Category Archives: Pain

The pharmacologic and clinical effects of medical cannabis.

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“Cannabis, or marijuana, has been used for medicinal purposes for many years. Several types of cannabinoid medicines are available in the United States and Canada. Dronabinol (schedule III), nabilone (schedule II), and nabiximols (not U.S. Food and Drug Administration approved) are cannabis-derived pharmaceuticals.

Medical cannabis or medical marijuana, a leafy plant cultivated for the production of its leaves and flowering tops, is a schedule I drug, but patients obtain it through cannabis dispensaries and statewide programs. The effect that cannabinoid compounds have on the cannabinoid receptors (CB(1) and CB(2) ) found in the brain can create varying pharmacologic responses based on formulation and patient characteristics. The cannabinoid Δ(9) -tetrahydrocannabinol has been determined to have the primary psychoactive effects; the effects of several other key cannabinoid compounds have yet to be fully elucidated. Dronabinol and nabilone are indicated for the treatment of nausea and vomiting associated with cancer chemotherapy and of anorexia associated with weight loss in patients with acquired immune deficiency syndrome. However, pain and muscle spasms are the most common reasons that medical cannabis is being recommended.

Studies of medical cannabis show significant improvement in various types of pain and muscle spasticity. Reported adverse effects are typically not serious, with the most common being dizziness. Safety concerns regarding cannabis include the increased risk of developing schizophrenia with adolescent use, impairments in memory and cognition, accidental pediatric ingestions, and lack of safety packaging for medical cannabis formulations. This article will describe the pharmacology of cannabis, effects of various dosage formulations, therapeutics benefits and risks of cannabis for pain and muscle spasm, and safety concerns of medical cannabis use.”

http://www.ncbi.nlm.nih.gov/pubmed/23386598

Peripheral Cannabinoids Attenuate Carcinoma Induced Nociception in Mice

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“Cancer pain remains poorly understood and there are no effective therapies…

 We tested whether a local CBr2 agonist produces antinociception. Our findings suggest that a peripheral CBr2 agonist could provide relief for cancer patients. Cannabinoids also potentiate the analgesic effects of morphine and prevent tolerance.

These desirable effects of cannabinoids show promise for management of cancer pain and may lead to improved analgesic therapy.

These findings support the suggestion that cannabinoids are capable of producing antinociception in carcinoma-induced pain.”

Full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771220/

Cannabidiol bioavailability after nasal and transdermal application: effect of permeation enhancers.

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“The nonpsychoactive cannabinoid, cannabidiol (CBD), has great potential for the treatment of chronic and ‘breakthrough’ pain that may occur in certain conditions like cancer. To fulfill this goal, suitable noninvasive drug delivery systems need to be developed for CBD. Chronic pain relief can be best achieved through the transdermal route, whereas ‘breakthrough’ pain can be best alleviated with intranasal (IN) delivery. Combining IN and transdermal delivery for CBD may serve to provide patient needs-driven treatment in the form of a nonaddictive nonopioid therapy.

CONCLUSION:

The results of this study indicated that CBD could be successfully delivered through the IN and transdermal routes.”

http://www.ncbi.nlm.nih.gov/pubmed/20545522

Cannabidiol Inhibits Growth and Induces Programmed Cell Death in Kaposi Sarcoma–Associated Herpesvirus-Infected Endothelium

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“Kaposi sarcoma is the most common neoplasm caused by Kaposi sarcoma–associated herpesvirus (KSHV). Current treatments for Kaposi sarcoma can inhibit tumor growth but are not able to eliminate KSHV from the host. When the host’s immune system weakens, KSHV begins to replicate again, and active tumor growth ensues. New therapeutic approaches are needed.

Cannabidiol (CBD), a plant-derived cannabinoid, exhibits promising antitumor effects without inducing psychoactive side effects. CBD is emerging as a novel therapeutic for various disorders, including cancer.

In this study, we investigated the effects of CBD both on the infection of endothelial cells (ECs) by KSHV and on the growth and apoptosis of KSHV-infected ECs, an in vitro model for the transformation of normal endothelium to Kaposi sarcoma….

Cannabidiol (CBD) was first isolated in 1940. It is a major component of the plant Cannabis sativa, which is also the source of Δ9-tetrahydrocannabinol (Δ9-THC). Due to its multiple biological activities, CBD has been identified as a potential clinical agent. Moreover, CBD affects these activities without the psychoactive side effects that typify Δ9-THC. Recent studies have documented the potential antitumorigenic properties of CBD in the treatment of various neoplasms, including breast cancer, lung cancer, bladder cancer, glioblastoma,and leukemia.CBD induces these effects through a variety of mechanisms and signaling pathways

CBD has been evaluated clinically for the treatment of various conditions, including anxiety, psychosis, and pain. In contrast to other members of the cannabinoid family, CBD has a strong safety profile and induces no psychotropic effects.Therefore, it has become an attractive agent in the search for new anticancer therapies.Our current study demonstrated that CBD preferentially enhanced apoptosis and inhibited the proliferation of KSHV-infected endothelial cells. This selective targeting of KSHV-induced neoplasia suggests that CBD may have a desirable therapeutic index when used to treat cancer. Moreover, a recent study demonstrated that CBD can be delivered effectively by nasal and transdermal routes, which may be particularly valuable for the treatment of Kaposi sarcoma oral or skin lesions.”

Full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527984/

Doctors utilise marijuana as pain relief

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“A pair of scientists at California Pacific Medical Center in San Francisco has found that a compound derived from marijuana could stop metastasis in many kinds of aggressive cancer, potentially altering the fatality of the disease forever.

“It took us about 20 years of research to figure this out, but we are very excited,” said Pierre Desprez, one of the scientists behind the discovery. The finding, which has already undergone both laboratory and animal testing, and is awaiting permission for clinical trials in humans.

Desprez, a molecular biologist, spent decades studying ID-1, the gene that causes cancer to spread. Fellow researcher  Sean McAllister was studying the effects of Cannabidiol, or CBD, a non-toxic, non-psychoactive chemical compound found in the cannabis plant. Finally, the pair collaborated, combining CBD and cells containing high levels of ID-1 in a petri dish.

“What we found was that his Cannabidiol could essentially ‘turn off’ the ID-1,” Desprez told HuffPost. The cells stopped spreading and returned to normal.

“We likely would not have found this on our own,” he added. “That’s why collaboration is so essential to scientific discovery.”

Desprez and McAllister’s findings was first published in 2007. Since then, their team has found that CBD works both in the lab and in animals. And now, they’ve found even more good news.

“We started by researching breast cancer. But now we’ve found that Cannabidiol works with many kinds of aggressive cancers–brain, prostate–any kind in which these high levels of ID-1 are present.”

“We’ve found no toxicity in the animals we’ve tested, and Cannabidiol is already used in humans for a variety of other ailments,” he said. Indeed, the compound is used to relieve anxiety and nausea, and, since it is non-psychoactive, does not cause the “high” associated with THC.

While marijuana advocates will surely praise the discovery, Desprez explained that it’s not so easy as just lighting up. “We used injections in the animal testing and are also testing pills. But you could never get enough Cannabidiol for it to be effective just from smoking.”

Furthermore, the team has started synthesizing the compound in the lab instead of using the plant in an effort to make it more potent.”It’s a common practice. But hopefully it will also keep us clear of any obstacles while seeking approval.””

By Sola Ogundipe

http://www.vanguardngr.com/2013/01/doctors-utilise-marijuana-as-pain-relief/

Marijuana’s Medicinal Value Vindicated Once Again, This Time For The Elderly

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Image Credit: Photos.com

Lee Rannals for redOrbit.com – Your Universe Online

“Researchers from Tel Aviv University say that smoking a little marijuana could help provide dramatic relief for the elderly who suffer from a variety of chronic ailments.

The scientists tested the effects of marijuana treatment on 19 residents of the Hadarim nursing home in Israel. During the study, the participants reported dramatic physical results, including healthy weight gain and the reduction of pain and tremors.

According to the study authors, the elderly participants also experienced an immediate improvement in their moods and communication skills after smoking cannabis.

Zach Klein, a graduate of Tel Aviv University’s Department of Film and Television Studies, said that the use of prescription medications was also significantly reduced as a result of using medical marijuana

The active ingredient in marijuana THC was first discovered in Israel by professors Raphael Mechoulam and Yechiel Gaoni. Israel is known as the world leader in medical cannabis research, according to Klein.

During the nursing home study, 19 patents between the ages of 69 and 101 were treated with medical cannabis in the form of powder, oil, vapor or smoke three times daily over the course of a year for conditions like chronic pain, lack of appetite, and muscle spasms and tremors.

Both researchers and nursing home staff members monitored participants for signs of improvement in their conditions as well as their overall quality of life.

Seventeen of the study participants achieved a healthy weight during their use of marijuana and experienced a noticeable reduction in pain, muscle spasms, joint stiffness and tremors. Nearly all of the patients using cannabis slept better, longer and had a reduced incidence of nightmares and flashbacks related to Post-Traumatic Stress Disorder (PTSD).

The researchers also reported a decline in the amount of prescribed medications taken by patients, such as antipsychotics, Parkinson’s treatment, mood stabilizers and pain relievers. Towards the end of the study, researchers found that 72 percent of participants were able to reduce their drug intake by an average of 1.7 medications per day.

For the next phase of his research, Klein wants to study the connection between medical cannabis and an improved ability to swallow. Difficulties in swallowing can lead to a decline in nutrition and, ultimately, premature death. He believes that cannabis will have a positive impact on patients suffering from this disorder, which is known in medical jargon as dysphagia.”

http://www.redorbit.com/news/health/1112770306/medical-benefits-of-marijuana-elderly-012413/

Medical cannabis eases pain, improves appetite

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“Medical Cannabis treatment can improve appetite, ease chronic pain, and more, researchers say.

Though controversial, medical cannabis has been gaining ground as a valid therapy, offering relief to suffers of diseases such as cancer, Post-Traumatic Stress Disorder, ALS and more.

The substance is known to soothe severe pain, increase the appetite, and ease insomnia where other common medications fail.”

http://articles.timesofindia.indiatimes.com/2013-01-25/health/36547301_1_medical-cannabis-chronic-pain-muscle-spasms

Medical cannabis can improve appetite, ease chronic pain, say researchers

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“Though controversial, medical cannabis has been gaining ground as a valid therapy, offering relief to suffers of diseases such as cancer, Post-Traumatic Stress Disorder, ALS and more. The substance is known to soothe severe pain, increase the appetite, and ease insomnia  where other common medications fail.

In 2009, Zach Klein, a graduate of Tel Aviv University’s Department of Film and Television Studies, directed the documentary Prescribed Grass. Through the process, he developed an interest in the scientific research behind medical marijuana, and now, as a specialist in policy-making surrounding medical cannabis and an MA student at TAU’s Porter School of Environmental Studies, he is conducting his own research into the benefits of medical cannabis.

Using marijuana from a farm called Tikkun Olam – a reference to the Jewish concept of healing the world – Klein and his fellow researchers tested the impact of the treatment on 19 residents of the Hadarim nursing home in Israel. The results, Klein says, have been outstanding. Not only did participants experience dramatic physical results, including healthy weight gain and the reduction of pain and tremors, but Hadarim staff saw an immediate improvement in the participants’ moods and communication skills. The use of chronic medications was also significantly reduced, he reports.”

Read more: http://www.news-medical.net/news/20130125/Medical-cannabis-can-improve-appetite-ease-chronic-pain-say-researchers.aspx

The endocannabinoid nervous system: unique opportunities for therapeutic intervention.

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“The active principle in marijuana, Delta(9)-tetrahydrocannabinol (THC), has been shown to have wide therapeutic application for a number of important medical conditions, including pain, anxiety, glaucoma, nausea, emesis, muscle spasms, and wasting diseases. Delta(9)-THC binds to and activates two known cannabinoid receptors found in mammalian tissue, CB1 and CB2. The development of cannabinoid-based therapeutics has focused predominantly on the CB1 receptor, based on its predominant and abundant localization in the CNS.

Like most of the known cannabinoid agonists, Delta(9)-THC is lipophilic and relatively nonselective for both receptor subtypes.

Clinical studies show that nonselective cannabinoid agonists are relatively safe and provide therapeutic efficacy, but that they also induce psychotropic side effects. Recent studies of the biosynthesis, release, transport, and disposition of anandamide are beginning to provide an understanding of the role of lipid transmitters in the CNS. This review attempts to link current understanding of the basic biology of the endocannabinoid nervous system to novel opportunities for therapeutic intervention.

This new knowledge may facilitate the development of cannabinoid receptor-targeted therapeutics with improved safety and efficacy profiles.”

http://www.ncbi.nlm.nih.gov/pubmed/11448725

Discovery and development of endocannabinoid-hydrolyzing enzyme inhibitors.

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“Fatty acid amide hydrolase (FAAH) and monoglyceride lipase (MGL) are hydrolytic enzymes which degrade the endogenous cannabinoids (endocannabinoids) N-arachidonoylethanolamine (anandamide, AEA) and 2-arachidonoylglycerol (2-AG), respectively. Endocannabinoids are an important class of lipid messenger molecules that are produced on demand in response to elevated intracellular calcium levels. They recognize and activate the cannabinoid CB(1) and CB(2) receptors, the molecular targets for Delta(9)-tetrahydrocannabinol (Delta(9)-THC) in marijuana evoking several beneficial therapeutic effects. However, in vivo the cannabimimetic effects of AEA and 2-AG remain weak owing to their rapid inactivation by FAAH and MGL, respectively. The inactivation of FAAH and MGL by specific enzyme inhibitors increases the levels of AEA and 2-AG, respectively, producing therapeutic effects such as pain relief and depression of anxiety.”

http://www.ncbi.nlm.nih.gov/pubmed/20370710