Luke A Henderson1, Vicki Kotsirilos2, Elizabeth A Cairns3, Alister Ramachandran4, Chris C Peck5, Iain S McGregor6. 1. PhD, Professor, School of Medical Sciences (Neuroscience), University of Sydney, Sydney, NSW; Brain and Mind Centre, University of Sydney, Sydney, NSW. 2. AM, MBBS, FACNEM, FASLM, Honorary RACGP Fellowship, Adjunct Associate Professor, NICM Health Research Institute, Western Sydney University, Sydney, NSW. 3. PhD, Postdoctoral Research Associate, Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, University of Sydney, Sydney, NSW; School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW. 4. FFPMANZCA, Anaesthetist and Pain Medicine Specialist, Pain Management Centre, Westmead Hospital, Westmead, NSW. 5. PhD, Pain Management Specialist, Pain Management and Research Centre, Royal North Shore Hospital, St Leonards, NSW. 6. PhD, Academic Director, Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, University of Sydney, Sydney, NSW; School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW.
Abstract
BACKGROUND: Chronic pain is a major health issue, adversely affecting millions of Australians and costing billions of dollars annually. Current pharmaceutical treatments may be limiting, and in some cases ineffective, while carrying substantial liabilities. Medicinal cannabis is an increasingly popular, albeit controversial, alternative. OBJECTIVE: The aim of this article is to briefly review the scientific evidence related to medicinal cannabis for the treatment of chronic pain and update physicians on relevant issues and optimal prescribing practices. DISCUSSION: To date, >130,000 medicinal cannabis approvals have been issued in Australia, mostly by general practitioners, with approximately 65% of these to treat chronic non-cancer pain. Available products deliver Δ9-tetrahydrocannabinol (THC) and/or cannabidiol (CBD). Despite robust supportive data from animal models, current clinical trial evidence for THC and CBD efficacy in chronic pain is incomplete. In their prescribing decisions, doctors must balance patient demand and curiosity with caution regarding potential risks and limited efficacy.
BACKGROUND: Chronic pain is a major health issue, adversely affecting millions of Australians and costing billions of dollars annually. Current pharmaceutical treatments may be limiting, and in some cases ineffective, while carrying substantial liabilities. Medicinal cannabis is an increasingly popular, albeit controversial, alternative. OBJECTIVE: The aim of this article is to briefly review the scientific evidence related to medicinal cannabis for the treatment of chronic pain and update physicians on relevant issues and optimal prescribing practices. DISCUSSION: To date, >130,000 medicinal cannabis approvals have been issued in Australia, mostly by general practitioners, with approximately 65% of these to treat chronic non-cancer pain. Available products deliver Δ9-tetrahydrocannabinol (THC) and/or cannabidiol (CBD). Despite robust supportive data from animal models, current clinical trial evidence for THC and CBD efficacy in chronic pain is incomplete. In their prescribing decisions, doctors must balance patient demand and curiosity with caution regarding potential risks and limited efficacy.
Authors: Sara L MacPhail; Miguel A Bedoya-Pérez; Rhys Cohen; Vicki Kotsirilos; Iain S McGregor; Elizabeth A Cairns Journal: Front Pharmacol Date: 2022-05-10 Impact factor: 5.988
Authors: Nicholas Lintzeris; Llewellyn Mills; Sarah V Abelev; Anastasia Suraev; Jonathon C Arnold; Iain S McGregor Journal: Harm Reduct J Date: 2022-07-30