Three Cannabis Based Medicinal Extracts (CBMEs) for sublingual use became available in 2000. A total of 34 'N of 1' studies were undertaken using this novel therapy for patients with chronic, mainly neuropathic, pain and associated symptoms to explore efficacy, tolerability, safety and dosages. Three CBMEs (D9 Tetrahydrocannabinol (THC), Cannabidiol (CBD) and a 1 : 1 mixture of them both) were given over a 12-week period. After an initial open-label period, the CBMEs were used in a randomised, double-blind, placebo controlled, crossover trial. Extracts which contained THC proved most effective in symptom control. Regimens for the use of the sublingual spray emerged and a wide range of dosing requirements was observed. Side-effects were common, reflecting a learning curve for both patient and study team. These were generally acceptable and little different to those seen when other psycho-active agents are used for chronic pain. These initial experiences with CBME open the way to more detailed and extensive studies.

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Research into social networks has been advancing over several decades, originally in relation to the general population and more recently in relation to their influences on health and mental health. The recent full implementation of the Community Care Act, with its stress on the role of carers and networks, reinforces the need for mental health nurses to be aware of these issues. This selective review examines some of the ways in which social networks can be analysed, explores the relationship between social networks and social support, and considers the effects of social networks and social support on mental health. Research into the social networks of people with long-term mental ill-health is discussed, and implications for mental health nursing in all care settings are addressed.

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