CClinicalTrials.gg
CompletedNCT04576507Updated Aug 8, 2025Results posted

Repeated Cannabis Administration on Experimental Pain and Abuse Liability

A Phase 2 interventional study of Active Cannabis and Placebo Cannabis in Cannabis, Pain and Tolerance, sponsored by New York State Psychiatric Institute. Completed at 1 site in United States. Open to participants aged 21 Years to 60 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-08-08.

Sponsored by New York State Psychiatric Institute · Phase 2, Interventional, and Basic science

Phase
Phase 2
Study type
Interventional
Enrollment
10
Allocation
Non-randomized
Ages
21 Years to 60 Years
Sex
All
01

Study summary

Chronic pain is a significant public health concern in the U.S., for which prescription opioids have historically been the standard treatment. This has resulted in striking rates of opioid use disorders and fatal overdoses. Identifying non-opioid medications for the management of chronic pain with minimal abuse liability is a public health necessity, and cannabinoids are a promising drug class for this purpose. More than 80% of medicinal cannabis users report pain as their primary medical indication. These patients tend to seek products that are low in delta-9-tetrahydrocannabinol (THC; the primary psychoactive, and thus intoxicating, component of cannabis), and high in cannabidiol (CBD), a cannabinoid that purportedly has therapeutic benefit for pain but does not produce intoxicating effects. However, there are few well-controlled human laboratory studies assessing the efficacy of high-CBD cannabis for pain in the context of abuse, and even less is known regarding the effects of daily repeated use of cannabis on pain and its relationship to abuse liability.

The proposed randomized, within-subjects, placebo-controlled 16-day crossover inpatient human laboratory pilot study (N = 16 healthy cannabis users; 8 men, 8 women) will address important gaps in our understanding of the potential therapeutic utility of cannabis for pain: 1) If repeated cannabis use can result in hyperalgesia; 2) If tolerance to the analgesic and abuse-related effects of cannabis develops and is reversible. Two distinct modalities of experimental pain will be assessed: The Cold Pressor Test (CPT) and Quantitative Sensory Testing Thermal Temporal Summation (QST-TTS), and participants will smoke cannabis 3x/day. Throughout the study, experimental pain and abuse-related effects will be assessed, as will sleep and subjective mood assessments.

This protocol is currently suspended due to the NYSPI human subjects research pause and results cannot currently be analyzed and posted. Upon un-suspension, we will analyze the data and post results immediately.

02

Conditions studied

  • Cannabis
  • Pain
  • Tolerance
  • Hyperalgesia
03

Who can participate

Ages eligible
21 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Males/non-pregnant females, 21-60 years old
  • Current cannabis user
  • Able to perform all study procedures

Exclusion criteria

Exclusion Criteria:

  • Use of other illicit drugs
  • If medical history, physical and psychiatric examination, or laboratory tests performed during the screening process reveal any significant illness that the study physician deems contraindicated for study participation
  • Insensitivity to the cold-water stimulus of the Cold Pressor Test or the heat stimulus of Quantitative Sensory Testing
04

Study design

Phase
Phase 2
Primary purpose
Basic science
Allocation
Non-randomized
Intervention model
Single group
Masking
None (open label)
Enrollment
10 participants (actual)

Study arms

  • Experimental
    Dose A: Standardization Phase

    On the first full inpatient day (Day 1), participants will smoke one specified strength (Dose A; 75% of active cannabis cigarette, 2.98% THC, 4.91% CBD) of cannabis.

    Drug: Active Cannabis

  • Placebo comparator
    Dose B: Placebo Phase

    Days 2-8 comprises the Placebo phase, in which a second strength (Dose B; 75% of one placebo cannabis cigarette, \<0.01% THC, CBD) of cannabis will be administered 3x/day.

    Drug: Placebo Cannabis

  • Experimental
    Dose A: Active Phase

    Days 9-15 comprise the Active Phase, cannabis Dose A (75% of one active cannabis cigarette, 2.98% THC, 4.91% CBD) will be administered once again, 3x/day.

    Drug: Active Cannabis

Interventions

  • DrugActive Cannabis

    2.98% THC:4.91% CBD cannabis.

  • DrugPlacebo Cannabis

    \<0.01% THC:CBD cannabis.

05

What researchers measure

Primary outcomes

  1. Change in Cold Pressor Test (CPT) Latency

    The CPT apparatus consists of two refrigerated circulators, filled with warm (36.5-37.5°C). participants will complete the CPT 30 minutes before the 1000h cannabis administration (baseline), and 15, 30, 45, 60, and 90 minutes post-cannabis administration. and cold (3.5 - 4.5°C) water. Participants will insert their non-dominant hand into the warm water and remove it after 3 minutes; skin temperature of the thumb pad will be measured. Participants will then insert their hand in the cold water and will be instructed to report when they first experience pain (pain threshold) and remove their hand when the cold water can no longer be tolerated (pain tolerance). Maximum immersion time will be 3 minutes. Data points reported here represent Percent Change in Pain Tolerance from Day 1 (first timepoint, 15 minutes post-cannabis \[2.98% THC / 4.91% CBD\]) across study days (Day 2, 5, 8, 9, 12, and 15). Other timepoints are not reported.

    Time frame: Up to 15 days

Secondary outcomes

  1. Change in Cannabis Rating Form (CRF) Ratings

    Participants rate the "high" experienced as a result of cannabis administration on a 100mm visual analog scale. Data points represent Percent Change from Day 1 (first timepoint, 15 minutes post-cannabis \[2.98% THC / 4.91% CBD\]) across study days (Day 2, 5, 8, 9, 12, and 15) Repeats at days 1, 2, 5, 8, 9, 12, and 15.

    Time frame: Up to 15 days

06

Results

Posted Aug 8, 2025

Participant flow

Participants were recruited between June 2021 and June 2023. Eligible participants were recruited from the New York, NY area and occurred through advertisements in local newspapers, online through Craigslist, RecruitMe, and by word of mouth.

Participant flow — Overall Study
MilestoneDose A - Dose B - Dose A
Started10
Completed5
Not completed5
Withdrew: Adverse event4
Withdrew: Withdrawal by subject1

Outcome measures

PrimaryChange in Cold Pressor Test (CPT) Latency

The CPT apparatus consists of two refrigerated circulators, filled with warm (36.5-37.5°C). participants will complete the CPT 30 minutes before the 1000h cannabis administration (baseline), and 15, 30, 45, 60, and 90 minutes post-cannabis administration. and cold (3.5 - 4.5°C) water. Participants will insert their non-dominant hand into the warm water and remove it after 3 minutes; skin temperature of the thumb pad will be measured. Participants will then insert their hand in the cold water and will be instructed to report when they first experience pain (pain threshold) and remove their hand when the cold water can no longer be tolerated (pain tolerance). Maximum immersion time will be 3 minutes. Data points reported here represent Percent Change in Pain Tolerance from Day 1 (first timepoint, 15 minutes post-cannabis \[2.98% THC / 4.91% CBD\]) across study days (Day 2, 5, 8, 9, 12, and 15). Other timepoints are not reported.

Time frame:
Up to 15 days
Reported as:
Mean · percent change from Day 1 baseline
Change in Cold Pressor Test (CPT) Latency
percent change from Day 1 baselineCPT Pain Tolerance: Day 2CPT Pain Tolerance: Day 5CPT Pain Tolerance: Day 8CPT Pain Tolerance: Day 9CPT Pain Tolerance: Day 12CPT Pain Tolerance: Day 15
Change in Cold Pressor Test (CPT) Latency21.40 ± 24.2210.94 ± 18.812.07 ± 5.8415.17 ± 16.9720.06 ± 25.0730.16 ± 28.67
SecondaryChange in Cannabis Rating Form (CRF) Ratings

Participants rate the "high" experienced as a result of cannabis administration on a 100mm visual analog scale. Data points represent Percent Change from Day 1 (first timepoint, 15 minutes post-cannabis \[2.98% THC / 4.91% CBD\]) across study days (Day 2, 5, 8, 9, 12, and 15) Repeats at days 1, 2, 5, 8, 9, 12, and 15.

Time frame:
Up to 15 days
Reported as:
Mean · score on a scale
Change in Cannabis Rating Form (CRF) Ratings
score on a scaleDay 1 Cannabis Rating Form: "High"Day 2 Cannabis Rating Form: "High"Day 5 Cannabis Rating Form: "High"Day 8 Cannabis Rating Form: "High"Day 9 Cannabis Rating Form: "High"Day 12 Cannabis Rating Form: "High"Day 15 Cannabis Rating Form: "High"
Change in Cannabis Rating Form (CRF) Ratings14.60 ± 7.539.6 ± 7.75617.60 ± 12.6611.20 ± 8.1630.80 ± 10.2942.00 ± 18.2041.40 ± 15.84

Adverse events

Collected over Information on adverse events was collected continuously for the duration of study participation for each participant, which was approximately 1 month (screening through study completion). All participants received the same order of drug administration and as such, are reported under one condition.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
All Participants0/10 (0%)0/10 (0%)4/10 (40%)
Most frequent other events
Most frequent other events
EventAll Participants
High blood pressureCardiac disorders1/10
Acid refluxGastrointestinal disorders1/10
High blood pressureCardiac disorders1/10
High blood pressureCardiac disorders1/10

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Dose A - Dose B - Dose A
<=18 years0
Between 18 and 65 years5
>=65 years0
Sex: Female, Male
Sex: Female, Male(Participants)Dose A - Dose B - Dose A
Female1
Male4
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Dose A - Dose B - Dose A
Hispanic or Latino2
Not Hispanic or Latino3
Unknown or Not Reported0
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Dose A - Dose B - Dose A
American Indian or Alaska Native1
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American3
White0
More than one race0
Unknown or Not Reported1
Region of Enrollment
Region of Enrollment(Participants)Dose A - Dose B - Dose A
United States5
07

Study locations

1 site
  • New York State Psychiatric Institute
    New York, New York 10032, United States
08

References and documents

Study documents

  • Study protocol · Feb 10, 2025
  • Statistical analysis plan · Apr 14, 2025

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Undecided

09

Registry details

Key details

Study ID
NCT04576507
Lead sponsor
New York State Psychiatric Institute
Collaborators
Alkermes, Inc.
Responsible party
Caroline A. Arout, Ph.D. (Assistant Professor of Clinical Neurobiology (in Psychiatry), New York State Psychiatric Institute) — Principal investigator
First posted
Oct 6, 2020
Start date
Jun 1, 2021
Primary completion
Dec 31, 2023
Completion
Dec 31, 2023
Results posted
Aug 8, 2025
Last update
Aug 8, 2025

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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