Tag Archives: medical

Cannabis spray found to help relieve cancer pain

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“Cancer patients who used a cannabis mouthspray had their level of pain reduced by 30%, a study has shown.

The cannabis-based spray, like a mouth freshener, was used on 177 patients by researchers from Edinburgh University.

They found it reduced pain levels by 30% in a group of cancer patients, all in the Edinburgh area, who had not been helped by morphine or other medicines.

The spray was developed so that it did not affect the mental state of patients in the way that using cannabis would.

Site of pain

They said the spray worked by activating molecules in the body called cannabinoid receptors which can stop nerve signals being sent to the brain from the site of pain.

Professor Marie Fallon, of the Edinburgh Cancer Research Centre at Edinburgh University, said: “These early results are very promising and demonstrate that cannabis-based medicines may deliver effective treatment for people with severe pain.

“Prescription of these drugs can be very useful in combating debilitating pain, but it is important to understand the difference between their medical and recreational use.””

http://www.plymouthwired.co.uk/news.php/2777-Cannabis-spray-found-to-help-relieve-cancer-pain

Marijuana Relieves Chronic Pain, Research Shows – WebMD

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“Three puffs a day of cannabis, better known as marijuana, helps people with chronic nerve pain due to injury or surgery feel less pain and sleep better, a Canadian team has found.

”It’s been known anecdotally,” says researcher Mark Ware, MD, assistant professor of anesthesia and family medicine at McGill University in Montreal. “About 10% to 15% of patients attending a chronic pain clinic use cannabis as part of their pain [control] strategy,” he tells WebMD.

But Ware’s study is more scientific — a clinical trial in which his team compared placebo with three different doses of cannabis. The research is published in CMAJ, the Canadian Medical Association Journal.

The new study ”adds to the trickle of evidence that cannabis may help some of the patients who are struggling [with pain] at present,” Henry McQuay, DM, an emeritus fellow at Balliol College, Oxford University, England, writes in a commentary accompanying the study…” More: http://www.webmd.com/pain-management/news/20100830/marijuana-relieves-chronic-pain-research-show

“Smoked cannabis for chronic neuropathic pain: a randomized controlled trial… A single inhalation of 25 mg of 9.4% tetrahydrocannabinol herbal cannabis three times daily for five days reduced the intensity ofpain, improved sleep and was well tolerated.”  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950205/

Cannabis stops the pain

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“Ann Vernon would like to understand one thing about the lawmakers who oppose the medical use of cannabis.

“I think you would have to be pretty heartless if you’re faced with these absolutely desperate people . . . and they say this [cannabis] helps and you turn them down? I don’t know.”

It is a question Ms Vernon, who sufferers from chronic pain and post-traumatic stress disorder, asks herself often. The most recent occasion was last week when she was standing before a judge on charges of cultivating cannabis.

Ms Vernon, 40, had plants in her home because she uses cannabis to ease her chronic pain. When the judge heard her medical evidence, backed by her doctor, he discharged her without conviction.

“He listened to me talk about what it was like to live with constant pain.”

The mother of three has now vowed to devote her time to fighting for changes in the law to allow the use of cannabis for medical purposes.

It was a doctor who first suggested cannabis to Ms Vernon.

Years and years of chronic pain – she was thrown from a horse as a teen and later suffered complications from surgery – left the once-active woman bedridden and in constant agony.

Sitting and standing were so agonising she would cart a mattress from room to room just so she could lie down.

Conventional painkillers failed and eventually cannabis was recommended.

“At first I was like ‘Oh what!’ I’d smoked cannabis as a teenager . . . now and then,” she says. “But then you get that desperate you will try anything.”

The drug – ingested with a vapouriser she imported from Australia – worked.

“With cannabis I have quality of life. I’ve come so far now that clearly I am not bedridden.”

Ms Vernon says that, while cannabis comes with a high, medical users get used to that very quickly. “I don’t find the high from the cannabis anywhere near as debilitating as the high I was getting from normal painkillers.”

Cannabis also helps with sleep and with appetite. “I also had a huge amount of nausea and that just wipes it.”

But she says it is hard not to feel like a criminal: “I have never even had a traffic infringement notice, not a parking ticket, nothing. So, yes, breaking the law is awful. To be made to feel like a criminal for something a doctor recommended to me and has helped me is awful.”

Being allowed to grow cannabis for medicinal use would mean less harm to the community, she says.

“It is also very hard, and very expensive, to get decent-quality cannabis. The supply is inconsistent, you don’t know what you are getting.”

Medical-cannabis patients are rendered vulnerable, she says.

“Many of them are much worse off physically than me and can’t come forward to speak.

“Some of the things I have seen, some of the effects I’ve seen of people when they consume cannabis. I’ve seen people get some movement back in limb they’ve had no movement in for eight years.

“I can’t imagine how cold people have to be to stop them from using the one thing that helps them.””

http://www.stuff.co.nz/dominion-post/news/national/7992118/Cannabis-stops-the-pain

Cannabis and the brain.

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Abstract

“The active compound in herbal cannabis, Delta(9)-tetrahydrocannabinol, exerts all of its known central effects through the CB(1) cannabinoid receptor. Research on cannabinoid mechanisms has been facilitated by the availability of selective antagonists acting at CB(1) receptors and the generation of CB(1) receptor knockout mice. Particularly important classes of neurons that express high levels of CB(1) receptors are GABAergic interneurons in hippocampus, amygdala and cerebral cortex, which also contain the neuropeptides cholecystokinin. Activation of CB(1) receptors leads to inhibition of the release of amino acid and monoamine neurotransmitters. The lipid derivatives anandamide and 2-arachidonylglycerol act as endogenous ligands for CB(1) receptors (endocannabinoids). They may act as retrograde synaptic mediators of the phenomena of depolarization-induced suppression of inhibition or excitation in hippocampus and cerebellum. Central effects of cannabinoids include disruption of psychomotor behaviour, short-term memory impairment, intoxication, stimulation of appetite, antinociceptive actions (particularly against pain of neuropathic origin) and anti-emetic effects. Although there are signs of mild cognitive impairment in chronic cannabis users there is little evidence that such impairments are irreversible, or that they are accompanied by drug-induced neuropathology. A proportion of regular users of cannabis develop tolerance and dependence on the drug. Some studies have linked chronic use of cannabis with an increased risk of psychiatric illness, but there is little evidence for any causal link. The potential medical applications of cannabis in the treatment of painful muscle spasms and other symptoms of multiple sclerosis are currently being tested in clinical trials. Medicines based on drugs that enhance the function of endocannabinoids may offer novel therapeutic approaches in the future.”

http://www.ncbi.nlm.nih.gov/pubmed/12764049

Medical use of cannabis. Cannabidiol: A new light for schizophrenia?

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Abstract

“The medical properties of cannabis have been known for many centuries; its first documented use dates back to 2800 BC when it was described for its hallucinogenic and pain-relieving properties. In the first half of the twentieth century, a number of pharmaceutical companies marked cannabis for indications such as asthma and pain, but since then its use has sharply declined, mainly due to its unpredictable effects, but also for socio-political issues. Recently, great attention has been directed to the medical properties of phytocannabinoids present in the cannabis plant alongside the main constituent Δ(9) -Tetrahydrocannabinol (THC); these include cannabinoids such as cannabidiol (CBD), cannabigerol (CBG), and tetrahydrocannabivarin (THCV). Evidence suggests an association between cannabis and schizophrenia: schizophrenics show a higher use of marijuana as compared to the healthy population. Additionally, the use of marijuana can trigger psychotic episodes in schizophrenic patients, and this has been ascribed to THC. Given the need to reduce the side effects of marketed antipsychotics, and their weak efficacy on some schizophrenic symptoms, cannabinoids have been suggested as a possible alternative treatment for schizophrenia. CBD, a non-psychoactive constituent of the Cannabis sativa plant, has been receiving growing attention for its anti-psychotic-like properties. Evidence suggests that CBD can ameliorate positive and negative symptoms of schizophrenia. Behavioural and neurochemical models suggest that CBD has a pharmacological profile similar to that of atypical anti-psychotic drugs and a clinical trial reported that this cannabinoid is a well-tolerated alternative treatment for schizophrenia.”

http://www.ncbi.nlm.nih.gov/pubmed/23109356

Curing addiction with cannabis medicines

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“Smokers trying to quit in the future could do it with the help of cannabis based medicines, according to research from The University of Nottingham.

Teams of pharmacologists, studying the cannabis-like compounds which exist naturally in our bodies (endocannabinoids), are exploring the potential for medical treatment. This includes treating conditions as diverse as obesity, diabetes, depression and addiction to substances like nicotine.

Scientists have known about endocannabinoids since the mid-1990s. This led to an explosion in the number of researchers looking into the future medical uses of cannabinoids and cannabis compounds.

Dr Steve Alexander, Associate Professor in the School of Biomedical Sciences, focused on a number of these projects in editing the first themed podcast for the British Journal of Pharmacology.

Dr Alexander said: “It is clear that there is very realistic potential for cannabinoids as medicines. Scientists are looking at a range of possible applications.”

One of these researchers is Professor David Kendall, a cellular pharmacologist at the University: “The brain is full of cannabinoid receptors. And so, not surprisingly with diseases like depression and anxiety, there’s a great deal of interest in exploiting these receptors and in doing so, developing anti-depressant compounds.”

Addiction is a real target – researchers like Professor Kendall believe the endocannabinoids could be a crucial link to addictive behaviour: “We know that the endocannabinoid system is intimately involved in reward pathways and drug seeking behaviour. So this tends to indicate that that if the link involving endocannabinoids and the reward pathway, using inhibitors, can be interrupted, it could turn down the drive to seek addictive agents like nicotine.”

Because cannabinoids have also been shown to bring down blood pressure, it is hoped that related compounds can be used in patients with conditions like hypertension.

Dr Michael Randall, a cardiovascular pharmacologist at the University has looked at how endocannabinoids cause blood vessels to relax. “This could have many implications,” Dr Randall said. “The endocannabinoids appear to lower blood pressure under certain conditions; states of shock for example. If the endocannabinoids are of physiological importance, this could have real therapeutic possibilities.”

“In terms of getting better medicines the endocannabinoid system has a lot to offer,” said Dr Alexander. “The range of cannabis-related medicines is currently limited, but by increasing our knowledge in this area we can increase our stock.”

The University of Nottingham”

http://www.brightsurf.com/news/headlines/36296/Curing_addiction_with_cannabis_medicines.html

[The endogenous cannabinoid system. Therapeutic implications for neurologic and psychiatric disorders].

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Abstract

“For about 5,000 years, cannabis has been used as a therapeutic agent. There has been growing interest in the medical use of cannabinoids. This is based on the discovery that cannabinoids act with specific receptors (CB1 and CB2). CB1 receptors are located in specific brain areas (e.g. cerebellum, basal ganglia, and hippocampus) and CB2 receptors on cells of the immune system. Endogenous ligands of the cannabinoid receptors were also discovered (e.g. anandamids). Many physiologic processes are modulated by the two subtypes of cannabinoid receptor: motor functions, memory, appetite, and pain. These innovative neurobiologic/pharmacologic findings could possibly lead to the use of synthetic and natural cannabinoids as therapeutic agents in various areas. Until now, cannabinoids were used as antiemetic agents in chemotherapy-induced emesis and in patients with HIV-wasting syndrome. Evidence suggests that cannabinoids may prove useful in some other diseases, e.g. movement disorders such as Gilles de la Tourette’s syndrome, multiple sclerosis, and pain. These new findings also explain the acute adverse effects following cannabis use.”

http://www.ncbi.nlm.nih.gov/pubmed/15776259

The Therapeutic Potential of Cannabis and Cannabinoids

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“Background

Cannabis-based medications have been a topic of intense study since the endogenous cannabinoid system was discovered two decades ago. In 2011, for the first time, a cannabis extract was approved for clinical use in Germany.”

“Therapeutic potential

Cannabis preparations exert numerous therapeutic effects. They have antispastic, analgesic, antiemetic, neuroprotective, and anti-inflammatory actions, and are effective against certain psychiatric diseases. Currently, however, only one cannabis extract is approved for use. It contains THC and CBD in a 1:1 ratio and was licensed in 2011 for treatment of moderate to severe refractory spasticity in multiple sclerosis (MS). In June 2012 the German Joint Federal Committee (JFC, Gemeinsamer Bundesausschuss) pronounced that the cannabis extract showed a “slight additional benefit” for this indication and granted a temporary license valid up to 2015.”

“The cannabis extract, which goes by the generic name nabiximols, has been approved by regulatory bodies in Germany and elsewhere for use as a sublingual spray. In the USA, dronabinol has been licensed since 1985 for the treatment of nausea and vomiting caused by cytostatic therapy and since 1992 for loss of appetite in HIV/Aids-related cachexia. In Great Britain, nabilone has been sanctioned for treatment of the side effects of chemotherapy in cancer patients.”

Results

“Cannabis-based medications exert their effects mainly through the activation of cannabinoid receptors (CB1 and CB2). More than 100 controlled clinical trials of cannabinoids or whole-plant preparations for various indications have been conducted since 1975. The findings of these trials have led to the approval of cannabis-based medicines (dronabinol, nabilone, and a cannabis extract [THC:CBD=1:1]) in several countries. In Germany, a cannabis extract was approved in 2011 for the treatment of moderate to severe refractory spasticity in multiple sclerosis. It is commonly used off label for the treatment of anorexia, nausea, and neuropathic pain. Patients can also apply for government permission to buy medicinal cannabis flowers for self-treatment under medical supervision. The most common side effects of cannabinoids are tiredness and dizziness (in more than 10% of patients), psychological effects, and dry mouth. Tolerance to these side effects nearly always develops within a short time. Withdrawal symptoms are hardly ever a problem in the therapeutic setting.”

Conclusion

“There is now clear evidence that cannabinoids are useful for the treatment of various medical conditions.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442177/

 

Therapeutic aspects of cannabis and cannabinoids

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The British Journal of Psychiatry

“HISTORY OF THERAPEUTIC USE

The first formal report of cannabis as a medicine appeared in China nearly 5000 years ago when it was recommended for malaria, constipation, rheumatic pains and childbirth and, mixed with wine, as a surgical analgesic. There are subsequent records of its use throughout Asia, the Middle East, Southern Africa and South America. Accounts by Pliny, Dioscorides and Galen remained influential in European medicine for 16 centuries.”

“It was not until the 19th century that cannabis became a mainstream medicine in Britain. W. B. O’Shaughnessy, an Irish scientist and physician, observed its use in India as an analgesic, anticonvulsant, anti-spasmodic, anti-emetic and hypnotic. After toxicity experiments on goats and dogs, he gave it to patients and was impressed with its muscle-relaxant, anticonvulsant and analgesic properties, and recorded its use-fulness as an anti-emetic.”

“After these observations were published in 1842, medicinal use of cannabis expanded rapidly. It soon became available ‘over the counter’ in pharmacies and by 1854 it had found its way into the United States Dispensatory. The American market became flooded with dozens of cannabis-containing home remedies.”

“Cannabis was outlawed in 1928 by ratification of the 1925 Geneva Convention on the manufacture, sale and movement of dangerous drugs. Prescription remained possible until final prohibition under the 1971 Misuse of Drugs Act, against the advice of the Advisory Committee on Drug Dependence.”

“In the USA, medical use was effectively ruled out by the Marijuana Tax Act 1937. This ruling has been under almost constant legal challenge and many special dispensations were made between 1976 and 1992 for individuals to receive ‘compassionate reefers’. Although this loophole has been closed, a 1996 California state law permits cultivation or consumption of cannabis for medical purposes, if a doctor provides a written endorsement. Similar arrangements apply in Italy and Canberra, Australia.”

“Results and Conclusions Cannabis and some cannabinoids are effective anti-emetics and analgesics and reduce intra-ocular pressure. There is evidence of symptom relief and improved well-being in selected neurological conditions, AIDS and certain cancers. Cannabinoids may reduce anxiety and improve sleep. Anticonvulsant activity requires clarification. Other properties identified by basic research await evaluation. Standard treatments for many relevant disorders are unsatisfactory. Cannabis is safe in overdose but often produces unwanted effects, typically sedation, intoxication, clumsiness, dizziness, dry mouth, lowered blood pressure or increased heart rate. The discovery of specific receptors and natural ligands may lead to drug developments. Research is needed to optimise dose and route of administration, quantify therapeutic and adverse effects, and examine interactions.”

http://bjp.rcpsych.org/content/178/2/107.long

Phytocannabinoids and endocannabinoids.

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“Progress in understanding the molecular mechanisms of cannabis action was made after discovery of cannabinoid receptors in the brain and the finding of endogenous metabolites with affinity to them. Activation of cannabinoid receptors on synaptic terminals results in regulation of ion channels, neurotransmitter release and synaptic plasticity

. Neuromodulation of synapses by the cannabinoids is proving to have a wide range of functional effects, making them potential targets as medical preparations in a variety of illnesses, including some mental disorders and neurodegenerative illnesses. Cannabis contains a large amount of substances with affinity for the cannabinoid receptors. The endocannabinoids are a family of lipid neurotransmitters that engage the same membrane receptors targeted by tetrahydrocannabinol and that mediate retrograde signal from postsynaptic neurons to presynaptic ones.

 Discovery of endogenous cannabinoids and studies of the physiological functions of the cannabinoid system in the brain and body are producing a number of important findings about the role of membrane lipids and fatty acids in nerve signal transduction. Plant, endogenous and synthetic cannabinoids are using in these studies. The role of lipid membranes in the cannabinoid system follows from the fact that the source and supply of endogenous cannabinoids are derived from arachidonic acid, an important membrane constituent

. The study of structure-activity relationships of molecules which influence the cannabinoid system in the brain and body is crucial in search of medical preparations with the therapeutic effects of the phytocannabinoids without the negative effects on cognitive function attributed to cannabis.”

http://www.ncbi.nlm.nih.gov/pubmed/19630737