Cannabinoid Analgesia as a Potential New Therapeutic Option in the Treatment of Chronic Pain

Department of Pharmacy Practice, Creighton University, Omaha, Nebraska, United States
Annals of Pharmacotherapy (Impact Factor: 2.06). 03/2006; 40(2):251-60. DOI: 10.1345/aph.1G217
Source: PubMed


To review the literature concerning the physiology of the endocannabinoid system, current drug development of cannabinoid agonists, and current clinical research on the use of cannabinoid agonists for analgesia.
Articles were identified through a search of MEDLINE (1966-August 2005) using the key words cannabis, cannabinoid, cannabi*, cannabidiol, nabilone, THC, pain, and analgesia. No search limits were included. Additional references were located through review of the bibliographies of the articles identified.
Studies of cannabinoid agonists for treatment of pain were selected and were not limited by pain type or etiology. Studies or reviews using animal models of pain were also included. Articles that related to the physiology and pharmacology of the endocannabinoid system were evaluated.
The discovery of cannabinoid receptors and endogenous ligands for these receptors has led to increased drug development of cannabinoid agonists. New cannabimimetic agents have been associated with fewer systemic adverse effects than delta-9-tetrahydrocannabinol, including recent development of cannabis medicinal extracts for sublingual use (approved in Canada), and have had promising results for analgesia in initial human trials. Several synthetic cannabinoids have also been studied in humans, including 2 cannabinoid agonists available on the international market.
Cannabinoids provide a potential approach to pain management with a novel therapeutic target and mechanism. Chronic pain often requires a polypharmaceutical approach to management, and cannabinoids are a potential addition to the arsenal of treatment options.

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Available from: Tammy L Burns, Nov 18, 2015
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    • "Analgesics typically used to treat neuropathic pain appear to be relatively ineffective in alleviating pain from CIPN (opioids: Cherny et al. 1994; gabapentin: Rao et al. 2007; amitriptyline: Kautio et al. 2008; for review, see Wolf et al. 2008). It is well known that cannabinoids reduce pain and hyperalgesia in models of inflammatory, neuropathic, and cancer pain (see reviews: Walker et al. 2001; Walker and Huang 2002; Burns and Ineck 2006; Rice et al. 2002). There is interest in whether the endogenous cannabinoids could be modulated in the periphery to attenuate or prevent CIPN. "
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    Journal of Neurophysiology 12/2014; 113(5):jn.00692.2014. DOI:10.1152/jn.00692.2014 · 2.89 Impact Factor
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    • "The use of C. sativa for medical purposes is supported by experimental evidence showing that it controls and improves symptoms of several disorders, including multiple sclerosis (associated with muscle spasticity, pain, and sleep disorders), psychosis, bipolar disorder, anxiety, chronic pain, anorexia, and cancer (Arias Horcajadas 2007; Borgelt et al. 2013; Burns and Ineck 2006; Crippa et al. 2012; de Jong et al. 2005; Grant et al. 2012; Hollister, 1986; Kalant 2001; O'Sullivan et al. 2005; Robson 2001; Sarne and Mechoulam 2005; Swartz 2010). If C. sativa can ameliorate sleep disorders then the question arises as to what molecule(s) from this plant would be most effective at treating these disorders? "
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    • "That the therapeutic benefits for sleep hours, nightmares, and pain were typically dramatic and noted within 1 to 2 weeks of starting on the drug and maintained throughout the trial suggests, however, that the nabilone was in large measure responsible for these therapeutic benefits. The crudeness of the pain measure is likely mitigated, given the already strong evidence for nabilone’s effectiveness in chronic pain.5,6 Given the lack of illicit cannabis within the STU, the effectiveness for nabilone as a harm reduction approach was not possible to test. "
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