New Research on THC and CBD for Various Conditions: November’s Healer Webinar

The November installment of the monthly Healer webinars, hosted by Dustin Sulak, DO, covered multiple published studies on cannabis for various conditions including diabetic neuropathy, chronic back pain, and opioid induced persistent apnea. The webinar also covered recent research in cannabinoids and Alzheimer’s disease symptoms.

Inhaled Cannabis and Diabetic Neuropathy (DN)

The first study discussed in the webinar, “Long-Term Efficacy and Safety of Inhaled Cannabis Therapy for Painful Diabetic Neuropathy: A 5-Year Longitudinal Observational Study,” was published in Biomedicines in September 2025. Here, 52 patients with confirmed painful DN that had not responded to at least three prior interventions consumed inhaled medical-grade cannabis (20% THC, <1% CBD), which had been titrated to each individual. Assessments for pain severity and relief were conducted at baseline and annually for five years. Significant reductions in pain severity were seen, as well as reduction in pain medication. Additionally, improvements in glycemic control was also seen, and no serious adverse effects were reported. Dr. Sulak pointed out that there was no control group, but that the results showed a promising long-term alternative. “This is a cohort that was highly refractory to standard care,” he stated. “The question is, would cannabis work as well when people that had less severe symptoms? This is not super high dose, but relatively high dose inhaled THC dominant cannabis.”

THC and Chronic Low Back Pain (CLBP)

The next study, “Long-Term Cannabis Therapy for Chronic Low Back Pain: A10-Year Prospective Study,” was published in Integrative Medicine Reports in September 2025. In this study, 168 adults with CLBP and anatomical abnormalities, such as herniated disc, consumed inhaled cannabis or edibles (20% THC, mean dose of 50 ± 10 g per month, range 30–100 g), which was titrated individually. Core strengthening exercises were recommended. Pain, disability, and opioid use were measured at baseline and then at 1, 3, 12, 24, 60, and 120 months. At 10 years, pain was significantly reduced, quality of life was improved, and opioid use decreased from 91% to 8.2%. “These findings highlight cannabis as a viable long-term alternative to traditional analgesics,” Dr. Sulak explained. “They highlight the role in personalized medicine, being able to adjust the dose for tolerance and side effects, being able to switch between oral and inhaled." He also noted that in Israel, where the study was conducted, doctors control how much cannabis is dispensed to the patient.

CBD Pretreatment for Opioid Induced Persistent Apnea (OIPA)

The final study, “Proof of concept for high-dose Cannabidiol pretreatment to antagonize opioid induced persistent apnea in mice,” was published in Frontiers in Neuroscience in October 2025. Currently, the study explained, “the only way to restore breathing following an opioid induced persistent apnea is with the administration of the opioid antagonist naloxone.” This rodent model study evaluated the effect on breathing frequency of mice given a dose of fentanyl and pretreated with saline, CBD (250 mg/kg), naltrexone, a combination of CBD and naltrexone, or a control. CBD was found to be as effective as naloxone in preventing breathing suppression from fentanyl in awake mice. CBD also increased the LD₅₀ (median lethal dose) of fentanyl in anesthetized mice, even more so when combined with naloxone.

Dr. Sulak noted the importance of these results in the context of providing options for individuals who use opioids. “CBD administration prior to opioid use may decrease the incidence of opioid induced persistent apnea and fatality without significantly affecting analgesia, euphoria, or precipitating acute withdrawal,” he explained. “Why is this important? Is there something we could give people with their opioid, maybe even put it into the same tablet or capsule, that would make that opioid safer? Or if it's someone that has opioid use disorder that's maybe receiving methadone or Suboxone, or maybe they're still using opioids illegally, but they want to do something that's going to make their use safer, could we do it without interfering with the reason they're using the opioids? Because they're not going to take it if it's blocking the pain relief, and if it's blocking euphoria, it's not a good candidate. CBD is not likely to do that, so it makes it a very good candidate.”