Cannabinoids and pain management
Theresa Mallick-Searle
Stanford Health Care, USA
: Analg Resusc: Curr Res
Abstract
The use of cannabis (marijuana) or of its psychoactive ingredient delta-9-tetrahydrocannabinol (THC) as a medicine has been highly contested in many settings. Preclinical and clinical studies have suggested that cannabinoids may be useful in treating diverse diseases, including those related to acute or chronic pain. The endo cannabinoid system (ECS) is now recognized as an important modulator of various central nervous system processes. More recently, an increasing body of evidence has accumulated to suggest antioxidant, anti-inflammatory, antineuropathic and neuroprotective roles of ECS. Cannabinoid receptor agonists have more capacity for suppressing pathophysiologic mechanisms like the windup phenomenon linked to chronic neuropathic pain (Strangman et al., 1999). Behavioral studies have shown that cannabinoids reduce thermal and mechanical allodynia in rat models of neuropathic pain. Recent clinical studies provided evidence that cannabinoid based medicine with controlled doses of plant derived cannabinoids can provide symptomatic relief in a subset of patientssuffering from pain, and there is hope based on preclinical studies that these medications would also positively modulate disease progression. Cannabis was a part of the American pharmacopoeia until 1942 and is currently available by prescription in Canada and many countries in Europe. In 1997, The Office of National Drug Control Policy commissioned the Institute of Medicine to conduct a comprehensive study of the medical efficacy of cannabis therapeutics. The IOM concluded that cannabis is a safe and effective medicine, patients should have access, and the government should expand avenues for research and drug development.
Biography
