But with little solid scientific evidence for which products work best and in what dosage, it’s up to patients to figure out by trial and error which cannabinoids, if any, help relieve their symptoms. In the past, clinical trials to determine whether marijuana is effective in treating certain conditions have been restrictive and limited. However, as medical marijuana becomes more common around the world, researchers are doing more studies.
Cannabinoid medications are available in pill form and liquid extracts formulated in an oromucous spray. Oral preparations are “problematic because of the absorption of cannabinoids into adipose tissue, from which they are slowly released, and the significant first-pass liver metabolism, which breaks down Δ9THC and further contributes to the variability of plasma concentrations.” Given the authors’ reporting of issues related to outcomes, future prospective studies should be guided by a standardized set of “core” outcomes to strive for consistency between studies and ensure the relevance of patient-centered care. The development of those core outcomes should be developed using the Core Outcome Measures in Effectiveness Trials methodology, and more consideration should be given to what outcomes may be common in cannabis research and which outcomes are condition-specific.
It’s unclear whether U.S. states can mitigate the adverse effects of the opioid epidemic by prescribing medical cannabis as an alternative pain management drug. Cannabis-based medicine is a rapidly emerging field, with implications for both healthcare professionals and patients. This scope review is intended to map the harms and benefits of medicinal cannabis and gather evidence. Many reviews could not give firm conclusions about the effectiveness of medicinal cannabis and the results of the reviews were mixed. Mild side effects have often been reported inconsistently, and it is possible that the disadvantages outweigh the benefits.
One review reported withdrawal due to adverse events per study and also reported that side effects such as nausea, drowsiness and dizziness were more common with higher doses of cannabinoids. The efficacy of cannabinoids in the treatment of chronic neurogenic pain is explained by the ecS modulation of the compromised descending supraspinal inhibitory pathway in patients with chronic pain. Cannabinoid activation of CB1 and CB2 receptors stimulates endogenous noradrenergic pathways, which activate peripheral adrenoreceptors to induce antinociception.
It was the most common method of medicinal cannabis use in the United States as of 2013. It is difficult to predict the pharmacological response to cannabis, as the concentration of cannabinoids varies greatly, as there are different ways to prepare it for consumption and the lack of production controls. The potential for adverse effects of smoke inhalation makes smoking a less viable option than oral preparations. Cannabis vaporizers have become popular because of the perception among users that fewer harmful chemicals are ingested when components are inhaled via aerosols instead of smoke.
Suggested treatments for related neurological and psychiatric side effects include Zyprexa or Haldo for acute psychosis, acute anxious psychotic symptoms, and the use of cannabidiol with a high THC content. For cognitive decline with repeated use, COX-2 inhibitors appear to provide some benefit based on preclinical primate studies.14 Also among the concerns in cultivation are contaminants from the cannabis plant, including fungal and bacterial organisms, heavy metals such as aluminum, and soil cadmium. Canada and some European countries are adopting all aspects of cannabis cultivation and testing all products to make sure they are safe before being distributed to medical/research workers, but there is no such process in the United States. While medical marijuana may not be a panacea, it can certainly improve the quality of life for someone dealing with chronic pain. The plant is in high demand today, as alternatives to commonly prescribed medications are more common and many patients are no longer willing to tolerate the adverse side effects of opioid-based medications. Strengths of this scope review are the use of an a priori protocol, peer-reviewed search strategies, an extensive search for reviews and consideration of observational designs for data on side effects.
He doesn’t wake up coughing at night anymore and within a few days he had a lot more energy and his complexion went from looking like he was going to die to looking rested and normal. It can be different for everyone, but for my father, the benefits of adding this to his treatment far outweigh the negative. Their doctor swears that almost all of the negative side effects people have experienced came from prolonged heavy use and even then they probably wouldn’t have been a noticeable obstacle for the patient or found worrying enough for a doctor to stop treatment. Anyway, Medwell Marijuana card I’ve seen him help my dad and I haven’t met anyone or read many stories of people who have had very life-changing negative experiences, so I have no reason to condemn him or protest his legalization. Preliminary evidence has shown that cannabis can reduce nausea and vomiting during chemotherapy and reduce chronic pain and muscle spasms. With regard to cannabis or uninhabited cannabinoids, a 2021 review found that it provided little relief from chronic pain and sleep disturbances and caused several transient side effects, such as cognitive decline, nausea, and drowsiness.
Twenty-seven reviews included only plant cannabinoid interventions, 10 studied only synthetic cannabinoids, and eight included only studies on plant-based cannabis products. Twenty-four reviews involved a combination of different types of cannabis, and the remaining three systematic reviews did not report what type of cannabinoid was administered in the included studies. In total, Whiting and his colleagues analyzed 79 randomized trials, the gold standard in medical research in which volunteers are randomly assigned to take a cannabis-related product or a placebo. The studies evaluated marijuana’s ability to relieve a variety of symptoms, including chemotherapy nausea, loss of appetite in HIV-positive patients, multiple sclerosis spasms, depression, anxiety, sleep disorders, psychosis and Tourette syndrome.
Evidence of longer-term, adequately driven, methodologically sound RCTs investigating different types of cannabis-based drugs is needed to obtain conclusive recommendations. Our findings are consistent with a recently published summary of cannabis-based medications for chronic pain management. This report found inconsistent results in systematic reviews of cannabis-based medications compared to placebo for chronic neuropathic pain, pain management in rheumatic diseases, and painful spasms in MS. The authors also concluded that cannabis was not superior to placebo in reducing cancer pain.