The Integrative Medicine is the practice that reaffirms the importance of the relationship between the patient and the health professional. The therapy is based on the consideration of all the aspects that interfere in the quality of life and well-being of people.
In this regard, the understanding of how the Endocannabinoid System (ECS) works is of paramount importance to the integrative physician, since the role of the ECS is to modulate and balance all physiological systems of the human body.
A deeper understanding of medical Cannabis and its broad therapeutic spectrum can contribute significantly to relieving several symptoms and clinical conditions.
Whether the symptoms are caused by physical or psychic factors, the goal of the integrative medicine is to balance the body, mind and emotions with the purpose of providing the patients with an integral and systemic care, as it is the primordial role of the Endocannabinoid System, which is to lead the homeostasis of the organism.
In this content, we will talk more about the subject and bring some scientifically based practices on the use of cannabinoids derivatives in the Integrative Medicine. For example, in the management of chronic pain, psychiatric disorders, gynecological disorders and cancer patient support.
Keep on reading to better understand the potential of cannabinoid derivatives in the integrative practice!
Cannabis and the Integrative Medicine
The Integrative Medicine has among its principles the following assumptions:
- The partnership between patient and physician in the healing process;
- The use of natural, effective, non-invasive methods and therapies whenever possible;
- The acknowledgement that Medicine should be evidence-based and should be investigative and open to new paradigms.
The knowledge about the Endocannabinoid System and the therapeutic potential of medical Cannabis are fully aligned with these principles. The Integrative Medicine emphasizes the relationship between patient and physician and combines conventional treatments and complementary therapies of which safety and efficacy have been scientifically proven.
The use of Cannabis for medical purposes has been around for thousands of years, although research on the subject only gained strength after the scientific discovery of the Endocannabinoid System (ECS) in the second half of the 20th century. More recently, with the Resolution 327 of the Brazilian Health Surveillance Agency (Anvisa)the discussions around medical Cannabis were intensified, helping to deconstruct the social and cultural stigmas behind this plant.
Due to the several therapeutic properties already scientifically unveiled, Cannabis has found a fertile ground in the integrative medicine, bringing promising results allied to the low occurrence of adverse effects to patients. The consolidation of Cannabis in this integrative care context is due to the plant’s hundreds of chemical compounds - cannabinoids, flavonoids and terpenes, which confer a wide and varied spectrum of action and help to balance the functional tone of the Endocannabinoid System (ECS)..
To learn more about it, download the Guide: Understand how the Endocannabinoid System, its receptors and phytocannabinoids interact.
The ECS is a vital regulatory system and is involved in virtually all our physiological and pathological processes. By interacting with their main ligands, the endocannabinoid receptors are able to regulate and modulate several physiological functions, such as our emotions, energy expenditure, cardiovascular function, immune system, inflammatory processes, learning and memory processes, among many others.
The balance of the Endocannabinoid System is crucial for the homeostasis of our organism because any imbalance in the physiological functions can trigger the onset and/or progression of diseases.
The scientific research growth on Medical Cannabis is one of the main reasons for its widespread use in the Integrative Medicine. There are currently already more than 25 thousand papers published on the subject in the PubMed, attesting to the potential of cannabinoids in the treatment of different clinical conditions. Below, we will discuss some of the practices already consolidated in this regard.
Use in chronic and neuropathic pain
The analgesic and anti-inflammatory properties of Cannabis have been explored for quite some time. The cannabidiol (CBD) stands out in the context of chronic and neuropathic pains. Scientific research shows a close relationship between this cannabinoid and the improvement in the quality of life of patients who suffer from this type of pain.
The CBD is used in a range of chronic pain conditions, including those cancer-relatedA positive point of the use of cannabinoids in this context is that there is a very interesting synergy of action between cannabinoid derivatives and opioidsThe Medical Cannabis helps to reduce average daily opioid doses and minimize overdose and dependence on these drugs.
An example is this in vitro research which evaluates the use of cannabinoids in patients who were taking opioids on a regular basis. The trial involved 500 patients who used Cannabis in combination with opioids for at least three months.
The results showed that 40% of the patients discontinued using opioids and 45% reduced their daily opioid doses.
Specifically regarding to pain, 80% of the patients reported an improvement in functional capacity and 87% reported an improvement in quality of life. Almost half of the users (48%) also reported a 40% to 100% reduction in the levels of perceived chronic pain.
The CBD’s potential in chronic pain management is also highlighted in this research which evaluates the use of the substance in osteoarthritis. This disorder is generally manifested by inflammatory, nociceptive and neuropathic pain. In the study in question, the CBD showed to have efficacy for all these pain-signaling pathways.
>> See the complete research here: Cannabis and joints: scientific evidence for the alleviation of osteoarthritis pain by cannabinoids.
Use in psychiatric disorders
Anxiety, depression and sleep disorders are some psychiatric disorders which can also show positive responses with cannabinoid therapy. The THC, for example, which has unique therapeutic properties in different contexts, stands out in fighting insomnia and parasomnias.
The substance is also a powerful appetite stimulant and contributes to relaxation and mood improvement that are essential in cases where the patient is in a deep state of psychic suffering. It is important to remember that, in an appropriate context of use, psychotoxic reactions resulting from THC are very rare. For this reason, the appropriate technical education in the area is fundamental for safe and assertive prescriptions.
The therapeutic results of the use of cannabinoid derivatives in anxiety disorders show great promise, as exemplified by this observational experiment carried out with 670 patients: 95% of them reported a decrease in the symptoms of agitation, irritability and stress due to anxiety pictures, after the therapeutic use of THC-predominant Cannabis products.
>> Read the full research at: The effectiveness of inhaled Cannabis flower for the treatment of agitation/irritability, anxiety, and common stress.
A study that was carried out by researchers from the Faculdade de Medicina of Ribeirão Preto, Universidade de São Paulo (USP), and published in 2021 in the Journal of the American Medical Association brings also promising results about the use of cannabidiol (CBD) in the treatment of burnout syndrome.
The study, conducted with 120 health professionals (physicians, nurses and physiotherapists) who developed burnout syndrome due to the exhausting work in the front-line fight against Covid-19showed that, among the participants who used CBD, anxiety symptoms reduced by 60%, depression symptoms reduced by 50% and general burnout condition reduced by 25%.
>> You can read the full study at:: Efficacy and Safety of Cannabidiol Plus Standard Care vs Standard Care Alone for the Treatment of Emotional Exhaustion and Burnout Among Frontline Health Care Workers During the COVID-19 Pandemic: A Randomized Clinical Trial.
Use in gynecological disorders
The medical Cannabis can also be useful in the integrative practice because of its potential in several gynecological contexts. Scientific research suggests important analgesic and anti-inflammatory effects of cannabinoid derivatives in the control of menstrual cramps, climacteric discomfort and endometriosis complications.
Specifically in the case of endometriosis, the use of medical Cannabis is very promising, since conventional treatments usually include the prescription of hormones or GnRH (gonadotropin-releasing hormone) agonists, of which side effects include menopausal symptoms such as hot flashes, vaginal dryness, mood swings, and early calcium loss from the bones, which can further compromise the quality of life of these women.
The phytocannabinoids are emerging as a safer and possibly more effective alternative for relieving these symptoms, such as this bibliographic review which brings relevant studies pointing to Cannabis as a potential therapeutic agent. The benefits include the ability to modulate pain perception and at the same time, the emotional components involved, providing relaxation and well-being and improving mood overall.
>>You can read the full bibliography at: The Clinical Significance of Endocannabinoids in Endometriosis Pain Management.
Use as adjuvant in cancer patients
Although the antineoplastic potential of cannabinoid derivatives is very promising, more robust scientific evidence is still needed to further clarify the use of this therapeutic tool for this purpose.
However, it is clear the potential of Cannabis as an adjuvant therapy in cancer patientsThe indications may be both to fight the symptoms resulting from radio and chemotherapy regimens, and to relieve the symptoms of cancer itself.
Cannabinoids stand out for their antiemetic, sleep-inducing, appetite-stimulating, and fatigue-fighting potential, besides also demonstrating efficacy in controlling anxiety and depression, common in the oncologic context. This is what is shown by this literature review published in the journal Therapeutic Advances in Medical Oncology.
>> Read the full review at: Opportunities for cannabis in supportive care in cancer.
Although scientific research has been increasingly confirming the therapeutic properties of cannabinoid derivatives, it must be emphasized that prescriptions must always be technically very careful. There are some risk profiles for the use of these substances in medical practice.
The elderlyfor example, demand extra attention in dosage titration to avoid important adverse effects. The same is true for adolescents, pregnant, lactating women, people with severe and unstable cardiovascular diseases and and people with untreated psychiatric illnesses. In these cases, the ideal is to titrate doses slowly until a dosage that optimizes therapeutic results and modulates potential adverse effects is found.
This is why a proper training in the area is essential for safe and assertive prescriptions, considering that each of us has a unique biochemical structure and Endocannabinoid System.
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