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Cannabinoids and Pain: New Insights From Old Molecules

Cannabis has been used for medicinal purposes for thousands of years. The prohibition of cannabis in the middle of the 20th century has arrested cannabis research. In recent years there is a growing debate about the use of cannabis for medical purposes. The term ‘medical cannabis’ refers to physicia...

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Autores principales: Vučković, Sonja, Srebro, Dragana, Vujović, Katarina Savić, Vučetić, Čedomir, Prostran, Milica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277878/
https://www.ncbi.nlm.nih.gov/pubmed/30542280
http://dx.doi.org/10.3389/fphar.2018.01259
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author Vučković, Sonja
Srebro, Dragana
Vujović, Katarina Savić
Vučetić, Čedomir
Prostran, Milica
author_facet Vučković, Sonja
Srebro, Dragana
Vujović, Katarina Savić
Vučetić, Čedomir
Prostran, Milica
author_sort Vučković, Sonja
collection PubMed
description Cannabis has been used for medicinal purposes for thousands of years. The prohibition of cannabis in the middle of the 20th century has arrested cannabis research. In recent years there is a growing debate about the use of cannabis for medical purposes. The term ‘medical cannabis’ refers to physician-recommended use of the cannabis plant and its components, called cannabinoids, to treat disease or improve symptoms. Chronic pain is the most commonly cited reason for using medical cannabis. Cannabinoids act via cannabinoid receptors, but they also affect the activities of many other receptors, ion channels and enzymes. Preclinical studies in animals using both pharmacological and genetic approaches have increased our understanding of the mechanisms of cannabinoid-induced analgesia and provided therapeutical strategies for treating pain in humans. The mechanisms of the analgesic effect of cannabinoids include inhibition of the release of neurotransmitters and neuropeptides from presynaptic nerve endings, modulation of postsynaptic neuron excitability, activation of descending inhibitory pain pathways, and reduction of neural inflammation. Recent meta-analyses of clinical trials that have examined the use of medical cannabis in chronic pain present a moderate amount of evidence that cannabis/cannabinoids exhibit analgesic activity, especially in neuropathic pain. The main limitations of these studies are short treatment duration, small numbers of patients, heterogeneous patient populations, examination of different cannabinoids, different doses, the use of different efficacy endpoints, as well as modest observable effects. Adverse effects in the short-term medical use of cannabis are generally mild to moderate, well tolerated and transient. However, there are scant data regarding the long-term safety of medical cannabis use. Larger well-designed studies of longer duration are mandatory to determine the long-term efficacy and long-term safety of cannabis/cannabinoids and to provide definitive answers to physicians and patients regarding the risk and benefits of its use in the treatment of pain. In conclusion, the evidence from current research supports the use of medical cannabis in the treatment of chronic pain in adults. Careful follow-up and monitoring of patients using cannabis/cannabinoids are mandatory.
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spelling pubmed-62778782018-12-12 Cannabinoids and Pain: New Insights From Old Molecules Vučković, Sonja Srebro, Dragana Vujović, Katarina Savić Vučetić, Čedomir Prostran, Milica Front Pharmacol Pharmacology Cannabis has been used for medicinal purposes for thousands of years. The prohibition of cannabis in the middle of the 20th century has arrested cannabis research. In recent years there is a growing debate about the use of cannabis for medical purposes. The term ‘medical cannabis’ refers to physician-recommended use of the cannabis plant and its components, called cannabinoids, to treat disease or improve symptoms. Chronic pain is the most commonly cited reason for using medical cannabis. Cannabinoids act via cannabinoid receptors, but they also affect the activities of many other receptors, ion channels and enzymes. Preclinical studies in animals using both pharmacological and genetic approaches have increased our understanding of the mechanisms of cannabinoid-induced analgesia and provided therapeutical strategies for treating pain in humans. The mechanisms of the analgesic effect of cannabinoids include inhibition of the release of neurotransmitters and neuropeptides from presynaptic nerve endings, modulation of postsynaptic neuron excitability, activation of descending inhibitory pain pathways, and reduction of neural inflammation. Recent meta-analyses of clinical trials that have examined the use of medical cannabis in chronic pain present a moderate amount of evidence that cannabis/cannabinoids exhibit analgesic activity, especially in neuropathic pain. The main limitations of these studies are short treatment duration, small numbers of patients, heterogeneous patient populations, examination of different cannabinoids, different doses, the use of different efficacy endpoints, as well as modest observable effects. Adverse effects in the short-term medical use of cannabis are generally mild to moderate, well tolerated and transient. However, there are scant data regarding the long-term safety of medical cannabis use. Larger well-designed studies of longer duration are mandatory to determine the long-term efficacy and long-term safety of cannabis/cannabinoids and to provide definitive answers to physicians and patients regarding the risk and benefits of its use in the treatment of pain. In conclusion, the evidence from current research supports the use of medical cannabis in the treatment of chronic pain in adults. Careful follow-up and monitoring of patients using cannabis/cannabinoids are mandatory. Frontiers Media S.A. 2018-11-13 /pmc/articles/PMC6277878/ /pubmed/30542280 http://dx.doi.org/10.3389/fphar.2018.01259 Text en Copyright © 2018 Vučković, Srebro, Vujović, Vučetić and Prostran. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Vučković, Sonja
Srebro, Dragana
Vujović, Katarina Savić
Vučetić, Čedomir
Prostran, Milica
Cannabinoids and Pain: New Insights From Old Molecules
title Cannabinoids and Pain: New Insights From Old Molecules
title_full Cannabinoids and Pain: New Insights From Old Molecules
title_fullStr Cannabinoids and Pain: New Insights From Old Molecules
title_full_unstemmed Cannabinoids and Pain: New Insights From Old Molecules
title_short Cannabinoids and Pain: New Insights From Old Molecules
title_sort cannabinoids and pain: new insights from old molecules
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277878/
https://www.ncbi.nlm.nih.gov/pubmed/30542280
http://dx.doi.org/10.3389/fphar.2018.01259
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