Tag Archives: marijuana

Smoking Marijuana Eases Chronic Neuropathic Pain.

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“Smoking cannabis reduces chronic neuropathic pain and also improves sleep, according to new research published today in the Canadian Medical Association Journal.

A single inhalation of 25 mg of 9.4% tetrahydrocannabinol herbal cannabis 3 times a day for 5 days was sufficient to achieve these outcomes, lead study author Mark A. Ware, MBBS, from McGill University Health Center, Montreal, Canada, told Medscape Medical News in an interview.

“Patients have been reporting that cannabis helps control their pain, and they have been saying so for a long time,” Dr. Ware said. “At the time that we had secured the funding and began the trial, there had been no clinical trials that had established this or investigated it.”

In addition, a large body of scientific knowledge is emerging abound the role of cannabinoid receptors and cannabinoid ligands in the human body, providing a potential scientific explanation as to why cannabinoids would be analgesic, he added. “So the 2 main supports came together, and in Canada at the time, there was an environment where we were able to secure funding sufficient for studies of this.”

Posttraumatic and Postsurgical Neuropathy

The study included 21 individuals older than 18 years (mean age, 45.4 years) with posttraumatic or postsurgical neuropathic pain lasting for at least 3 months. They were randomly assigned to receive cannabis at 4 potencies — 0%, 2.5%, 6%, and 9.4% tetrahydrocannabinol — during 4 periods in a crossover design. Each period lasted 14 days and began with 5 days of cannabis use followed by a 9-day washout period.

The cannabis doses were delivered in a single smoked inhalation using a titanium pipe. Patients self-administered the first dose of each period under supervision and were instructed to inhale for 5 seconds while the cannabis was lit, hold the smoke in their lungs for 10 seconds, and then exhale. They self-administered the remaining doses for each period at home.

The participants were allowed to continue their routine medications, and the use of acetaminophen as breakthrough analgesia was also permitted.

Pain intensity was measured using an 11-item numeric rating scale that used “no pain” and “worst pain possible” as anchors.

The study found that the higher dose of cannabis was the most efficient in reducing pain. The average daily pain intensity was 5.4 with the 9.4% tetrahydrocannabinol cannabis dose compared with 6.1 with the 0% or placebo dose (95% confidence interval, 0.02 – 1.4; P = .023).

In addition, participants reported significantly more drowsiness and reported getting to sleep more easily, faster, and with fewer periods of wakefulness when taking the 9.4% dose than when taking the 0% dose ( P < .05). The higher dose also improved anxiety and depression compared with the placebo dose.

Blind Held; Studies Feasible

“It was feared that participants would know right away if they were smoking cannabis because of the acute psychoactive effects of the drug, but our results do not support this,” Dr. Ware noted. “They do show that short-term placebo-controlled trials of smoked cannabis are feasible.”

He would like his study to act as a stimulus for other studies on cannabis and pain relief.

“Studies of this kind can be done. Ours was difficult to do because it was the first time we had done anything like this. We were breaking new ground with regard to regulations and so on, but it is possible. Having done it once, it’s not as difficult to do it again. So our results raise the possibility of extending the study for a longer duration, or being able to look at safety issues, and so on. It is possible to do a scientific trial with this compound. Your political views shouldn’t matter. This is just good science,” Dr. Ware said.

In a related commentary, Henry J. McQuay, DM, from Balliol College, Oxford, United Kingdom, writes that the study authors should be congratulated for tackling the question of whether cannabis helps in neuropathic pain, “particularly given that the regulatory hurdles for their trial must have been a nightmare.”

He concludes that the study “adds to the trickle of evidence that cannabis may help some of the patients who are struggling at present.””

http://www.medscape.com/viewarticle/727702

Research: Marijuana can treat chronic pain – ABC

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“SACRAMENTO, CA (KGO) — A program commissioned more than a decade ago by the state Legislature to look into the therapeutic value of medicinal marijuana is expected to release a report on its findings today, a spokeswoman for state Sen. Mark Leno said.

A UC medical marijuana research panel today released the results of a ten year clinical study and according to its report, pot can effectively treat chronic pain.

Volunteers with multiple sclerosis and spinal cord injuries were randomly treated with marijuana or a placebo. Patients given cannabis reported fewer multiple sclerosis muscle spasms, and less spinal injury pain.

In another study, the panel found that pot effectively also treats migraines.

But researchers used marijuana grown by the federal government, not the kinds available to California medical marijuana users.

Medical marijuana has been legal under California law since voters approved Proposition 215, also known as the Compassionate Use Act, in 1996.

The state Legislature clarified in 2004 that the Compassionate Use Act allows qualified patients and their primary caregivers to cultivate marijuana for medicinal use.

Medical marijuana remains illegal under federal law, though, leaving patients and providers open to prosecution in federal court.”

http://abclocal.go.com/kgo/story?section=news/state&id=7283032

Marijuana Relieves HIV Nerve Pain

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“Smoking marijuana effectively relieves chronic HIV-associated nerve pain, including aching, painful numbness, and burning, according to a study published in the February 13, 2007, issue of Neurology®, the scientific journal of the American Academy of Neurology.

For the study, 50 people with HIV-associated sensory neuropathy, the most common HIV nerve disorder, were admitted to a California hospital and randomly assigned to smoke either marijuana or identical placebo cigarettes three times a day for five days.

The study found people who smoked marijuana reduced their daily nerve pain by 34 percent compared to 17 percent in the placebo group.

“Smoking marijuana was well tolerated and effectively relieved chronic nerve pain from HIV-associated sensory neuropathy,” said study author Donald Abrams, MD, with San Francisco General Hospital in San Francisco, California. “Our findings show the amount of relief from smoking marijuana is comparable to relief provided by oral drugs currently used for chronic nerve pain.”

Abrams says while some HIV patients with chronic nerve pain are able to take anticonvulsant drugs, such as lamotrigine and gabapentin, to ease pain, some patients don’t respond well to these drugs. He says that’s why there’s heightened interest in evaluating marijuana as a treatment for chronic nerve pain.

The study also found the first marijuana cigarette reduced chronic pain by an average of 72 percent versus 15 percent with placebo. And more than half of the people who smoked marijuana reported more than a 30-percent reduction in pain compared to 24 percent in the placebo group.

Participants in the study reported no serious side effects.

Researchers say similar results were reported in two recent placebo-controlled studies of marijuana-related therapies for nerve pain associated with multiple sclerosis.

The study was supported by the University of California Center for Medicinal Cannabis Research and conducted at the National Institutes of Health-funded General Clinical Research Center at San Francisco General Hospital.”

http://www.medicalnewstoday.com/releases/63333.php

Marijuana component could ease pain from chemotherapy drugs

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“A chemical component of the marijuana plant could prevent the onset of pain associated with drugs used in chemo therapy, particularly in breast cancer patients, according to researchers at Temple University’s School of Pharmacy.

“We found that cannabidiol completely prevented the onset of the neuropathic, or caused by the chemo drug Paclitaxel, which is used to treat ,” said Ward, who is also a research associate professor in Temple’s Center for Substance Abuse Research.

Ward said that one of cannabidiol’s major benefits is that, unlike other chemicals found in marijuana such as THC, it does not produce psycho-active effects such as euphoria, increased appetite or cognitive deficits. “Cannabidiol has the therapeutic qualities of marijuana but not the side effects,” she said.”

Read more: http://medicalxpress.com/news/2011-10-marijuana-component-ease-pain-chemotherapy.html

Marijuana Relieves Chronic Pain, Research Shows – WebMD

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“Three puffs a day of cannabis, better known as marijuana, helps people with chronic nerve pain due to injury or surgery feel less pain and sleep better, a Canadian team has found.

”It’s been known anecdotally,” says researcher Mark Ware, MD, assistant professor of anesthesia and family medicine at McGill University in Montreal. “About 10% to 15% of patients attending a chronic pain clinic use cannabis as part of their pain [control] strategy,” he tells WebMD.

But Ware’s study is more scientific — a clinical trial in which his team compared placebo with three different doses of cannabis. The research is published in CMAJ, the Canadian Medical Association Journal.

The new study ”adds to the trickle of evidence that cannabis may help some of the patients who are struggling [with pain] at present,” Henry McQuay, DM, an emeritus fellow at Balliol College, Oxford University, England, writes in a commentary accompanying the study…” More: http://www.webmd.com/pain-management/news/20100830/marijuana-relieves-chronic-pain-research-show

“Smoked cannabis for chronic neuropathic pain: a randomized controlled trial… A single inhalation of 25 mg of 9.4% tetrahydrocannabinol herbal cannabis three times daily for five days reduced the intensity ofpain, improved sleep and was well tolerated.”  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950205/

For many patients, cannabis may offer the best medicinal pain relief yet discovered

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by: Raw Michelle

“(NaturalNews) By the beginning of the 1980s, after a four decade long lockdown, a re-interest in cannabis arose in the scientific community. In 1982, the American Institute of Medicinepublished an intriguing report entitled “Marijuana and Health”. The report was a collection of tentative exploratory research and case studies of the use of cannabis as a medicine.

The reappearance of a powerful plant in human pharmacopeia

The studies provided a glimpse of something that intrigued health care researchers. While the plant’s effects were entirely congruent with the goal of healing, the methodology used by the plant’s chemicals was very different from those employed by typical pharmaceuticals. To developers, cannabis suddenly represented a precedent for a whole new type of medicine. With over 88 pharmacologically active substances, cannabis introduced hundreds of new compounds to the medical world. The institute’s report concluded that further research into cannabis’ potential would be of great value to the field.

However, further research was very limited, stifled by cannabis’ legal status and social stigma. The legal status forces researchers to expend an overwhelming amount of time and effort to get permission to conduct the studies. The social stigma causes institutes to be less likely to receive funding for the projects, and that researchers are sacrificing their reputation in the professional world. That also means most of the studies conducted are federally funded. Unfortunately, in addition, successful researchers will still have to face a further publication bias, as journals also risk their reputations and status when publishing cannabis related research. It is ironic that even within a scientific community, researchers are punished for being unbiased. As a result, outlets that focus solely on cannabis related research have arisen. Internet publications have opened a wide market for research that would have previously been buried.

Where opiates don’t quite cut it

Of the studies that have been conducted, most have focused on marijuana as a treatment for neuropathic pain, one of the earliest treatments for which physicians saw potential. Neuropathic pain results from nerve damage in which the cells experience difficulty communicating. This can happen from traumas like surgery, where nerve connections are severed, but continue trying to communicate news of the damage to the next cell over. Similarly, when new nerve cells are formed but not yet hooked into the neural highway, they sputter and spark, trying to achieve connection. The sensation can be very painful. Neuropathic pain is very common symptom of cancer. Tumour growth can crush nerve trunks as it bullies its way to more territory.

Sometimes just talking about it helps

Early studies demonstrate that cannabis is hugely effective in treating neuropathic pain. The cannabinoids allow nerve cells to reverse the communication path. Cells sending trauma notifications to the main trunk would normally continue doing so until the stimuli was resolved. From a practical standpoint, it is difficult to eliminate pain the moment it is recognised, but from a human level, once the person is cognizant of the problem, there is no benefit to remaining in pain. Cannabis simply tells the alarmed cell that authorities have been notified and that the problem will be resolved shortly. It doesn’t, as is popularly believed, relieve pain by making cells “stoned” or unfocused so as to disrupt communication.

The few studies have been conducted have returned agreeing with the American Medical Institute’s findings and recommendations. After only preliminary examination, cannabis presents itself as a powerful tool. More in-depth research is likely to further displace today’s most relied-upon pharmaceuticals.”

 
 
 

The Endocannabinoid System and Pain

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“Cannabis has been used for more than twelve thousand years and for many different purposes (i.e. fiber, medicinal, recreational). However, the endocannabinoid signaling system has only recently been the focus of medical research and considered a potential therapeutic target. Endocannabinoids … Continue reading → Continue reading →

Seizure exacerbation in two patients with focal epilepsy following marijuana cessation.

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Abstract

“While animal models of epilepsy suggest that exogenous cannabinoids may have anticonvulsant properties, scant evidence exists for these compounds’ efficacy in humans. Here, we report on two patients whose focal epilepsy was nearly controlled through regular outpatient marijuana use. Both stopped marijuana upon admission to our epilepsy monitoring unit (EMU) and developed a dramatic increase in seizure frequency documented by video-EEG telemetry. These seizures occurred in the absence of other provocative procedures, including changes to anticonvulsant medications. We review these cases and discuss mechanisms for the potentially anticonvulsant properties of cannabis, based on a review of the literature.”

http://www.ncbi.nlm.nih.gov/pubmed/23159379

Therapeutic potential of the endocannabinoid system in the brain.

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Abstract

“Cannabinoids have been predominantly considered as the substances responsible of the psychoactive properties of marijuana and other derivatives of Cannabis sativa. However, these compounds are now being also considered for their therapeutic potential, since the term “cannabinoid” includes much more compounds than those present in Cannabis sativa derivatives. Among them, there are numerous synthetic cannabinoids obtained by modifications from plant-derived cannabinoids, but also from the compounds that behave as endogenous ligands for the different cannabinoid receptor subtypes. Within the family of “cannabinoid-related compounds”, one should also include some prototypes of selective antagonists for these receptors, and also the recently developed inhibitors of the mechanism of finalization of the biological action of endocannabinoids (transporter + FAAH). All this boom of the cannabinoid pharmacology has, therefore, an explanation in the recent discovery and characterization of the endocannabinoid signaling system, which plays a modulatory role mainly in the brain but also in the periphery. The objective of the present article will be to review, from pharmacological and biochemical points of view, the more recent advances in the study of the endocannabinoid system and their functions in the brain, as well as their alterations in a variety of pathologies and the proposed therapeutic benefits of novel cannabinoid-related compounds that improve the pharmacokinetic and pharmacodynamic properties of classic cannabinoids.”

http://www.ncbi.nlm.nih.gov/pubmed/16026307

Endocannabinoids in Liver Disease.

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“Marijuana has been used for its psychoactive and medicinal properties for millennia. As other plant-derived substances, marijuana has been slow to yield its secrets, with insights into its mechanism of action beginning to emerge only during the last decades. The existence of specific CB receptors in mammalian tissues was first revealed by radioligand binding, followed by the molecular cloning of two G protein-coupled cannabinoid receptors (1). CB1 receptors are the most abundant receptors in the mammalian brain, but are also expressed in peripheral tissues, including various cell types of the liver, at much lower yet functionally relevant concentrations. CB2 receptors are expressed primarily in immune and hematopoietic cells, and have also been detected in the liver in certain pathological states. Additional CB receptors may exist…”

“Endocannabinoids are lipid mediators of the same cannabinoid (CB) receptors that mediate the effects of marijuana. The endocannabinoid system (ECS) consists of CB receptors, endocannabinoids, and the enzymes involved in their biosynthesis and degradation, and is present both in brain and peripheral tissues, including the liver. The hepatic ECS is activated in various liver diseases, which contributes to the underlying pathologies. In cirrhosis of various etiologies, activation of vascular and cardiac CB1 receptors by macrophage- and platelet-derived endocannabinoids contribute to the vasodilated state and cardiomyopathy, which can be reversed by CB1 blockade. In mouse models of liver fibrosis, activation of CB1 receptors on hepatic stellate cells is fibrogenic, and CB1 blockade slows the progression of fibrosis. Fatty liver induced by high-fat diets or chronic alcohol feeding depend on activation of peripheral, including hepatic CB1 receptors, which also contribute to insulin resistance and dyslipidemias. Although the documented therapeutic potential of CB1 blockade is limited by neuropsychiatric side effects, these may be mitigated by using novel, peripherally restricted CB1 antagonists.”

“Concluding Remarks

The ECS is present in the liver and is involved in the control of various hepatic functions with important therapeutic implications. Increased CB1 activity contributes to the hemodynamic abnormalities and promotes fibrosis in liver cirrhosis, whereas CB1 blockade attenuates and delays these changes. Endocannabinoids acting via hepatic CB1 receptors have emerged as mediators of both diet-induced and alcoholic fatty liver which, together, account for the majority of cirrhosis in Western societies. Additionally, hepatic CB1 activation contributes to obesity-related insulin- and leptin-resistance and dyslipidemias. This provides strong rationale for the therapeutic use of CB1 antagonists in these conditions. Although neuropsychiatric side effects limit the therapeutic potential of brain-penetrant CB1 antagonists, the recent emergence of second generation, peripherally-restricted CB1 antagonists may mitigate this problem. Additionally, non-psychoactive CB2 agonists may offer therapeutic benefit in attenuating liver injury and promoting tissue repair in the fibrotic liver.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3073545/