An escalating number of fatalities resulting from accidental opioid overdoses typically attributed to respiratory depression continue to define the opioid epidemic. Opioid respiratory depression results from a decrease in reflexive inspiration within the preBötzinger complex in the brainstem. Cannabinoid receptor agonism is reported to enhance opioid analgesia, yet whether cannabinoids enhance or inhibit opioid-induced respiratory depression is unknown.
https://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.png00Michelle Smithhttps://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.pngMichelle Smith2025-04-08 10:02:572025-04-08 10:02:57Cannabinoid Therapeutic Effects in Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
An escalating number of fatalities resulting from accidental opioid overdoses typically attributed to respiratory depression continue to define the opioid epidemic. Opioid respiratory depression results from a decrease in reflexive inspiration within the preBötzinger complex in the brainstem. Cannabinoid receptor agonism is reported to enhance opioid analgesia, yet whether cannabinoids enhance or inhibit opioid-induced respiratory depression is unknown.
The use of opioids in pain management is hampered by the emergence of analgesic tolerance, which leads to increased dosing and side effects, both of which have contributed to the opioid epidemic. One promising potential approach to limit opioid analgesic tolerance is activating the endocannabinoid system in the CNS, via activation of CB1 receptors in the descending pain inhibitory pathway. In this review, we first discuss preclinical and clinical evidence revealing the potential of pharmacological activation of CB1 receptors in modulating opioid tolerance, including activation by phytocannabinoids, synthetic CB1 receptor agonists, endocannabinoid degradation enzyme inhibitors, and recently discovered positive allosteric modulators of CB1 receptors.
https://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.png00Michelle Smithhttps://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.pngMichelle Smith2025-02-20 08:13:162025-02-20 08:13:59Alternative pain management via endocannabinoids in the time of the opioid epidemic: Peripheral neuromodulation and pharmacological interventions
Opioid therapy is critical for pain relief for most hospice patients but may be limited by adverse side effects. Combining medical cannabis with opioids may help mitigate adverse effects while maintaining effective pain relief. This single-arm study investigated the impact of combined medical cannabis/opioid therapy on pain relief, opioid dose, appetite, respiratory function, well-being, nausea, and adverse events in hospice inpatients.
https://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.png00Michelle Smithhttps://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.pngMichelle Smith2023-12-21 04:26:102023-12-21 04:26:10Medical Marijuana for Pain Management in Hospice Care as a Complementary Approach to Scheduled Opioids: A Single Arm Study
The opioid crisis continues in full force, as physicians and caregivers are desperate for resources to help patients with opioid use and chronic pain disorders find safer and more accessible non-opioid tools.
Main body
The purpose of this article is to review the current state of the opioid epidemic; the shifting picture of cannabinoids; and the research, policy, and current events that make opioid risk reduction an urgent public health challenge. The provided table contains an evidence-based clinical framework for the utilization of cannabinoids to treat patients with chronic pain who are dependent on opioids, seeking alternatives to opioids, and tapering opioids.
Data continue to emerge on the use of cannabinoids for pain management, narcotic substitution, and heroin withdrawal. Building on previous studies, I present a case demonstrating the effectiveness of dose-controlled, oral cannabinoids to rapidly remove prescription opioids using cannabis substitution therapy. Cannabis is recreationally and medically legal in California. In accordance with regulations, medications containing cannabis must be measured, labeled, tested, and verified by a state-licensed third-party laboratory. The following case involves a patient who presented to the ReLeaf Institute in Los Angeles, California in February 2018 for evaluation of chronic pain, with the goal of removing prescription opioids via the use of cannabis medications.
Pain is a global phenomenon encompassing many subtypes that include neuropathic, musculoskeletal, acute postoperative, cancer, and geriatric pain. Traditionally, opioids have been a mainstay pharmacological agent for managing many types of pain. However, opioids have been a subject of controversy with increased addiction, fatality rates, and cost burden on the US healthcare system. Cannabinoids have emerged as a potentially favorable alternative or adjunctive treatment for various types of acute and chronic pain. This narrative review seeks to describe the efficacy, risks, and benefits of cannabinoids as an adjunct or even potential replacement for opioids in the treatment of various subtypes of pain.
https://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.png00Michelle Smithhttps://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.pngMichelle Smith2023-03-04 18:42:402023-03-04 18:42:40Cannabinoids as a Potential Alternative to Opioids in the Management of Various Pain Subtypes: Benefits, Limitations, and Risks
Chronic non-cancer pain (CNCP) is estimated to affect 20% of the adult population. Current United States and Canadian Chronic non-cancer pain guidelines recommend careful reassessment of the risk-benefit ratio for doses greater than 90 mg morphine equivalent dose (MED), due to low evidence for improved pain efficacy at higher morphine equivalent dose and a significant increase in morbidity and mortality. There are a number of human studies demonstrating cannabis opioid synergy. This preliminary evidence suggests a potential role of cannabis as an adjunctive therapy with or without opioids to optimize pain control.
To describe the prevalence and patterns of cannabidiol (CBD) use in women with co-existing chronic pelvic pain (CPP) and fibromyalgia, and to evaluate characteristics associated with pain improvement.
To describe the prevalence and patterns of cannabidiol (CBD) use in women with co-existing chronic pelvic pain (CPP) and fibromyalgia, and to evaluate characteristics associated with pain improvement.
To describe the prevalence and patterns of cannabidiol (CBD) use in women with co-existing chronic pelvic pain (CPP) and fibromyalgia, and to evaluate characteristics associated with pain improvement.
Many cannabinoids display promising non-hallucinogenic bioactivities that are determined by the variable nature of the side chain and prenyl group defined by the enzymes involved in their synthesis.
https://www.cannabisclinicians.org/wp-content/uploads/2021/01/cannabis-nomenclature-kenzi-riboulet-zimouli-1.jpg8001200Michelle Smithhttps://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.pngMichelle Smith2021-10-20 11:03:362021-10-20 11:03:36Practical Strategies Using Medical Cannabis to Reduce Harms Associated With Long Term Opioid Use in Chronic Pain
Authors Philippe Lucas, MA PhD, Susan Boyd, PhD, M -J Milloy, PhD, Zach Walsh, PhD Published in Pain Medicine December 2020 Abstract Objective This article presents findings from a large…
https://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.png00Michelle Smithhttps://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.pngMichelle Smith2021-01-07 12:26:352021-01-07 12:26:35Cannabis Significantly Reduces the Use of Prescription Opioids and Improves Quality of Life in Authorized Patients: Results of a Large Prospective Study
Authors Hefei Wen, PhD; Jason M. Hockenberry, PhD Published in JAMA Internal Medicine May 2018 Abstract Importance Overprescribing of opioids is considered a major driving force behind the opioid epidemic in…
https://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.png00Michelle Smithhttps://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.pngMichelle Smith2020-12-18 11:32:442020-12-20 23:52:21Association of Medical and Adult-Use Marijuana Laws With Opioid Prescribing for Medicaid Enrollees
https://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.png00Michelle Smithhttps://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.pngMichelle Smith2020-11-09 13:32:082020-12-04 12:16:01Prescribed medical cannabis in women with gynecologic malignancies: A single-institution survey-based study
Author: Alex Capano, Richard Weaver & Elisa Burkman Published in Postgraduate Medicine November 2019 Abstract Context: Chronic pain is highly prevalent in most of the industrialized nations around the world….
https://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.png00Michelle Smithhttps://www.cannabisclinicians.org/wp-content/uploads/2020/06/scc_logo-long-R-2-1.pngMichelle Smith2020-08-12 19:03:422020-08-13 04:48:49Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study
