A Long-Term Alternative to Traditional Pain Medications
Painful diabetic neuropathy (DN) is one of the most debilitating complications of diabetes, causing chronic nerve pain, mobility issues, and disrupted sleep for millions. Despite widespread use of painkillers, including opioids, many patients remain underserved. A new five-year observational study offers hope: inhaled medical cannabis significantly reduced pain and medication dependency in patients with treatment-resistant DN.
Study Design: Real Patients, Real Results
Conducted in Israel between 2018 and 2025, the study followed 52 patients suffering from painful diabetic neuropathy. All had previously failed to find relief through at least three different types of analgesics. After a 1-month washout period, patients began a carefully titrated regimen of inhaled medical-grade cannabis (20% THC, <1% CBD), using vaporizers or smoking as their delivery method.
Follow-ups occurred yearly for five years, tracking pain levels, medication usage, blood sugar control, and safety. A striking 96% of patients completed the full study.
Key Findings: Pain Down, Function Up
The results showed significant improvements across multiple health indicators:
- Pain severity dropped from 9.0 to 2.0 on a 10-point scale.
- Pain interference—how pain disrupted daily life—fell from 7.5 to 2.2.
- Neuropathic symptom score (LANSS) improved by over 9 points.
- HbA1c levels, a key marker of blood sugar control, fell from 9.77% to 7.79%.
Cannabis not only relieved symptoms—it reduced dependency on opioids and other drugs:
- Morphine-equivalent opioid use dropped by 93%.
- Gabapentin, duloxetine, and pregabalin usage fell by over 90%.
Safety and Tolerance
No serious adverse events were reported. A minority of patients (15.4%) experienced mild side effects, such as dry mouth or temporary euphoria, mostly during dose titration. The study found that the treatment was well-tolerated even in patients with multiple chronic conditions, including cardiovascular disease.
The Role of the Endocannabinoid System
The observed benefits likely stem from how cannabis interacts with the endocannabinoid system, which plays a key role in regulating pain and inflammation. THC, the active component in cannabis, binds to CB1 and CB2 receptors located in the nervous system. This interaction appears to block pain signals and reduce nerve damage caused by chronic hyperglycemia.
Why Inhalation Works
Inhalation allows for rapid onset of pain relief—within minutes—and flexible, patient-driven dose adjustments. Unlike edibles or sublingual oils, inhaled cannabis offers quick symptom control, which may be especially useful during pain flares.
What Comes Next
While the study’s design was observational and lacked a placebo group, the consistency of results over five years is compelling. The researchers advocate for randomized controlled trials (RCTs) to confirm findings and fine-tune optimal dosages. They also suggest integrating biomarker tools—such as salivary diagnostics or pupillometry—to improve dosing precision and personalize care.
Bridging Cannabis Science and Daily Wellness
This study adds to a growing body of research suggesting that cannabinoids may offer targeted relief for hard-to-treat conditions. For more on how THC affects chronic pain conditions, check out our article on the brain’s pain filters and fibromyalgia here.
Curious about cannabis outside of medicine? Explore how THC-infused beverages are emerging as a new alternative to alcohol in 2025 in this article.
And if your interest leans toward dermatology, read our science-based review on CBD in skincare and its potential to treat acne and psoriasis right here.
FAQ: Understanding Key Terms
What is THC?
Tetrahydrocannabinol (THC) is the primary psychoactive compound in cannabis. In medical doses, it interacts with receptors in the nervous system to reduce pain and inflammation.
What is HbA1c?
HbA1c is a blood test that reflects a person’s average blood sugar levels over the past 2–3 months. Lower values suggest better diabetes management.
What does “LANSS score” measure?
The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) evaluates symptoms like tingling, burning, and sensitivity to touch, helping diagnose nerve-related pain.
What are morphine equivalents (MEQ)?
Morphine equivalent is a standardized measure of opioid strength. It allows doctors to compare doses across different painkillers.
