Cannabinoids:their role in pain and palliation
- PMID: 18032352
Cannabinoids:their role in pain and palliation
Abstract
Controversy is associated with the issue of cannabis and cannabinoids in clinical care in the United States. Recent research has demonstrated the underlying mechanisms of cannabinoid analgesia via endocannabinoids, an endogenous system of retrograde neuromodulatory messengers that work in tandem with endogenous opioids. Additional receptor and non-receptor mechanisms of cannabinoid drugs have pertinent activity, including anti-carcinogenesis and neuroprotection, that may be of key importance in aging and terminal patient populations. The results of clinical trials with synthetic and plant-based cannabinoids suggest that the role of formulation and delivery system is critical in optimizing the risk-benefit profile of cannabinoid products. Synergy between opioids and cannabinoids may produce opioid-sparing effects, as well as extend the duration of analgesia and reduce opioid tolerance and dependence. This article reviews the mechanism of action of cannabinoids, examines marketed agents and those in clinical trials, and addresses their role in treatment of chronic pain, cancer, neurodegenerative diseases, and HIV/ AIDS. The ability of cannabinoid medicines to treat pain, associated sleep disorders, appetite loss, muscle spasm and a wide variety of other symptoms suggests that such agents may in the future play an important role in palliative care.
Similar articles
-
Cannabinoid analgesia as a potential new therapeutic option in the treatment of chronic pain.Ann Pharmacother. 2006 Feb;40(2):251-60. doi: 10.1345/aph.1G217. Epub 2006 Jan 31. Ann Pharmacother. 2006. PMID: 16449552 Review.
-
Interaction of the cannabinoid and opioid systems in the modulation of nociception.Int Rev Psychiatry. 2009 Apr;21(2):143-51. doi: 10.1080/09540260902782794. Int Rev Psychiatry. 2009. PMID: 19367508 Review.
-
Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone).Pain Pract. 2008 Jul-Aug;8(4):287-313. doi: 10.1111/j.1533-2500.2008.00204.x. Epub 2008 May 23. Pain Pract. 2008. PMID: 18503626
-
Cannabinoids in the treatment of pain and spasticity in multiple sclerosis.Curr Opin Investig Drugs. 2002 Jun;3(6):859-64. Curr Opin Investig Drugs. 2002. PMID: 12137404 Review.
-
The future of cannabinoids as analgesic agents: a pharmacologic, pharmacokinetic, and pharmacodynamic overview.Am J Ther. 2007 Sep-Oct;14(5):475-83. doi: 10.1097/MJT.0b013e3180a5e581. Am J Ther. 2007. PMID: 17890938 Review.
Cited by
-
Cannabidiol as a treatment for arthritis and joint pain: an exploratory cross-sectional study.J Cannabis Res. 2022 Aug 24;4(1):47. doi: 10.1186/s42238-022-00154-9. J Cannabis Res. 2022. PMID: 35999581 Free PMC article.
-
Should Medical Cannabis Administered by Inhalation Be Allowed for Hospitalized Patients?Can J Hosp Pharm. 2018 May-Jun;71(3):211-214. Epub 2018 Jun 28. Can J Hosp Pharm. 2018. PMID: 29955195 Free PMC article. No abstract available.
-
Weighing the balance: how analgesics used in chronic pain influence sleep?Br J Pain. 2014 Aug;8(3):107-18. doi: 10.1177/2049463714525355. Br J Pain. 2014. PMID: 26516542 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Medical