Cannabis Edibles Can Ease Pain and Improve Sleep for Cancer Patients

Over-the-counter edible cannabis products can help cancer patients manage their symptoms and the side effects of chemotherapy, according to a study.

Published in Exploration in Medicine, the study assessed 25 cancer patients in Colorado who were asked to buy and consume their own legal cannabis edibles.

After two weeks of cannabis use, the patients reported significant improvements in their sleep and cognition as well as reductions in their levels of pain.

Cannabis for chemo

To begin their study, the researchers from the University of Colorado, Boulder, recruited 25 cancer patients via ads in oncology clinics and posts on social media. The patients’ cancers ranged from lung to colon, to brain and breast.

Before their cannabis use, all participants completed a survey to assess their levels of sleep quality, psychological functioning, pain intensity and overall quality of life.

The 25 patients were then asked to buy their own edible cannabis products – the quantity was up to them – from state retailers and consume the edibles at their own leisure. The products ranged across 18 brands and included chocolates, gummies and tinctures with a variety of THC:CBD ratios.

After two weeks of cannabis use, the participants completed another survey. The research team then compared the results from both questionnaires.

Measurement tools and laboratory methods

The following laboratory tools and methods were used in the study to investigate a link between edibles and chemo:

• Self‑reporting – Structured questionnaires at baseline and two weeks quantified sleep quality, pain intensity and interference, psychological functioning and quality of life, including subjective cognition.
• Objective cognition – Standardized computerized interference tasks yielded reaction time and accuracy metrics capturing acute and sustained changes.
• Biochemical verification – In in‑person sessions, venous blood was collected pre‑ and post‑ingestion. Plasma THC and CBD were quantified via liquid chromatography mass spectrometry with sub‑ng/mL limits of quantification.
• Data and analytics – Electronic capture platforms and mixed‑effects models estimated within‑person change over two weeks and acute pre‑ to post‑ingestion effects. Cannabinoid‑specific covariates probed differential associations.

Key findings relevant to edibles and chemo

The researchers found that participants experienced, on average, a significant boost in sleep quality, especially those who consumed CBD-rich edibles.

High-CBD products also seemed to treat the pain many patients were experiencing; the participants who used CBD-rich products reported steeper reductions in pain intensity.

To their surprise, the researchers also observed a significant boost in the patients’ perceived cognitive abilities.

“We thought we might see some problems with cognitive function,” Dr. Angela Bryan, a professor of psychology and neuroscience at the University of Colorado, Boulder, and co-author of the study, said in a statement.

“But people actually felt like they were thinking more clearly. It was a surprise.”

Credit: iStock.

Bryan and her colleagues have linked the participants’ gains in cognition to their reductions in pain; the more people’s pain subsided, the more their thinking seemed to improve.

Other survey measurements didn’t change much post-edibles, however. The participants reported no significant differences in their quality of life, for instance, and the edibles’ effects on anxiety and depression were considered marginal.

Overall, though, Bryan and her colleagues concluded that over-the-counter edibles could provide a significant benefit to cancer patients experiencing pain and poor sleep. They say further, more rigorous studies will be needed to confirm this conclusion, however.

“We know oncologists and patients are concerned about the possible negative impact of cancer treatment on cognitive function, so the potential, indirect role of cannabis use on improving subjective cognitive function should be studied further,” Gregory Giordano, a professional research assistant at the University of Colorado, Boulder, and lead author of the study, said in a statement.

Mechanistic context

Receptor targets and analgesia

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THC engages CB1 receptors in the central nervous system and CB2 receptors peripherally, modulating nociception and inflammatory signaling. CBD modulates TRP channels, 5‑HT1A and adenosine uptake and may attenuate THC‑related dysphoria and cognitive impairment via pharmacodynamic and pharmacokinetic mechanisms. These complementary actions help explain why balanced or CBD‑rich edibles are attractive during chemotherapy when minimizing cognitive burden is a priority.

Pharmacokinetics and drug–drug interactions

Oral ingestion yields slower onset (typical peak ~1–2 hours) and prolonged duration due to first‑pass metabolism with formation of 11‑OH‑THC and other metabolites. THC and CBD are substrates and inhibitors of CYP2C9, CYP2C19 and CYP3A4. At higher daily doses, CBD can inhibit CYP3A4/CYP2C19, and THC can inhibit CYP2C9/CYP3A4. In oncology regimens reliant on these enzymes (e.g., some tyrosine kinase inhibitors, certain antiemetics, corticosteroids and adjuncts), the potential exists for pharmacokinetic interactions.

Cannabis and cancer pain

The Boulder study is thought to be one of the first to measure the effects of commercially available cannabis products; most cannabis-cancer studies use clinical cannabinoid formulations, and these studies have come to conflicting conclusions.

One systematic review of six randomized controlled trials, published in 2020, found that cannabinoid formulations were no different to placebos when it came to changing cancer patients’ average pain scores.

“I think there is great interest in cannabinoid medicines from the general public at the moment,” Mike Bennett, a professor of palliative medicine at the University of Leeds and co-author of that review, told Analytical Cannabis at the time. “But in cancer pain, using this particular product, we can’t see a positive benefit.”

Bennett did hint at the time, however, that other kinds of cannabis products – other than the medical-grade extracts used in the six trials – may offer a benefit to cancer patients.

“So, I think for now, the evidence doesn’t support these cannabinoid medicines for the management of cancer pain. But I can imagine that more research using different sorts of cannabinoid products and different outcome measures might need to be done to me more certain.”

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