Adverse effects are minimal in an assertive prescribing context. That is what we are going to talk about here, demonstrating the safety and efficacy of cannabinoid derivatives in different clinical settings.
Medicinal cannabis and quality of life
One of the main complaints from chronic pain patients is the noticeable decrease in well-being and quality of life, which in many cases leads to psycho-emotional symptoms that further aggravate the conditions.
Nonsteroidal anti-inflammatory drugs and opioid derivatives, although they occasionally help in controlling pain, are not safe medicines for continuous use and often cause relevant adverse effects such as gastroduodenal irritation, fatigue, constipation and cardiovascular events.
Antidepressants, anxiolytics, anticonvulsants, and muscle relaxants are also medicines frequently used in the context of chronic pain, which not infrequently show limitations regarding efficacy and toxicity.
In this scenario, medicinal cannabis has been shown to be a promising alternative, due to the potential to bring therapeutic results both in pain perception and in fighting common symptoms in chronic pain patients, namely, insomnia, anxiety and fatigue, without triggering major adverse effects..
This is what several scientific researches show, for example this experiment carried out in 2020 by means of the Pennsylvania Medicinal Cannabis Program, in the United States.
The experiment, conducted by researchers at the Philadelphia University of Sciences, Department of Pharmacy, included 181 participants who completed the EQ-5D quality-of-life questionnaire. The EQ-5D comprises 5 dimensions, such as: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, from which a HRQoL (Health-related quality of life). Participants started using medicinal cannabis from the first visit and completed this questionnaire at the first visit and after 2, 4 and 8 weeks.
The results showed that the quality of life increased considerably between the second and the eighth week. There was also a significant improvement in pain scores between the first and fourth visit. In addition to validating pain reliefscore subscales also indicated a better control in anxiety pictures.
>> Se:e the complete study here: Measuring the Change in Health-Related Quality of Life in Patients Using Marijuana for Pain Relief.
Fighting chronic pain and reducing the use of opioids
One of the highlights in the relationship between quality of life and medicinal cannabis is the possibility of reducing the use of opioids to fight chronic pain. We highlight the phytocannabinoid THC, due to its potential to modulate unpleasant perceptions related to pain, as it is a partial agonist to CB1 endocannabinoid receptors, widely present in the motor sensory cortex and amygdala. Furthermore, there is a synergistic effect in the association between opioids and cannabinoids, preventing the development of tolerance to opioids, avoiding the continuous need to increase the dosage.
Several studies show this possibility, for example this U.S study published in 2021 and conducted by researchers at the Faculty of Medicine at Tel Aviv University, in Israel.
The study interviewed 100 patients with chronic pain, aged 18-70 years, of whom 76 regularly used opioid medications. Of these, 93% decreased or stopped opioids after starting treatment with medicinal cannabis.
>> See the full experiment here: Risk and benefit of cannabis prescription for chronic non-cancer pain.
Still on the reduction of opioids, this study from Canada, published in 2021, also brings promising results. The study was conducted in 21 medical clinics across the country, including 1.145 patients who were followed-up for a period of 6 months.
Participants were mostly female (57.6%), with a mean age of 52 years. Of the total number of participants, 28% were taking opioids. This rate dropped to 11% after 6 months of treatment with cannabinoid derivatives. In addition, the mean opioid dosage was also reduced from 152mg morphine equivalent (MME) at baseline to 32.2mg MME after 6 months, a 78% reduction..
These results suggest that medicinal cannabis, in addition to being an ally in the quality of life of said patients, is an important tool for reducing overdose and death caused by excess opioids.
Chronic Pain Relief with Medicinal Cannabis
Other studies suggest the therapeutic potential of cannabis in treating chronic pain, such as pain associated with degenerative disc diseases of the spine and pain associated with cancer.
In the first case, the results come this U.S study in North America, carried out on 214 patients suffering from back pain and taking cannabidiol (CBD) as an alternative to conventional analgesics. Of these, 66.7% reported pain relief.
Positive results were also evidenced for fighting neck (37,0%)pain, lower limbs pain (35,2%) and/or upper limbs pain (9,3%). In addition, users reported improvement in insomnia (25,9%), anxiety (20,4%) and mood in general (18,5%).
>> See the complete research here: Prevalence of Cannabidiol Use in Patients With Spine Complaints: Results of an Anonymous Survey.
Medicinal cannabis and cancer pain
With respect to cancer-related pain, although there is already other scientific evidence in this regard, some studies that have been developed in Argentina are noteworthy. With the regulation of Law 27,350 – which authorized the self-cultivation of Cannabis for medicinal purposes, expanding its use beyond refractory epilepsy – research on the use of cannabinoid derivatives as an adjuvant in the context of cancer pain has gained new dimensions.
Por iniciativa do Ministério do Desenvolvimento Produtivo, um grupo de cientistas da Universidade Austral e do CONICET (Consejo Nacional de Investigaciones Científicas y Técnicas) assinou um acordo com a estatal Cannava visando iniciar pre-clinical studieslinking medicinal cannabis to reduction of cancer pain. This is the first research carried out in Argentina with cannabis oil produced domestically.
We all know how challenging cancer pain management is. Although there are many methods and medicines to alleviate cancer pain, we are often faced with results below expectations and with the occurrence of important side effects. In this sense, it is essential to have additional resources, such as medicinal cannabis, to alleviate pain and improve the quality of life of said patients.
This, of course, as long as the prescriptions are technically safe and assertive. The WeCann Academy is committed to your journey of learning in this scenario and offers the International Certification in Endocannabinoid Medicine, exclusively for medical professionals, in Brazil and abroad.
If you want to be part of our community, learn more about our course on Medicinal Cannabis and get ready for this new frontier of Medicine!
Lovecchio F, Langhans MT, Bennett T, Steinhaus M, Premkumar A, Cunningham M, Farmer J, Albert T, Huang R, Katsuura Y, Qureshi S, Schwab F, Sandhu H, Kim HJ, Lafage V, Iyer S. Prevalence of Cannabidiol Use in Patients With Spine Complaints: Results of an Anonymous Survey. Int J Spine Surg. 2021.
Lucas P, Boyd S, Milloy MJ, Walsh Z. Cannabis Significantly Reduces the Use of Prescription Opioids and Improves Quality of Life in Authorized Patients: Results of a Large Prospective Study. Pain Med. 2021.
Peterson A, Le C, Dautrich T. Measuring the Change in Health-Related Quality of Life in Patients Using Marijuana for Pain Relief. S. Karger AG, Basel, 2021.
Zloczower O, Brill S, Zeitak Y, Peles E. Risk and benefit of cannabis prescription for chronic non-cancer pain. J Addict Dis. 202.