Pharmacotherapeutic considerations for use of cannabinoids to relieve pain in patients with malignant diseases

Darkovska-Serafimovska, Marija; Serafimovska, Tijana; Arsova‐Sarafinovska, Zorica; Stefanoski, Sasho; Keskovski, Zlatko; Balkanov, Trajan

doi:10.2147/jpr.s160556

Cited by 43 publications

(38 citation statements)

References 38 publications

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“…Specifically, Sativex is a plant-derived cannabis medication that consists of approximately equal parts of THC and CBD and is administered orally through a spray. Sativex has recognized analgesic effects, [56][57][58] and has been approved for use in the United Kingdom, Canada, and 28 countries in Europe, South America, and Asia.…”

Section: Safety and Tolerability Of Cannabis In Various Formulationsmentioning

confidence: 99%

Cannabinoids, Pain, and Opioid Use Reduction: The Importance of Distilling and Disseminating Existing Data

Hutchison

Hagerty

Galinkin

et al. 2019

Cannabis and Cannabinoid Research

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The high prevalence of chronic pain conditions combined with an over-reliance on opioid prescriptions has resulted in an opioid epidemic and a desperate need for solutions. There is some debate about whether cannabis might play a role in addressing chronic pain conditions as well as the opioid epidemic. Recent surveys suggest that a large number of people are using cannabis as a treatment for pain and to reduce use of opioids, and cannabis-derived products demonstrate at least modest efficacy in the treatment of pain in randomized controlled trials. In addition, surveillance studies from countries that have approved the use of Sativex, which is a cannabis-based product, have demonstrated that a combination of D9-tetrahydrocannabinol and cannabidiol has low potential for harm, is well tolerated, and is helpful to patients. Given the number of people in the United States who are already using cannabis to manage pain and opioid use in state-regulated markets, it is imperative to conduct additional research in these areas, and to disseminate information on how to minimize harm and maximize any benefits of using cannabinoids to mitigate pain and reduce opioid use. The purpose of this article is to call attention to the fact that cannabis is being used in the management of chronic pain. Thus, this article also provides a set of guidelines on how to approach using cannabis to treat pain.

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Section: Safety and Tolerability Of Cannabis In Various Formulationsmentioning

confidence: 99%

Cannabinoids, Pain, and Opioid Use Reduction: The Importance of Distilling and Disseminating Existing Data

Hutchison

Hagerty

Galinkin

et al. 2019

Cannabis and Cannabinoid Research

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show abstract

“…Przegląd danych z 2018 r. dotyczył wyłącznie nabiksymoli, a jego autorzy stwierdzili, że istnieją dowody na bezpieczeństwo i umiarkowaną ich skuteczność w łagodzeniu bólu neuropatycznego i bólu związanego z chorobami nowotworowymi, zaś najczęściej występujące działania niepożądane (senność, nudności, wymioty, suchość w ustach) były dobrze tolerowane przez pacjentów [28].…”

Section: Medyczne Zastosowanie Kanabinoidówunclassified

“…Najczęstsze działania niepożądane kanabinoidów stosowanych w celach medycznych to: zawroty głowy, osłabienie, senność, euforia, halucynacje, splątanie, dezorientacja, nudności, wymioty oraz suchość w jamie ustnej [1,28].…”

Section: Profil Działań Niepożądanychunclassified

Cannabinoids – the possible use in palliative medicine

Dzierżanowski¹

2018

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W ostatnich latach wzrosło zainteresowanie kanabinoidami w leczeniu objawowym w opiece paliatywnej. Ich wielokierunkowe działanie, pomimo ograniczonej skuteczności, czyni je atrakcyjną alternatywą, szczególnie u chorych z wieloma objawami współistniejącymi. Do wskazań o udowodnionej skuteczności kanabinoidów należą: ból, spastyczność, drgawki, zaburzenia snu, nudności i wymioty oraz zespół Tourette'a. Mimo że skuteczność w leczeniu bólu jest ograniczona, to potwierdzono ją w bólu neuropatycznym oraz w leczeniu adiuwantowym w połączeniu z opioidami. Korzystny profil działań niepożądanych, w tym brak depresyjnego działania na układ oddechowy, sprawia, że kanabinoidy mogą uzupełnić stosunkowo wąski zestaw leków, jakie pozostają do dyspozycji lekarza medycyny paliatywnej.

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“…13 Harms commonly associated with cannabis use include psychiatric disturbances such as psychosis, dysphoria or 'feeling high', as well as others such as withdrawal, hyperemesis, sedation, blurred vision, tinnitus and ataxia. [10][11][12] The extent to which patient use of cannabis affects anaesthesia and is not fully known as reflected by the medical literature surrounding cannabis using patients and the perioperative period. A 2018 double-blinded randomised controlled trial examined the effect of preoperative cannabis extract (nabiximols) administration on anaesthetic depth.…”

Section: Introductionmentioning

confidence: 99%

Perioperative pain and addiction interdisciplinary network (PAIN): protocol for the perioperative management of cannabis and cannabinoid-based medicines using a modified Delphi process

et al. 2020

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IntroductionAt the conception of this study (January 2019), a literature search by the authors found no evidence-based or consensus perioperative guidelines for patients consuming cannabis products, or for those patients in whom a cannabinoid medication could be considered for perioperative treatment. Currently, there is a large global population that consumes cannabis. The availability of cannabis has also increased this decade with greater legal access to cannabis products in some countries such as USA, Canada, Uruguay, Israel, Australia and Germany. There are recognised possible therapeutic benefits for the use of cannabis in patients with chronic pain, chronic neuropathic pain and chemotherapy-induced nausea and vomiting. There are also potential side effects from cannabis use such as psychosis, cannabis hyperemesis syndrome, misuse disorder and cannabis withdrawal syndrome. There is evidence that cannabis may also affect factors in the perioperative period such as monitoring, quality of analgesia, sleep and opioid consumption. Given the large population of persons using cannabis, the heterogeneity of cannabis products and the paucity (and heterogeneity) of perioperative literature surrounding it, perioperative guidelines for cannabis consuming patients are both lacking and necessary. In this paper, we present the design for a modified Delphi technique that has been started with the intent of deriving cannabis perioperative guidelines from the available medical literature and the consensus of multidisciplinary experts.Materials, methods and analysisThis study will use a scoping narrative literature review and modified Delphi process to generate cannabis perioperative guidelines. A scoping narrative review of cannabis in the perioperative period by the authors of this proposal was completed and provided to a panel of 17 experts. These experts were recruited for their knowledge and expertise regarding cannabis and/or perioperative medicine. They were asked to rate a series of indications and clinical scenarios in two rounds. During the first round, the expert panel was blinded to each other’s participation. During the second round of this process, the expert panel met after being provided with an analysis of the first round’s submissions so they could be discussed further and, if possible, reach a further consensus regarding them. Using the results obtained from the Delphi review process, a draft of proposed cannabis perioperative guidelines will be generated. These proposed guidelines will be returned to the expert panel for critiquing prior to their finalisation.Ethics and disseminationStudy and panellist data will be deidentified and stored as per institutional (Toronto General Hospital) guidelines. Institutional research ethics board provided a waiver for this modified Delphi protocol. Findings will be presented and published in peer-reviewed publications and conferences.

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Pharmacotherapeutic considerations for use of cannabinoids to relieve pain in patients with malignant diseases

Cited by 43 publications

References 38 publications

Cannabinoids, Pain, and Opioid Use Reduction: The Importance of Distilling and Disseminating Existing Data

Cannabinoids, Pain, and Opioid Use Reduction: The Importance of Distilling and Disseminating Existing Data

Cannabinoids – the possible use in palliative medicine

Perioperative pain and addiction interdisciplinary network (PAIN): protocol for the perioperative management of cannabis and cannabinoid-based medicines using a modified Delphi process

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