knee replacement surgery. We plan to conduct a large-scale study to determine whether .
With a more than $6 million National Institutes of Health (NIH) grant, Dr. Joel Gagnier, associate professor of epidemiology, biostatics, and surgery at Schulich School of Medicine and Dentistry, and his colleagues will follow 380 patients over five years. We plan to do so. , a multicenter 2×2 factorial clinical trial.
In addition to Dr. Gagné, who has expertise in clinical trials and methodology in orthopedic clinical trials, Chad Brummett, MD, a professor with expertise in perioperative opioid use, and Kevin, assistant professor with expertise in CBD.・Dr. Behnke is an assistant professor in the Department of Anesthesiology at the same university. University of Michigan – Examining whether CBD can also help reduce opioid use, pain, and other outcomes before and after surgery.
The two main components of cannabis are tetrahydrocannabinol (THC), the main psychoactive component, and cannabidiol (CBD), the main non-psychoactive component. While there is some preliminary evidence for CBD to reduce pain through a recent meta-analysis by Gagné and his team, there is still research to confirm these early findings and related perioperative effects. Large-scale, rigorous, and definitive trials have not yet been conducted.
“We expect that patients who take CBD pre- and post-operatively will have a reduced need for painkillers such as opioids, which is our main result. They will also see improved physical and psychological functioning. I look forward to that,” said Gagnier, who joined Schulich Medicine and Dentistry in 2022 after 12 years at the University of Michigan. “Of course, these results will have a positive impact on clinical practice in orthopedics and related surgical fields where patients experience pain, if we see the responses we expect. We hope to deter potential use and abuse.”
joel gagne
Associate Professor, Department of Epidemiology, Biostatistics, and Surgery
Due to continued demand from an aging population, more than 1 million total knee arthroplasties (TKA) are performed annually in the United States, compared to about 80,000 in Canada, Gagné said. .
These procedures are key to improving the quality of life for patients with severe osteoarthritis, but they carry the risk of life-threatening addiction to opioids, the main method of post-procedure pain treatment.
The 2023 numbers paint a tragic picture of opioid addiction in both the United States and Canada.
Although there will be a slight decline in the United States in 2023, the overall trend remains alarming, with approximately 100,000 drug overdose deaths (mostly opioid-related) occurring each year. The opioid crisis has reached critical levels in Canada, with an average of 22 opioid-related deaths per day, or about 8,000 per year, primarily caused by fentanyl and other synthetic opioids.
Opioids also have serious side effects, including drowsiness, dizziness, and high anxiety.
“There is certainly an opioid crisis in the United States and, to a lesser extent, in Canada,” Gagné said. “Finding ways to reduce opioid use during recovery is critical to reducing the risk of addiction. It has the potential to spread to other surgical fields.”
Both the University of Michigan in Ann Arbor and Henry Ford Hospital in Detroit are recruiting, with Western University planning to hire in the fall of 2025, Gagne said.
