Michigan Researchers Awarded Millions by State to Study Efficacy of CBD for Veterans with Chronic Pain

A generous grant bestowed upon U-M researchers by the Veteran Marijuana Research (VMR) grant program will be used to financially support a forthcoming study titled “Pragmatic Trial of Cannabidiol and Tailored Cannabis Coaching to Improve Chronic Pain Symptoms among Veterans.” The VMR’s five-year, $7.4 million grant will permit U-M pain researchers to investigate the efficacy of using cannabidiol (CBD) and other types of medical cannabis products as a way of managing chronic pain in U.S. Veterans. 

With this new grant, the research team intends to prove that cannabis’ primary non-psychoactive cannabinoid, CBD, can amplify the quality of life for veterans who struggle with “varying types of pain” caused by injuries endured during military service. 

The co-principal researchers are as follows:

• Kevin Boehnke, Ph.D. — A research analyst in the Department of Anesthesiology and the Chronic Pain and Fatigue Research Center
• Rachel Bergmans, Ph.D. — A research analyst in the department of anesthesiology and the Chronic Pain and Fatigue Research Center
• Amy Bohnert, Ph.D., MHS  — A professor of anesthesiology, epidemiology, and psychiatry. 

Is it possible that CBD for veterans managing chronic pain could be effective and safe? “In the first part of our study, we will get a better understanding of what kinds of chronic pain might best respond to cannabidiol (CBD) products,” explained Boehnke. “CBD is very low risk and remarkably safe, with potential as a first-line cannabis-based pain reliever, so conducting this large, pragmatic trial will help inform whether and when it might be useful.” 

Veterans Are More Likely to Experience Chronic Pain

Compared with the general population, chronic pain is more prevalent among veterans. This was confirmed in a research report by The Veterans Health Administration Office of Research and Development, which found that “persistent chronic pain can contribute to depression, anxiety, poor sleep patterns, decreased quality of life, and substance use disorders.” 

Researchers from the Administration emphasized the need for effective and safe treatment options for chronic pain. They drew extra attention to the fact that there is a pressing urge for alternatives to opioid painkillers amid the opioid epidemic. Suicide is the 10th leading cause of death in the U.S., mainly from drug overdose, many of which involve opioids. Chronic pain among veterans was also reported to be a risk factor for suicide.

“The veteran community is underrepresented in research on health interventions. Recruiting a veteran population to participate in such a study is significant for breaking down research barriers. To expand upon existing literature, one of the aims of our study is to report on barriers and facilitators to participation,” stated Bergmans, who is in charge of leading the research team’s efforts.

The forthcoming study’s community-engaged approach has been described as “unique” by Bergmans. She hopes the team’s research will provide veterans who require chronic pain medication with enough evidence of cannabis’ suitability as a treatment option. Their efforts are valid since there is a distinct lack of research opportunity knowledge among veterans.

Bohnert’s collaborations with Precision Health have proven immensely important in the study’s development. The researcher is optimistic that the study will ameliorate her position within the company. She is also a co-investigator of Precision Health’s PROMPT study and Precision Opioid Prescribing use case.

“This project benefits from years of experience, developed across several Precision Health projects, with collecting health data remotely and securely. It will also further the goals of Precision Health by studying which people benefit from which treatments to manage pain and mental health problems,” said Bohnert. 

Two Consecutive Interventions are Included in the Clinical Trial on CBD for Veterans

In the initial study, the team will determine the efficacy of using commercially available CBD products to ease chronic pain. The second clinical trial will see the study subjects receive customized guidance on properly using medical cannabis products sold at licensed dispensaries.

“Many people report that cannabis and CBD are helpful, both in reducing pain and associated symptoms, as well as being used as a substitute for other pain medications, including opioids,” said Boehnke. However, treatment guidelines have yet to be developed. 

Boehnke noted that many people proceed to consume medical cannabis without first seeking guidance or support. This is likely due to poor training and a lack of guidance on federally illegal cannabis products.

For the first time, this educational clinical trial seeks to test guidance proposed by experts on the appropriate use of cannabis products for chronic pain. A primary goal of the study is to glean scientific literature-based practical advice that may help patients choose suitable cannabis products for pain management.

Boehnke added that the team is actively working towards preparing an intervention that will give veterans the empowerment they need to yield better therapeutic results from medical cannabis and reduce harm from products available in legal dispensaries.

Together, the research team plans to form a community advisory board to help them join forces with Veteran groups and streamline the study recruitment process. The board will also aid the research group in identifying and overcoming barriers to participation, clarifying the study findings, and disseminating the results.”

“We have and will continue to prioritize Veteran voices throughout the process of the study,” said Boehnke. “In so doing, we will be responsive to Veteran needs, which is incredibly important to our team given Veterans’ extraordinary commitment and advocacy, which has helped make this research possible in the first place. I feel excited and privileged that this project focuses on working with Veterans to improve their pain management outcomes.”

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