From the Guidelines
In Australia, three medicinal cannabis options for chronic back pain include Tilray 10:10 Balance, Cannatrek T20 Ruby, and MedReleaf Sedapain, which can be considered for treatment after conventional therapies have failed, as suggested by the 2017 HIVMA of IDSA clinical practice guideline for the management of chronic pain in patients living with HIV 1.
Medicinal Cannabis Options
- Tilray 10:10 Balance contains equal parts CBD and THC (10mg/ml of each), typically administered as 0.5-1ml under the tongue twice daily, providing balanced pain relief with moderate psychoactive effects.
- Cannatrek T20 Ruby is a THC-dominant oil (20mg/ml THC) used at 0.2-0.5ml doses in the evening, offering stronger pain relief but more pronounced sedative effects, making it suitable for nighttime use.
- MedReleaf Sedapain contains 5mg/ml THC and 20mg/ml CBD, administered as 0.5-1ml twice daily, providing pain relief with reduced psychoactive effects due to the higher CBD content.
Important Considerations
All these products require a prescription from an authorized prescriber through the Special Access Scheme. Treatment typically begins with low doses that increase gradually to minimize side effects like dizziness or drowsiness. These medications work by interacting with the endocannabinoid system, which modulates pain perception and inflammation, potentially offering relief when conventional treatments have failed, as noted in the diagnosis and treatment of low back pain guidelines from the American College of Physicians and the American Pain Society 1.
From the FDA Drug Label
PRINCIPAL DISPLAY PANEL - 59 ML Bottle Box MDSCIENCE™CANNABIDIOLTHE SCIENCE OF HEALTHY CBD 250MG TOTAL CBDMUSCLE AND JOINTPAIN RELIEFCREAM 2FL OZ (59ML) The following are three options for medicinal cannabis products available in Australia to treat chronic back pain:
- Cannabidiol (PO): as mentioned in the drug label 2
- No other options are mentioned in the provided drug label
- No other options can be concluded from the provided information The FDA drug label does not answer the question.
From the Research
Medicinal Cannabis Products for Chronic Back Pain in Australia
There are several medicinal cannabis products available in Australia to treat chronic back pain. Here are three options:
- Sativex, a synthetic combination of cannabidiol (CBD) and Δ9-tetrahydrocannabinol (Δ9-THC) 3
- THC-dominant edible cannabis products, which have been shown to be effective in reducing short-term pain relief 4
- Combination tetrahydrocannabinol (THC)/cannabidiol (CBD) medicines, which have been shown to be effective in treating chronic pain, especially neuropathic and nociplastic pain or pain with an inflammatory component 5
Key Considerations
When considering medicinal cannabis products for chronic back pain, it is essential to note that:
- The effectiveness of THC and CBD in chronic pain is incomplete, and more research is needed to fully understand their potential benefits and risks 6
- Combination THC/CBD medicines have a good tolerability and safety profile relative to opioid analgesics, but should be avoided in patients predisposed to depression, psychosis, and suicide 5
- CBD-only medication has substantial evidence for stress, moderate evidence for anxiety and insomnia, and minimal evidence for depression and pain 5