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20/Feb/2024

Cannabinoids in neurology

Since 2017, doctors in Germany have been able to prescribe cannabis flowers and extracts as well as synthetic cannabinoids to patients for the treatment of various serious illnesses. However, according to the current state of knowledge, such treatment is only covered by health insurance companies in rare cases. The prerequisite is a sensible use of the treatment as well as the condition that “a generally recognized treatment corresponding to the medical standard is not available, cannot be used in the individual case […] after weighing up the expected side effects and taking into account the clinical picture […] and there is a not entirely remote prospect of a noticeable positive effect on the course of the disease or on serious symptoms”. (1).

Neurological diseases for which medical cannabis is already approved for treatment in Germany include epilepsy, Dravet syndrome, pharmacotherapy-resistant epilepsy syndromes and multiple sclerosis (2).

In principle, any doctor in Germany can prescribe cannabinoids (THC). However, for final reimbursement by the health insurance company, prior authorization for the prescription must be obtained from the respective health insurance company. Around 40 % of these applications are not approved.

Study situation

In the treatment of neurological diseases, the study situation on the long-term effects is particularly important, as one-off or short-term use in such cases would only bring a short-term improvement/relief of symptoms for those affected. To date, there is little information on the long-term effects of medical cannabis use. A meta-analysis of non-cancer chronic pain suggests that long-term use is likely to be safe. However, the studies included in the analysis were based on a maximum observation period of 12 months. The different studies also show different results with regard to the use of cannabinoids in multiple sclerosis.

Two large national patient surveys on the use of cannabinoids in Parkinson’s disease show that the treatment may be particularly useful for treatment-resistant non-motor symptoms such as pain, sleep disturbances or anxiety, as well as for improving motor symptoms.

Overall, there is only limited, clear evidence of a “general, safe” mode of action of cannabinoids in neurology (2).

Conclusion

In principle, it should be noted that all effects of medical cannabis use are influenced by several factors. The frequency of use, the THC content, the age of the user and individual susceptibility must therefore be taken into account when making general statements about possible effects/side effects. In the treatment of neurological disorders, there is a fundamental risk of cognitive impairment, especially in younger people. Although THC-containing cannabinoids also appear to be generally well tolerated in the above-mentioned patient survey, further high-quality studies are urgently required in order to create a valid database.

In principle, however, patients with severe symptoms should not be denied access to this therapeutic option if other therapeutic approaches have proven to be inadequate, especially since the response to treatment varies from case to case and there is already growing evidence that medicinal cannabis can have a positive effect on the symptoms of neurological diseases.

 


References:

1 – Bundestag Deutschland (2017): Deutscher Bundestag. Gesetz zur Änderung betäubungsmittel-rechtlicher und anderer Vorschriften (06. März 2017)  

2 – Hidding, U., Mainka, T., & Buhmann, C. (2024): Therapeutic use of medical Cannabis in neurological diseases: a clinical update. Journal of neural transmission (Vienna, Austria : 1996), 131(2), 117–126.  URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10791790/. 


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15/Feb/2024

Supporting gut health with medicinal cannabis in people with advanced cancer


The potential of medicinal cannabis to support gut health in people with advanced cancer is an exciting area of research for many sufferers, with some positive results already available. A study published in 2024 looked specifically at how medicinal cannabis could be used to control mucositis and prevent the associated symptom complex.


Mucositis

One of the side effects of conventional cancer treatment with chemotherapy is damage to healthy tissue, which often leads to a breakdown of the mucosal barrier of the gastrointestinal tract, known as mucositis. This is due to rapid and extensive DNA damage in highly proliferative stem cells throughout the gastrointestinal mucosa. The resulting cell death and inflammation leads to the breakdown of the mucosa and the formation of lesions in the mouth, esophagus, intestines and rectum. This leads to changes in taste, dysphagia, pain and malabsorption, which in turn leads to anorexia, malnutrition and dehydration. The resulting gaps in the protective mucosa create an unfavorable environment for the resident intestinal bacteria. This leads to a further weakening of the mucosal barrier. Fever, cognitive impairment and fatigue can be the result.

The role of the endocannabinoid system

Medicinal cannabis contains compounds such as cannabinoids, including cannabidiol (CBD) and tetrahydrocannabinol (THC), which interact with the body’s endocannabinoid system. This regulates a number of functions known to be negatively affected by chemotherapy, including mood, anxiety, cognition, appetite, sleep and pain. Gastrointestinal inflammation, mucosal defense and gastric motility, including diarrhea and constipation, also play a role. Given the immunomodulatory ability of the ECS, many symptoms and side effects of chemotherapy can be influenced by the ECS.

Previous use of medicinal cannabis in cancer

There are already numerous studies on the use of medicinal cannabis in cancer treatment. Pain is the most commonly reported symptom. Nausea, vomiting, loss of appetite, sleep disturbances and psychological symptoms (depression, anxiety) also play a major role. New findings show the possible role of cannabis in these side effects caused by chemotherapy. CBD and THC in particular are being studied intensively for their ability to influence the function of the gastrointestinal tract. This is due to the fact that the endocannabinoid system (ECS) controls gastrointestinal homeostasis to a significant degree. CNR1 and CNR2, G-protein-coupled receptors present in the gastrointestinal tract, are responsible for this. This network of ECS receptors controls gastric motility.

Medicinal cannabis – use during active cancer treatment

According to the study reviewed for this article [1], medical cannabis should be used during active chemotherapy to minimize both the depth and duration of mucositis. It is important to point out that much of the evidence for the use of medicinal cannabis in cancer has only been studied in vitro or in preclinical (animal) models.

However, there are also human clinical trials investigating the role of cannabinoids in the active treatment of cancer. The results of these studies show that in the standard treatment of recurrent high-grade glioma, the addition of medical cannabis resulted in an improvement in quality of life and imaging-indicated tumor response in 11% of patients, while in 34% of patients, disease progression remained stable compared to previous controls. These clinical trials make it clear that some patients may benefit from treatment with cannabinoids.
However, there are currently no predictive biomarkers to identify responders and non-responders.

Although the use of medicinal cannabis during active chemotherapy still presents some challenges, including drug interactions, there are also potential benefits and opportunities that have been highlighted in these studies. The focus of medical cannabis adjunctive therapy is on combating the development of some symptoms or controlling these symptoms at an early stage.

Targeted adjunctive treatment with medicinal cannabis for mucositis may have the following benefits:

  • Medicinal cannabis can influence eating behavior in weight loss due to reduced oral food intake (anorexia) through taste changes and pain (appetite stimulant) in a way that can have a positive effect on weight maintenance and nutritional status.
  • Sleep disturbances due to diarrhea and pain. Due to the pain-relieving properties of medicinal cannabis, targeted treatment has the potential to improve patients’ quality of life.
  • Anti-inflammatory properties of medicinal cannabis.

For mucositis, the use of CBD and THC (along with other cannabinoids and compounds such as terpenes) is probably best suited to provide meaningful benefits due to their synergistic effects. CBD has been shown to counteract the (undesirable) psychotropic effects of THC, while THC can, for example, help with anxiety or promote food intake/appetite and sleep quality.

Conclusion

Given the numerous symptoms that occur as a secondary consequence of mucosal barrier impairment in mucositis, the use of medical cannabis as an adjunctive therapy has the potential to alleviate certain symptoms and improve quality of life for individuals during active cancer treatment.
Further studies are needed to better understand the specific effects of medical cannabis on gut health in people with advanced cancer and to validate the efficacy and safety of this treatment option.


Reference:

1 –Wardill, H. R., et al. (2024). Supporting gut health with medicinal cannabis in people with advanced cancer: potential benefits and challenges. British journal of cancer, 130(1), 19–30. https://doi.org/10.1038/s41416-023-02466-w


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08/Feb/2024

CBD and sportbenefits for performance and regeneration  

Regular physical activity, whether through sport or targeted exercise, plays a crucial role in maintaining and promoting health. Sport is not only good for physical fitness, but also has a positive impact on mental health and quality of life.   

In recent years, one particular development has gained popularity in the world of sport and fitness: the use of CBD, a non-psychoactive component of the cannabis plant, as a potential aid for athletes. 

Based on previous studies, the following potential benefits of CBD in conjunction with sports can be identified: 

    • Better recovery, e.g. through improvement of sleep latency, sleep continuity, subjective sleep quality and reduction of nightmares and insomnia (anxiolytic) 
    • Stress reduction and well-being in competitive situations (stress situations), in particular due to the anxiolytic and antidepressant effect   
    • Relaxation of the muscles after physical exertion   
    • CBD can help to alleviate inflammation and, in particular, to cope more quickly with the muscle breakdown caused by running, jumping or frequent, rapid changes of direction and the resulting inflammation.  
    • Pain relief after high physical exertion 

The influence of CBD on the endocannabinoid system, which is responsible for maintaining homeostasis, leads to changes on a physiological and cognitive level. For example, CBD can contribute to improved muscle recovery by reducing inflammation and promoting better sleep, which allows athletes to regenerate more efficiently between training sessions or competitions. Due to its anxiolytic and stress-reducing properties, CBD can also contribute to mental recovery and promote a sense of calm and mental well-being. It is particularly helpful for (professional) athletes to manage their stress levels in this way in order to achieve optimal performance.  

The World Anti-Doping Agency, which is responsible for controlling banned substances in sport worldwide, has removed pure CBD (must not contain THC) from the list of banned substances for professional athletes. This means that you can also consume approved CBD products before upcoming competitions without having to reckon with the consequences of possible doping.   

It should be noted that randomized controlled trials with placebo are also necessary in this area in order to test and verify the acute and chronic effects of different dosages. 

 


Reference:

1 – Rojas-Valverde, D., & Fallas-Campos, A. (2023). Cannabidiol in sports: insights on how CBD could improve performance and recovery. Frontiers in pharmacology, 14, 1210202. https://doi.org/10.3389/fphar.2023.1210202. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10556669/.  


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23/Jan/2024

Medical cannabis for PTSD  



Modern society is faced with a variety of stressors, be it pandemics, wars, natural disasters or individual traumatic experiences, which in some cases can lead to post-traumatic stress disorder. Due to the growing awareness of mental health issues, people are becoming more aware of their experiences and symptoms and are seeking professional help.


 

Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental illness that can occur as a result of trauma caused by stressful events or particularly threatening situations. War, sexual abuse or even serious accidents play a major role here (1).
If the event is not dealt with and processed, a post-traumatic stress disorder can develop from the (co-)experience of such a trauma – in other words, the stressful memories return and are “lived through” again and again. Intense anxiety, flashbacks and sleep disorders can dominate the daily lives of those affected (1).

PTSD can often be treated well with cognitive behavioral therapy or the administration of medication (usually psychotropic drugs: antidepressants) (1). In recent years, the use of medicinal cannabis has also emerged as a possible treatment option.

Current study data

A pilot study from Florida in 2023 shows that the severity of PTSD symptoms in the study participants improved significantly after 30 and 70-day follow-up examinations due to the use of medicinal cannabis. In particular, a statistically significant reduction in nightmares was observed, as well as longer sleep duration, better sleep quality and higher sleep efficiency. General mental health improved significantly (2).

The results of the Florida study underscore the potential of medical cannabis to improve outcomes in patients with PTSD, particularly those with sleep disorders that do not respond to currently available treatments (2).

Cannabinoids

THC, the psychoactive component of cannabis, may help reduce anxiety and modulate emotional responses to traumatic memories. CBD, on the other hand, the non-psychoactive part of cannabis, shows anti-inflammatory and anti-anxiety properties, which could contribute to a possible improvement of sleep disorders and stress symptoms.

News of the world – Ukraine

Already last year, activists and advocates of medical cannabis in Ukraine pleaded for access to this treatment method, especially with the aim of helping millions of people, including soldiers wounded in the Ukrainian war. In December last year, the Ukrainian parliament passed a first draft law on the legalization of medical cannabis.

The aim of legalization is to help cancer patients in particular, but also people with PTSD, and to offer an additional treatment therapy for the respective symptoms.

According to Mariia Mezentseva, who spoke out in favour of legalization in parliament, medicinal cannabis is needed by up to 6 million Ukrainians, including civilians with post-traumatic stress disorder (PTSD) and wounded soldiers (3).

Legalization, which is expected to take place in the second half of 2024, is to take place under the strictest conditions. “Only approved facilities with the necessary licenses and GMP certificates will be allowed to grow cannabis. For security reasons, there will be constant video surveillance by the national police. Each plant will be given a unique code so that its path to the patient can be precisely tracked. The cannabis-based medicines will only be available with an electronic prescription. This would be issued by a doctor according to the patient’s condition.” (3). Recreational use remains illegal by law. 

 


References:

1 – AOK – Die Gesundheitskasse. (2023). Was ist eine Posttraumatische Belastungsstörung? https://www.aok.de/pk/magazin/koerper-psyche/psychologie/ptbs-ursachen-symptome-und-behandlung/ 

2 – Vaddiparti, K., et al. (2023). Improved Post-Traumatic Stress Disorder Symptoms and Related Sleep Disturbances after Initiation of Medical Marijuana Use: Evidence from a Prospective Single Arm Pilot Study. Medical cannabis and cannabinoids, 6(1), 160–169. https://doi.org/10.1159/000534710 

3 – Nagel, T. (2023). Medizinisches Cannabis gegen Kriegs-Folgen: Ukraine beschließt Legalisierung. Frankfurter Rundschau. https://www.fr.de/politik/kritik-medizinisches-cannabis-ukraine-krieg-folgen-legalisierung-posttraumatische-belastungsstoerung-92742015.html 


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16/Jan/2024

Advances in medical cannabis therapy for attention-deficit/hyperactivity disorder (ADHD)  



Medical research into the treatment of various health conditions with cannabinoids has steadily intensified in recent years, including the management of attention deficit/hyperactivity disorder (ADHD) 


 

ADHD

ADHD is a neurological disorder that can affect people at different stages of life. The disorder manifests itself primarily in hyperactivity (excessive urge to move), inattention (impaired ability to concentrate) and impulsivity (rash behavior) and affects an estimated 5% of all children and 2.5% of all adults worldwide (1,3). In addition to behavioral therapy, other approaches are often based on stimulants or other medications (2). These methods are considered relatively safe and effective, but are often associated with decreased appetite, insomnia, emotional dysregulation, irritability and an increased risk of adverse cardiovascular events (1). 
There is evidence that cannabinoids may play a promising role in the symptom management of ADHD due to their neuroprotective and anti-inflammatory properties.

Endocannabinoidsystem (ECS)

The endocannabinoid system (ECS) can be described as a signaling network of the body that consists of cannabinoid receptors (type 1 and type 2), among others. CB1 receptors are widely distributed throughout the central nervous system, with high concentrations detected in regions associated with cognitive function and processing. Therefore, activation of CB1 receptors directly or by increasing AEA, an endogenous ligand of CB1 receptors whose activation leads to modulation of neurotransmitter release, is thought to be a potential target for the treatment of ADHD (1).   

ADHD study

In a study conducted by the British Medicinal Cannabis Registry in 2023, a total of 68 participants diagnosed with ADHD were treated with medicinal cannabis over a period of 12 months. Inhaled preparations of dried flowers and sublingual oil preparations were prescribed individually and in combination. The results of the study show that, among other things, the severity of anxiety and sleep quality as well as the general health-related quality of life could be improved.

These findings may open up new avenues for personalized treatment approaches that are better tailored to the individual needs of people with ADHD.  

Further studies are needed to understand the long-term effects and optimal mode of action. Nevertheless, the discovery of new treatment options has the potential to support conventional therapeutic approaches and improve the lives of those affected through symptom relief.   

 


References:

1 – Bundesministerium für Gesundheit (o.D.): Aufmerksamkeitsdefizitsyndrom. Stand 2023. https://www.bundesgesundheitsministerium.de/themen/praevention/kindergesundheit/aufmerksamkeitsdefizitsyndrom.  

2 – Enable Me (o.D.). Was hilft bei ADHS?. Enable Me – Stiftung My Handicap. https://www.enableme.ch/de/artikel/adhs-behandlung-und-strategien-10281.  

3 – Ittiphakorn, P. et al. (2023): UK Medical Cannabis Registry: An analysis of clinical outcomes of medicinal cannabis therapy for attention-deficit/hyperactivity disorder. Neuropsychopharmacology reports, 10.1002/npr2.12400. Advance online publication. https://doi.org/10.1002/npr2.12400 

 


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05/Jan/2024

Transforming Gynecological Pain Care – Spotlight on Endometriosis  



Gynecological pain is common in women of all ages and occurs in conditions such as endometriosis, chronic pelvic pain and primary dysmenorrhea [1]. Conventional approaches to treating such pain have often proven inadequate, prompting researchers and healthcare professionals to seek alternative adjunctive therapies. The exploration of cannabinoids could be a step forward in gynecological pain management to provide women with individualized and effective add-on therapies for managing their pain and improving their overall well-being. 


 

Understanding Cannabinoids 

Cannabinoids, including THC (tetrahydrocannabinol) and CBD (cannabidiol), interact with the endocannabinoid system in the human body. This system plays a crucial role in regulating various physiological processes, including the perception of pain [2]. The potential therapeutic effects of cannabinoids on gynecological pain have sparked interest in their use as an adjunct to conventional treatments. 

Chronic Pelvic Pain Conditions, focus on Endometriosis 

Chronic abdominal pain, such as endometriosis, is a major challenge for women’s health. Widespread pain, especially in the lower abdomen, as well as fatigue, sleep disturbances and cognitive disorders accompany those affected [3]. Endometriosis patients often express dissatisfaction with current treatment approaches, with only 25% considering their symptom control to be satisfactory. There are studies suggesting that cannabinoids have anti-inflammatory and pain-relieving properties that could benefit people suffering from endometriosis [1]. The phytocannabinoids from cannabis not only interact with the CB1 and CB2 receptors to exert an analgesic effect but can also indirectly relieve pain by triggering anxiolytic and antidepressant effects. Further analgesic effects of cannabinoids are also suspected, particularly in endometriosis, which are induced by antiangiogenic, immunomodulatory and antiproliferative processes [1]. 

Potential Benefits of cannabinoids  

Potential benefits of cannabinoids in gynecologic pain management include a favorable side effect profile compared to some conventional medications [1,4]. However, challenges such as standardization of dosing, long-term safety and regulatory considerations highlight the need for further research, particularly with regard to specific use in endometriosis. 

 


References:

1 – Sinclair, J., Abbott, J., Proudfoot, A., & Armour, M. (2023). The Place of Cannabinoids in the Treatment of Gynecological Pain. Drugs, 83(17), 1571–1579. https://doi.org/10.1007/s40265-023-01951-z 

2 – Dingermann T. (2021). Grundlagen der Pharmakologie von Cannabinoiden. Schmerzmedizin, 37(Suppl 1), 8–13. https://doi.org/10.1007/s00940-021-3139-9  

3 – Kaltsas, G., & Tsiveriotis, K. (2023). Fibromyalgia. In K. R. Feingold (Eds.) et. al., Endotext. MDText.com, Inc.  

4 – Armour, M., Sinclair, J., Chalmers, K. J., & Smith, C. A. (2019). Cannabis use, a self-management strategy among Australian women with Endometriosis: Results From a National Online Survey. Journal of Obstetrics and Gynaecology Canada. https://www.jogc.com/article/S1701-2163(19)30808-4/fulltext 

 


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19/Dec/2023

Potential effect of cannabinoids on neurocognitive diseases



Cannabinoids are a group of chemical compounds found in the cannabis plant. They interact with the body’s endocannabinoid system (ECS), a complex network of receptors, enzymes and endocannabinoids that plays a crucial role in regulating various physiological functions. Cannabinoids act on the brain by primarily activating the CB1 and CB2 receptors [1].


 

Studies suggest that cannabis use in the form of synthetic THC-based prescription drugs such as nabiximols, dronabinol and nabilone has increased in recent years among older adults and people with chronic degenerative/inflammatory brain diseases [1]. These diseases include, for example, amyotrophic lateral sclerosis (ALS), Parkinson’s disease, multiple sclerosis, Alzheimer’s disease and schizophrenia.

By linking the development of these diseases to the ECS, certain cannabinoids have potential effects that can support patients suffering from one of these diseases and alleviate their symptoms.

Studies suggest, for example, that cannabis can slow down the onset and severity of ALS symptoms. It can have positive effects on pain, spasticity, drooling, anorexia and sleep disorders. It is also known that cannabis can help ALS patients who suffer from breathing difficulties by increasing bronchodilation [1].

Parkinson’s disease is another neurocognitive disorder where medicinal cannabis has been successful in providing symptom relief. This is a progressive neurodegenerative disease that mainly affects older people and is characterized by the loss of dopaminergic neurons. The resulting decline in dopamine levels leads to the main symptoms of Parkinson’s disease. These often manifest as slowness of movement, stiffness of the limbs and slow rhythmic tremors [1].
Studies suggest that the administration of THC can improve physical activity and hand-eye coordination as well as motor problems, including resting tremor, stiffness and posture. CBD also shows positive effects, particularly by reducing REM sleep and improving sleep behavior disorders [1].
Finally, it has been shown that the combination of CBD and synthetic cannabinoid agonists can reduce the motor problems and pain caused by Parkinson’s disease [1].

Overall, it can be concluded from the above studies that short-term cannabis use can temporarily alleviate a wide range of symptoms associated with neurological disorders and thereby support the treatment of such conditions.

 


Reference:

1 Leinen, Z. J., Mohan, R., Premadasa, L. S., Acharya, A., Mohan, M., & Byrareddy, S. N. (2023). Therapeutic Potential of Cannabis: A Comprehensive Review of Current and Future Applications. Biomedicines, 11(10), 2630. https://doi.org/10.3390/biomedicines11102630  

 


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12/Dec/2023

Hope for brain tumors



The use of medical cannabis as an add-on therapy for brain tumors opens up fascinating perspectives in modern medicine. In this dynamic sphere of healthcare, the potential of cannabis-based therapies can be discovered as a supportive measure to improve the quality of life of patients with brain tumors.  


 

Primary brain tumors or tumors of the spinal cord refer to all benign and malignant neoplasms that arise in the central nervous system. These include all growths originating from the brain or spinal cord substance itself or the surrounding meninges (1).
There are various approaches to the treatment of brain tumors. In addition to surgical interventions, radiotherapy or chemotherapy is also considered a successful method (2). These therapies are often associated with severe side effects and do not contribute to an improvement in the patient’s quality of life, at least during treatment. Common negative side effects include nausea, vomiting and diarrhea, resulting in weight loss, blood count changes, inflammation of the oral mucosa or hair loss (3).

Global awareness of the medicinal properties of the cannabis plant has increased significantly, especially in recent years. Coupled with the challenges posed by these side effects of conventional therapies, interest in medicinal cannabis among patients with brain tumors has significantly intensified due to its perceived safer profile (4).

Various studies suggest that medicinal cannabis can reduce some of these side effects caused by chemotherapy. For example, the plant shows promise in inhibiting nausea and vomiting, stimulating appetite, reducing pain, reducing inflammation and promoting cancer cell survival (5). Cannabinoid therapies could therefore not only be a useful addition to palliative therapies to improve symptom management and the quality of life of those affected during therapy, but could also make a positive contribution to the holistic care of patients.

 


References:

1 Neuroonkologische Arbeitsgemeinschaft (NOA). (2017).  Primäre Tumoren von Gehirn und Rückenmark. Onko Internetportal. https://www.krebsgesellschaft.de/onko-internetportal/basis-informationen-krebs/krebsarten/hirntumor/definition-und-haeufigkeit.html  

2 Universitätsmedizin Mannheim (UMM) (o.D.). Hirntumore am Neuroonkologischen Zentrum Mannheim behandeln. Medizinische Fakultät Mannheim der Universität Heidelberg. https://www.umm.de/neuroonkologisches-zentrum-mannheim/hirntumore-behandeln.  

3 UKM Hirntumorzentrum (o.D.). Chemotherapie und tumorspezifische Medikamente. Universitätsklinikum Münster. https://web.ukm.de/hirntumorzentrum-chemotherapie.  

4 Rodriguez-Almaraz, J. E., & Butowski, N. (2023). Therapeutic and Supportive Effects of Cannabinoids in Patients with Brain Tumors (CBD Oil and Cannabis). Current treatment options in oncology, 24(1), 30–44. https://doi.org/10.1007/s11864-022-01047-y 

5 Abrams DI. Integrating cannabis into clinical cancer care. Current Oncology. 2016;23:8–14. doi: 10.3747/co.23.3099.  in Rodriguez-Almaraz, J. E., & Butowski, N. (2023). Therapeutic and Supportive Effects of Cannabinoids in Patients with Brain Tumors (CBD Oil and Cannabis). Current treatment options in oncology, 24(1), 30–44. https://doi.org/10.1007/s11864-022-01047-y 

 

 


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30/Nov/2023

The endocannabinoid system: the key to the effects of medicinal cannabis



Medical cannabis has established itself as a promising option for pain relief in recent years. Due to its natural properties and potential to relieve various types of pain, it is attracting growing interest from both patients and healthcare professionals.  


 

One of the main components of cannabis that is responsible for its pain-relieving properties is cannabidiol (CBD). CBD interacts with the endocannabinoid system in the body and helps to regulate pain and inflammation. This makes it particularly valuable for people suffering from chronic pain caused by arthritis, neuropathy or fibromyalgia (1,2,3). Medicinal cannabis may therefore be particularly beneficial for those who do not respond well to conventional painkillers or have already experienced their side effects (3).   

A recent study by Andreae et al., based on Bayesian analysis of five randomized trials, showed that inhaled cannabis provided short-term relief in 15-20% of patients with chronic neuropathic pain (4).  

A very comprehensive study of over 338 patients with various chronic pain conditions investigated the effect of cannabis floss brew as an adjunct treatment over 12 months. The results showed statistically significant improvements in pain intensity, pain disability, anxiety and depression compared to the status at the beginning of the study (3).    

In another observational study of 428 people suffering from osteoarthritis or rheumatoid arthritis, the effectiveness of CBD on pain and arthritis symptoms was investigated based on the participants’ own assessments and whether the dosage of their other medications had changed after taking CBD. The results showed that some of the participants experienced improved pain relief as a result of treatment with CBD. Scored on a 10-point scale, 44% of the total group experienced an average pain relief of 2.58. In addition, 60.5% of respondents who took CBD for joint pain reported that they either reduced or discontinued other medications due to the positive effects of CBD (3). 

Medical cannabis offers a promising route to pain relief, especially for people suffering from chronic pain. The potential efficacy of medical cannabis as an adjunct to existing analgesic therapies has been demonstrated by the studies. While more research is needed to fully understand the efficacy and safety of medical cannabis, it has the potential to provide relief and improve the quality of life for many patients. 

 


References: 

1 Boehnke, K. F., Gagnier, J. J., Matallana, L., & Williams, D. A. (2021). Substituting Cannabidiol for Opioids and Pain Medications Among Individuals With Fibromyalgia: A Large Online Survey. The journal of pain, 22(11), 1418–1428. https://doi.org/10.1016/j.jpain.2021.04.011    

2 Guillouard, M., Authier, N., Pereira, B., Soubrier, M., & Mathieu, S. (2021). Cannabis use assessment and its impact on pain in rheumatologic diseases: a systematic review and meta-analysis. Rheumatology (Oxford, England), 60(2), 549–556. https://doi.org/10.1093/rheumatology/keaa534 

3 Leinen, Z. J., Mohan, R., Premadasa, L. S., Acharya, A., Mohan, M., & Byrareddy, S. N. (2023). Therapeutic Potential of Cannabis: A Comprehensive Review of Current and Future Applications. Biomedicines, 11(10), 2630. https://doi.org/10.3390/biomedicines11102630  

4 Andreae, M. H., Carter, G. M., Shaparin, N., Suslov, K., Ellis, R. J., Ware, M. A., Abrams, D. I., Prasad, H., Wilsey, B., Indyk, D., Johnson, M., & Sacks, H. S. (2015). Inhaled Cannabis for Chronic Neuropathic Pain: A Meta-analysis of Individual Patient Data. The journal of pain, 16(12), 1221–1232. https://doi.org/10.1016/j.jpain.2015.07.009 

 


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23/Nov/2023



In today’s ever-evolving medical world, we are finding new ways to improve patient care. One such avenue is medical cannabis, an area that is rapidly expanding and offering many patients an alternative option to traditional pain medicine.
 


 

The Bridge to Relief

Medical cannabis is not just a plant, but a bridge to relief from pain and discomfort for many patients. It offers a range of benefits, from treating chronic pain and reducing anxiety to alleviating the symptoms of epilepsy and improving the quality of life for people battling cancer (1-5).    

A World of Discoveries

Research in this field is growing daily, revealing the immense potential of cannabis compounds. Cannabinoids such as CBD and THC, as well as terpenes such as limonene or caryophyllene, are emerging as key factors in alternative healthcare solutions.   

Association of medical professionals 

To harness this potential, it is important that we, CanPharma, as healthcare professionals, join forces with like-minded people and share our knowledge. Building connections between physicians, pharmacists and other healthcare professionals is vital to the responsible use and promotion of medical cannabis.  

Education is the Key

In collaboration with other experts, it is possible to learn even more about medical cannabis, adapt to the new potential ways to relieve pain and treat patients, and advocate for their well-being. Whether it’s understanding the endocannabinoid system, exploring dosing guidelines or staying on top of the latest research, shared knowledge can drive progress.   

A Global Movement 

Across the world, the acceptance of medicinal cannabis is growing. CanPharma is eager to join this global movement and connect with healthcare professionals, pharmacists, physicians, and industry leaders to ensure the best is made of this promising plant. 

 


References: 

1 Kluwe, L., Scholze, C., Schmidberg, L. M., Wichmann, J. L., Gemkov, M., Keller, M. J., & Farschtschi, S. C. (2023). Medical Cannabis Alleviates Chronic Neuropathic Pain Effectively and Sustainably without Severe Adverse Effect: A Retrospective Study on 99 Cases. Medical cannabis and cannabinoids, 6(1), 89–96. https://doi.org/10.1159/000531667 

2 Valikhanova, G., Kato, Y., Fitzcharles, M. A., Ware, M., Da Costa, D., Lowensteyn, I., Cheung, H. S., & Grover, S. (2023). Medical Cannabis Use Among Canadian Veterans and Non-Veterans: A National Survey. Integrative medicine reports, 2(1), 120–128. https://doi.org/10.1089/imr.2023.0022 

3 Gaston, T. E., Ampah, S. B., Martina Bebin, E., Grayson, L. P., Cutter, G. R., Hernando, K., Szaflarski, J. P., & UAB CBD Program (2021). Long-term safety and efficacy of highly purified cannabidiol for treatment refractory epilepsy. Epilepsy & behavior : E&B, 117, 107862. https://doi.org/10.1016/j.yebeh.2021.107862 

4 Hinz, B., & Ramer, R. (2022). Cannabinoids as anticancer drugs: current status of preclinical research. British Journal of Cancer, 127(1), 1–13. https://doi.org/10.1038/s41416-022-01727-4  

5 Twelves, C., Sabel, M., Checketts, D., Miller, S., Tayo, B., Jove, M., Brazil, L., & Short, S. C. (2021). A phase 1b randomised, placebo-controlled trial of nabiximols cannabinoid oromucosal spray with temozolomide in patients with recurrent glioblastoma. British Journal of Cancer, 124(8), 1379–1387. https://doi.org/10.1038/s41416-021-01259-3 

 

 


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