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Role of Cannabinoids in Pain Management

Authors: Ethan B. Russo, Andrea G. Hohmann
Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches, 2013

It is a curious fact that we owe a great deal of our insight into pharmacological treatment of pain to the plant world. Willow bark from Salix spp. led to development of aspirin and eventual elucidation of the analgesic effects of prostaglandins and their role in inflammation…

Multiple sclerosis and extract of cannabis: results of the MUSEC trial.

Authors: John Peter Zajicek, Jeremy C. Hobart, Anita Slade, David Barnes, Paul G. Mattison
Journal of Neurology, Neurosurgery, & Psychiatry, November 2012

OBJECTIVE: Multiple sclerosis (MS) is associated with chronic symptoms, including muscle stiffness, spasms, pain and insomnia. Here we report the results of the Multiple Sclerosis and Extract of Cannabis (MUSEC) study that aimed to substantiate the patient based findings of pr…

Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial.

Authors: Jody Corey-Bloom, Tanya Wolfson, Anthony Gamst, Shelia Jin, Thomas D. Marcotte, et al
CMAJ, 10 July 2012

BACKGROUND: Spasticity is a common and poorly controlled symptom of multiple sclerosis. Our objective was to determine the short-term effect of smoked cannabis on this symptom. METHODS: We conducted a placebo-controlled, crossover trial involving adult patients with multiple s…

Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: a randomized, placebo-controlled, graded-dose trial.

Authors: Russell K. Portenoy, Elena Doina Ganae-Motan, Silvia Allende, Ronald Yanagihara, et al
The Journal of Pain, May 2012

Patients with advanced cancer who have pain that responds poorly to opioid therapy pose a clinical challenge. Nabiximols (Nabiximols is the U.S. Adopted Name [USAN] for Sativex [GW Pharma Ltd, Wiltshire, U.K.], which does not yet have an INN), a novel cannabinoid formulation, …

Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: a randomized, placebo-controlled, graded-dose trial.

Authors: Russell K. Portenoy, Elena Doina Ganae-Motan, Silvia Allende, Ronald Yanagihara, et al
The Journal of Pain, May 2012

Patients with advanced cancer who have pain that responds poorly to opioid therapy pose a clinical challenge. Nabiximols (Nabiximols is the U.S. Adopted Name [USAN] for Sativex [GW Pharma Ltd, Wiltshire, U.K.], which does not yet have an INN), a novel cannabinoid formulation…

Prescribing cannabis for harm reduction.

Authors: Mark Collen
Harm Reduction Journal, 1 January 2012

Neuropathic pain affects between 5% and 10% of the US population and can be refractory to treatment. Opioids may be recommended as a second-line pharmacotherapy but have risks including overdose and death. Cannabis has been shown to be effective for treating nerve pain without…

Cannabinoid-opioid interaction in chronic pain.

Authors: D. I. Abrams, P. Couey, S. B. Shade, M. E. Kelly, N. L. Benowitz
Clinical Pharmacology & Therapeutics, December 2011

Cannabinoids and opioids share several pharmacologic properties and may act synergistically. The potential pharmacokinetics and the safety of the combination in humans are unknown. We therefore undertook a study to answer these questions. Twenty-one individuals with chronic pa…

Cannabidiol prevents the development of cold and mechanical allodynia in paclitaxel-treated female C57Bl6 mice.

Authors: Sara Ward, Michael Ramirez, Harshini Neelakantan, Ellen Walker
Anesthesia and Analgesia, October 2011

The taxane chemotherapeutic paclitaxel frequently produces peripheral neuropathy in humans. Rodent models to investigate mechanisms and treatments are largely restricted to male rats, whereas female mouse studies are lacking. We characterized a range of paclitaxel doses on col…

Cannabis in palliative medicine: improving care and reducing opioid-related morbidity.

Authors: Gregory T. Carter, Aaron M. Flanagan, Mitchell Earleywine, Donald I. Abrams, et al
American Journal of Hospice and Palliative Medicine, August 2011

Unlike hospice, long-term drug safety is an important issue in palliative medicine. Opioids may produce significant morbidity. Cannabis is a safer alternative with broad applicability for palliative care. Yet the Drug Enforcement Agency (DEA) classifies cannabis as Schedule I…

Smoked cannabis for chronic neuropathic pain: a randomized controlled trial.

Authors: Mark A. Ware, Tongtong Wang, Stan Shapiro, Ann Robinson, Thierry Ducruet, Thao Huynh, et al
CMAJ, 5 October 2010

BACKGROUND: Chronic neuropathic pain affects 1%-2% of the adult population and is often refractory to standard pharmacologic treatment. Patients with chronic pain have reported using smoked cannabis to relieve pain, improve sleep and improve mood. METHODS: Adults with post-tra…

A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain.

Authors: Barth Wilsey, Thomas Marcotte, Alexander Tsodikov, Jeanna Millman, Heather Bentley, et al
The Journal of Pain, June 2008

The Food and Drug Administration (FDA), Substance Abuse and Mental Health Services Administration (SAMHSA), and the National Institute for Drug Abuse (NIDA) report that no sound scientific studies support the medicinal use of cannabis. Despite this lack of scientific validatio…

Adjunctive nabilone in cancer pain and symptom management: a prospective observational study using propensity scoring.

Authors: Vincent Maida, Marguerite Ennis, Shiraz Irani, Mario Corbo, Michael Dolzhykov
Journal of Supportive Oncology, March 2008

A prospective observational study assessed the effectiveness of adjuvant nabilone (Cesamet) therapy in managing pain and symptoms experienced by advanced cancer patients. The primary outcomes were the differences between treated and untreated patients at 30 days’ follow-up, in…