Brain Mechanisms Supporting Cannabis-induced Pain Relief

Chronic low back pain is a common and disabling condition that affects millions of people in the United States. Many people with chronic low back pain do not get enough relief from current treatments. Cannabis may help reduce pain, but researchers do not fully understand how it affects the brain in people with chronic pain. The purpose of this study is to examine how inhaled cannabis changes brain activity and reduces pain in people with chronic low back pain. Results from this study may help researchers better understand how cannabis works for pain and support the development of improved pain treatments.

Chronic low back pain is one of the most common causes of pain and disability in adults. Unfortunately, treatments that can directly reduce chronic low back pain remain limited. Cannabis has shown promise for pain relief, but researchers do not yet fully understand how it affects the brain or reduces pain in people with chronic pain.

The purpose of this study is to examine how inhaled (vaporized, not smoked) cannabis affects pain responses and brain activity in adults with chronic low back pain. Researchers will compare the effects of cannabis containing tetrahydrocannabinol (THC) to a placebo cannabis containing 0% THC.

This study involves one visit to the Keck Center for Functional MRI at UC San Diego. Participants will complete screening procedures, questionnaires, and pain testing using heat stimulation applied to the calf. Participants will be trained to rate their pain intensity and unpleasantness. A straight leg raise maneuver will also be performed to assess low back pain and any pain radiating down the leg.

Participants will inhale either THC-containing cannabis or placebo cannabis (no THC) using a vaporization device under study staff supervision. Brain imaging, heat pain testing, leg raise assessments, and pain ratings will be collected before and after cannabis administration to evaluate changes in pain processing and brain activity. Researchers will also assess self-reported pain, mood, sleep, stress, and cannabis-related effects using standardized questionnaires.

This study may improve understanding of how cannabis influences the brain and pain systems in people with chronic low back pain, and findings may help support the development of improved treatments for chronic pain.