Abstract Details

Title Medical Cannabis in the Treatment of Post-Traumatic Concussion

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-027

Objective

Examine medical cannabis (MC) as treatment for concussion-related chronic pain in an established MC clinic.

Background Individuals with concussion often experience chronic discomfort from post-traumatic headaches. MC treatment was approved for use in chronic pain by New York State in March 2017. DENT has treated 5,260 patients with MC, including 4,017 for chronic pain and 399 with concussion symptoms.

Design/Methods

A retrospective analysis of post-traumatic concussion patients with active MC treatment (N=70) and those without MC treatment (N=33) was conducted. In total, 103 charts were reviewed, with a total of 150 expected by presentation in May.

Results

The Patient Global Impression of Improvement (PGI-I) scale revealed 70% of patients experienced significant improvement in activity level and symptoms. Five common concussion symptoms (headache, mood, sleep, attention/concentration, and dizziness) were tracked. MC treatment provided the greatest improvement to sleep (80%), headache (77%), and mood (77%). Quality of Life (QOL) after Brain Injury Score (QOLIBRI) scores were obtained for both groups. This comparison showed a significant improvement (p=0.0002) in QOL of individuals on MC. Of the 21 patients on opioid pain medications, 38% of patients decreased or discontinued these medications. For the 69 patients on other concussion related medications, 13% decreased or discontinued those medications. The routes of administration that produced optimal benefit were 20:1 (THC:CBD) oral tincture at an average dose of 1.6 milliliters TID for prophylaxis and 20:1 vapor inhalation pen for acute pain. Together these products cost an average of $221 per month. Side effects were reported in 19% of patients, all minimal, with 40% related to administration route (poor taste, cough). No patients discontinued MC due to side effects.

Conclusions

Results support MC as an option for treatment of concussion-related chronic pain. While prospective studies are required, these preliminary results lay the foundation for investigating MC as a valid treatment for concussion-related pain.

Authors/Disclosures
Jennifer W. McVige, MD, FAAN (Dent Neurological Institute) PRESENTER	Dr. McVige has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. McVige has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AbbVie. Dr. McVige has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for UCB. Dr. McVige has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Neurelis. The institution of Dr. McVige has received research support from Amgen. The institution of Dr. McVige has received research support from Eli Lily. The institution of Dr. McVige has received research support from Biohaven/Pfizer. The institution of Dr. McVige has received research support from Lundbeck. The institution of Dr. McVige has received research support from Dent Family Foundation. The institution of Dr. McVige has received research support from Abbvie. The institution of Dr. McVige has received research support from Teva. The institution of Dr. McVige has received research support from Theranica. Dr. McVige has a non-compensated relationship as a Neurology Board with UCNS that is relevant to AAN interests or activities. Dr. McVige has a non-compensated relationship as a Board Exam Board Member with ABPN that is relevant to AAN interests or activities.
Dilpreet Kaur-Spencer, MD (Madigan Army Medical Center - JBLM)	No disclosure on file
Paul B. Hart	Mr. Hart has nothing to disclose.
Michael Lillis, Jr., LMHC (Dent Neurologic Institute)	No disclosure on file
Laszlo Mechtler, MD, FEAN, FASN, FAHS, FAAN (Dent Neurologic Institute)	Dr. Mechtler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Impel Pharma. Dr. Mechtler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Mechtler has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Genomate Health. The institution of Dr. Mechtler has received research support from The Harry Dent Family Foundation, Inc. The institution of Dr. Mechtler has received research support from Alpheus medical. The institution of Dr. Mechtler has received research support from Shiratronics. The institution of Dr. Mechtler has received research support from Abbvie Inc. The institution of Dr. Mechtler has received research support from Amgen. The institution of Dr. Mechtler has received research support from Eli Lilly Company. The institution of Dr. Mechtler has received research support from H. Lundbeck HS. The institution of Dr. Mechtler has received research support from Pfizer. Dr. Mechtler has received personal compensation in the range of $100,000-$499,999 for serving as a Ownership interest with Neurology Practce Consortium GPO. Dr. Mechtler has a non-compensated relationship as a Board member with International Headache Society that is relevant to AAN interests or activities.
Vincent H. Bargnes III	Mr. Bargnes has received research support from Harry Dent Family Foundation.
Said Shukri, MD (University of Michigan)	Dr. Shukri has nothing to disclose.

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