The effect of medical cannabis on chronic pain is very well researched. Therefore, it is considered a therapeutic option with few side effects in the treatment of chronic pain. An observational study from Canada proofed that again.

What is the difference between acute and chronic pain?

Acute pain is caused by an injury or damage and is usually limited to the place of origin, such as a broken leg. The intensity of pain depends on the injury. The pain ends when the injury has healed.

We speak of chronic pain if it persists for at least three months. The causes are usually not apparent or the pain persists even though the cause has been eliminated. As a result, an independent disease forms and the brain develops a pain memory.

Treatment of chronic pain

Often the therapy shapes difficultly. Therefore, multimodal therapy, i.e. a combination of different treatments, is commonly used. These include, for example, physical therapies, psychological therapies or complementary procedures such as naturopathic treatment.

In addition to these therapy options, drugs also play an important role in pain medicine. Classic pain medication such as paracetamol, ASS or ibuprofen can relieve pain. However, these drugs can cause serious side effects if taken over a long period of time. Opioids or opiates are also often prescribed for very severe pain, which can not only cause severe side effects but also have a high potential for addiction.

Results of the study

Canadian researchers from Toronto have worked on a prospective observational study with 751 chronic pain patients over a period of 12 months who started medical cannabis treatment. The results show that the patients' pain severity improved after one month of treatment and did not worsen over the 12-month period. Within three months, significant improvements in physical and mental health were also observed. In addition, symptoms such as headaches, anxiety, nausea and fatigue decreased in patients.

Particularly interesting is that patients taking opioid drugs were able to reduce the dose by using medical cannabis.

Insomnia that persists for a long period of time can seriously endanger your health. In a randomized double-blind clinical trial, researchers have now been able to show that treatment with medical cannabis can be effective.

There are multiple causes of chronic sleep disorders. Often, they are triggered by psychological strain, stress and unfavourable sleeping conditions. Various neurological diseases, such as restless legs syndrome or chronic pain, can also make it difficult to fall asleep and prevent people from getting a good night’s sleep. Similarly, the use of medications (e.g. thyroid hormones or antidepressants) and illegal drugs can also cause sleep problems.

Due to the lack of sleep, symptoms such as tiredness during the day, nervousness, inner restlessness as well as concentration and comprehension problems can occur. Sleep disorders can also affect mental stability, resulting in depression or anxiety disorders. The immune system also suffers from sleep disorders.

Treatment of insomnia

The therapy depends on the cause. If psychological problems are present, psychotherapy or cognitive behavioural therapy may be appropriate. Learning relaxation techniques (e.g. autogenic training or meditation) can also be helpful for those affected.

It is also important for those affected to pay attention to a healthy diet and proper sleep hygiene. With the help of special rules of conduct, those affected can promote healthy sleep.

As a rule, sleeping pills are only used in severe cases, as they lose their effectiveness after a short time and also quickly become accustomed. It is also problematic that the sleep disorders reappear when the medication is discontinued.

Medical cannabis as a therapeutic option

In a recent randomized double-blind clinical trial, 23 subjects were treated with medical cannabis for 14 nights. After a one-week rinsing phase, they again received a placebo for 14 nights. The subjects took a single dose of 11.5 milligrams of cannabinoids or a double dose of 23 milligrams of cannabinoids using a sublingual solution.

The results show that the volunteers treated with medical cannabis fell asleep more quickly and also slept significantly longer. The volunteers also reported that their quality of life improved, they felt less stressed and less tired. They also felt better rested after sleep.

The results of a placebo-controlled study by the Center for Applied Health Science in Stow, USA, stated that cannabis extracts containing CBD improved HDL cholesterol levels of volunteers.

Cholesterol is a fat-like substance that is involved in numerous important tasks in the organism, such as metabolic processes in the brain. At the same time, however, cholesterol is also an important starting material for the formation of vitamin D and certain hormones (e.g. testosterone and oestrogen) and for the production of bile acids for fat digestion.

Cholesterol can only be transported in the blood if the fat-like, water-insoluble substance (lipid) combines with the water-soluble proteins. The resulting lipoproteins are classified according to their different densities, depending on their protein content, into Very-Low-Density-Lipoproteins (VLDL), Low-Density-Lipoproteins (LDL) and High-Density-Lipoproteins (HDL).

Because of its high lipid content, LDL is also called “bad” cholesterol and HDL is called “good” cholesterol. If the LDL cholesterol level in the blood is permanently elevated, vascular calcifications can develop. As a result, cardiovascular diseases, heart attacks and strokes can occur.

Results of the study

The study involved 65 overweight participants. They received either a hemp oil extract [hemp, 60 mg/d PlusCBDTM hemp oil extract (15 mg hemp-derived CBD)] or a placebo daily for six weeks. Every participant should maintain their eating habits and sporting activities and not change them.

In the hemp CBD group, HDL cholesterol improved significantly. In addition, the participants from this group reported that feelings of stress were reduced. The quality of sleep had also improved.

The researchers also stated that the hemp-CBD combination was well tolerated by the volunteers.

It is estimated that approximately 60% to 80% of the population in Germany suffer from recurring or chronic back pain. In most cases, the main causes of the complaints are muscle tensions or hardenings, signs of wear and tear or slipped discs, which are caused by lack of movement and improper posture.

In the past, various studies have investigated the effectiveness of cannabinoid-containing drugs for chronic pain. In 2017, researchers presented an evaluation of 11 randomized controlled trials. This states that patients with chronic pain, in which conventional pain therapy no longer showed a positive effect, could benefit from therapy with selective cannabinoids such as nabilone, nabiximole and dronabinol.

In addition to the reduction in pain intensity under cannabinoid therapy, the quality of sleep also improved. As a result, patients reported an improvement in the general quality of life.

From the findings, the researchers concluded that therapy with cannabinoid-containing drugs could be considered if other pain therapies did not show sufficient outcomes.

Case studies with two patients

Doctors from the Portsmouth Anesthesia Associates in Virginia (USA) have presented case studies with two patients suffering from chronic back pain. One patient suffered a lumbar compression fracture and another patient complained of chest pain with dysesthesia due to a surgically resected meningioma.

To relieve the pain, the doctors administered CBD cream to both patients. This contained 400mg of CBD per 2oz , which is approximately 1.4% CBD.

The results show that regular application of the transdermal CBD cream led to significant pain relief in both patients.

https://pubmed.ncbi.nlm.nih.gov/28537982/
https://pubmed.ncbi.nlm.nih.gov/32421842/

Abrupt withdrawal of cannabidiol (CBD) is not associated with physical withdrawal symptoms

The abrupt withdrawal of CBD is not associated with physical withdrawal symptoms in healthy subjects, according to a recent clinical study.

A team of researchers from the United Kingdom and the United States assessed the occurrence of withdrawal symptoms caused by the abrupt withdrawal of CBD. The subjects in the study were healthy people who took 750 mg of herbal CBD twice daily for four weeks. Study participants either continued to receive CBD or received a placebo in weeks five and six.

The researchers did not report any serious adverse events due to the discontinuation of CBD.

They concluded that healthy subjects had no evidence of withdrawal syndrome when short-term CBD treatment was abruptly discontinued.

source: https://www.ncbi.nlm.nih.gov/pubmed

The magazine “Medical Cannabis Network” from Health Europa is one of the best-known sources of information on medical cannabis in Europe. An article published in the current issue now reports on the history of CanPharma’s origins, goals and visions and an exclusive interview with COO and co-founder Stefan Jacker.

CanPharma was one of the first European companies to focus on medical cannabis. The patient is always in the foreground. As wholesaler/distributor CanPharma imports medical cannabis and delivers it to pharmacies all over Germany to supply patients with cannabis of pharmaceutical quality.

“We see ourselves as a vertically integrated, data-driven pharmaceutical company for medical cannabis and have one goal: to bridge the gap between plant and patient. CanPharma wants to offer its patients a therapy tailored to their individual needs – this is also our top priority in the development of our product portfolio,” says Dr. Henrik Sprengel, CEO and co-founder of CanPharma.

Due to the constantly increasing demand, it was then a logical consequence for CanPharma to push ahead with research and bring its own products to market. With the help of its subsidiary KSK Labs, CanPharma therefore researches and develops prescription cannabis-based drugs that meet the highest quality standards.

Another central branch of the company’s strategy is to introduce new brands and additional product lines in the wellness sector together with KSK Labs, in addition to the existing brands myCBD and CBDinol.

Future projects of CanPharma

CanPharma’s future projects will focus on three important aspects, namely the education and training of physicians, further research on the cannabis plant and its spectrum of effects, and the expansion of the network with physicians and researchers.

Kalapa-Clinic plans to expand its telemedical services

In addition, the Kalapa Clinic in Barcelona, an independent part of the CanPharma group, also receives attention in the article. The Kalapa Clinic was founded in 2015 with a team operating throughout Europe. This team consists of medical specialists and cannabis researchers. The focus is on the consultation and support of cannabis patients and doctors via Skype or on site in Barcelona in six languages. In the course of this year the Kalapa-Clinic plans to expand their telemedical services.

The full article including the interview with Stefan Jacker can be found here.

CanPharma extends its high-quality product range with the certified full spectrum extract, CBDinol. CBDinol with a CBD concentration of 6% (PZN 16353901) or 15% (PZN 16353870) is now exclusively available for pharmacies from CanPharma.

CBDinol is made from EU certified hemp and has no psychoactive effect due to its THC content of less than 0.2%. It is well tolerated and easy to use. CBDinol consists of extracted hemp seed oil and contains the entire spectrum of cannabinoids, terpenes and nutrients. This is guaranteed by a gentle manufacturing process and responsible cultivation of the hemp plants.

CBDinol is obtained from a special extraction process using ethanol, with no addition of any additives. All product batches are laboratory tested to ensure the highest possible quality and stability of the product. The hemp plants are free from GMOs and chemical fertilisers, and are also free from gluten, preservatives and dyes. The production runs accordingly to strict European standards.

www.cbdinol.com

Legal Medicinal Cannabis in Europe

As the cannabis market has boomed and new scientific discoveries arise, legislation has become a topic in question which has put a lot of pressure on governments around Europe.

International Drug Policy Consortium Regulations

There are two main kinds of regulation that the International Drug Policy Consortium (IDPC) have established in 2018. The first one comes from the government’s will to improve public health which has resulted into policy. In certain cases, recreational cannabis goes hand in hand with this as well, for example, Canada. The second one comes from the social pressures and the citizen’s initiative to fight for the legalisation which is essentially the case in the UK in which they offer a legal license to patients who comply with strict requirements.

The difficulty in legalising medicinal cannabis

Back in 1961, cannabis was under the Single Convention on Narcotic Drugs meaning it was internationally prohibited, essentially putting an end to medical and scientific research. From this ban, for countries to be able to adopt to the new regulations, there must be irrefutable evidence showcasing the therapeutic uses of the substance. Without the backing of a strong scientific foundation, legalising medicinal cannabis can become challenging.

A few European countries are close to regulating medicinal cannabis

• The United Kingdom

In the UK, the Department of Health was forced to grant emergency licences to two severe cases of epilepsy in children which consequently began a process to allow access to the medicine. However, this is only allowed in certain conditions such as refractory epilepsy, spasticity, multiple sclerosis and chemotherapy induced nausea and vomiting. It is also necessary for the patients to have undergone all kinds of conventional treatments which have failed. After presenting all the necessary documents, only the Department of Health can determine if the patient can gain access.

• Germany

Medicinal cannabis was legalised in Germany in 2017 and is one of the first countries to regulate medicinal cannabis in public and private health sectors. To begin treatment, patients must go through a health insurance company, which will then be reimbursed by the government. Cannabis cultivation is also allowed if companies have enough experience.

• Italy

In 2015, the Italian Minister of Health released a legislation wherein physicians are able to prescribe patients with medicinal cannabis only if the condition can be backed by scientific literature. Similar to the UK, it is only available if previous treatment has failed.

• Denmark

In 2018, the Danish Parliament released a 4-year programme allowing doctors to prescribe medicinal cannabis products only if standard treatments have failed.

• Netherlands

The Netherlands is the only country that does not have the stigma that other countries may have, and doctors’ reputations aren’t tarnished if they prescribe medicinal cannabis. Cannabis in the Netherlands is under a lower classification drug compared to other countries and can also be prescribed by doctors if previous standard treatments have failed.

Is medicinal cannabis a necessity?

The World Health Organisation (WHO) as well as the Expert Committee on Drug Dependence (ECDD) has recommended for cannabis to be removed from the highest classification of drugs and that its therapeutic importance should be recognised. The European Parliament has also made it known that cannabis is a medicinal necessity. On that, as many important entities have had similar statements, medicinal cannabis should be seen as a necessity by everyone.

Source: https://www.kalapa-clinic.com/en/use-medical-cannabis-legal-framework/

Will medical cannabis be legalised in the European Union?

As cannabis is on the rise in demand, EU governments still remain deeply divided in their attitudes to cannabis which is hindering the process of legalisation. Many patients, and even scientists, have pleaded for the use of cannabinoids to treat certain conditions which greatly benefit and improve the symptomologies of pathologies such as cancer pain, depression, sleep and neurological disorders. From this, a few countries have already allowed, or are in the process of allowing, medical cannabis for certain illnesses including the UK, Ireland, the Netherlands and France. Some think that legalising cannabis production will be the best option in order to be able to regulate consumption, enable prevention and even create economic opportunities in agriculture.

Will recreational cannabis use be legalised?

Due to the stigma around the cannabis plant, the government is still divided because the people are divided. With appropriate legal framework, the legalisation of recreational use can benefit society by ensuring that safe products are sold to consumers and phase out black markets. In other words, complete legalisation may be the most efficient way to regulate cannabis, not leaving people at the mercy of the black market. A prime example of this is Canada, who have legalised and regulated and have greatly benefited from this decision.

Source: https://www.politico.eu/article/high-time-for-legal-cannabis-in-europe-weed-marijuana-health-care-eu-brussels/

The World Anti-Doping Agency has officially removed cannabidiol from the 2020 list of prohibited substance

The World Anti-Doping Agency (WADA) has recently published the new list of prohibited substance for the new year. Even though it still states that all natural and synthetic cannabinoids are banned, cannabidiol (CBD) is an exception. Tetrahydrocannabinols (THCs) are still on the list whether natural or synthetic as it has been thought to cause respiratory illnesses due to vaping. However, under the US federal law, if CBD contains less than 0.3% THC, it is legal.

THC still under investigation

THC, the psychoactive compound, has raised certain concerns due to its relation to respiratory illnesses. THC, CBD and even nicotine, mixed with other chemical substances within e-liquids can be a possible factor to these illnesses. However, this is still under investigation.

Source: https://sputniknews.com/sport/201910011076930256-cannabidiol-excluded-from-wadas-2020-prohibited-substances-list/