The state of cannabinoids to treat pain
Researchers from the Peninsula Medical School in Plymouth, UK have reviewed the state of cannabinoid pharmacology with a focus on pain medicine.
Here are the highlights.
Cannabinoids are chemical compounds derived from cannabis (marijuana). The major psychotropic cannabinoid, delta-9-tetrahydrocannabinol was isolated in 1964, and the first cannabinoid receptor (CB1R) was cloned in 1990.
The results of studies of cannabinoids in people with multiple sclerosis suggest a benefit in neuropathic pain.
However, studies of cannabinoids to treat pain are limited by poor study design.
- Small groups of participants
- Study participants with many different characteristics that make it difficult to apply the results to the genaral population
- Use of subjective (rather than objective) measures of response to treatment
Furthermore, cannabinoids have variable pharmacokinetics, and they affect emotions and behavior.
Cannabinoids are currently licensed to prevent nausea and vomiting associated with cancer chemotherapy. They can also be prescribed on a named-patient basis for neuropathic pain.
The bottom line?
Here’s to future studies that correct past deficiencies and focus on the effect on cannabinoids on CB1R receptors in the nervous system and CB2R immune-cell receptors in order to minimize side effects and document their potential complementary role to opioids for pain relief.
10/28/08 22:12 JR