Availability and approval of cannabis‐based medicines for chronic pain management and palliative/supportive care in Europe: A survey of the status in the chapters of the European Pain Federation

Krcevski–Škvarc, Nevenka; Wells, Chris; Haüser, Winfried

doi:10.1002/ejp.1147

Cited by 87 publications

(80 citation statements)

References 15 publications

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“…Additional information that is pertinent but unavailable included the baseline levels of symptoms prior to initiating cannabis, duration of cannabis use for all medical users, and treatment adjustments related to cannabis use. This is a single‐setting study that included only patients seen in a specialist rheumatology clinic; therefore results may not be reflective of a broader patient population and cannot be extrapolated to other countries where recreational cannabis is illegal or where medical cannabis is prescribed by physicians and/or is reimbursed by public or private insurers (21). A strength is that we have repeated a previous study, using the same methods, in a similar setting at two distinct time points, namely before and after recreational cannabis legalization.…”

Section: Discussionmentioning

confidence: 99%

Medical Cannabis Use by Rheumatology Patients Following Recreational Legalization: A Prospective Observational Study of 1000 Patients in Canada

Fitzcharles

Rampakakis²,

Sampalis

et al. 2020

ACR Open Rheumatology

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Objective. Recreational legalization of cannabis may influence the medical use by patients. When only medical access was legally available in Canada, 4.3% of rheumatology patients reported use. With the current recreational legalization, we have reexamined the prevalence and characteristics of medical cannabis use in this same rheumatology setting.Methods. Consecutively attending rheumatology patients participated in an onsite survey comprising the following two questionnaires: 1) demographic and disease information completed by the rheumatologist and 2) patient anonymous questionnaire of health status, cannabis use (recreational and/or medicinal), and characteristics of cannabis use.Results. Of 1047 attendees from June to August 2019, with 1000 participating, medical cannabis had been used by 12.6% of patients (95% confidence interval 10.7%-14.8%), with half continuing use for mostly pain relief. Discontinuation was due to lack of effect in 57% of patients and side effects in 28% of patients. Ever medical users were younger (61.2 vs. 64.9 years; P = 0.006), more likely unemployed/disabled (16.7% vs. 5.9%; P < 0.001), and had more previous (47.6% vs. 25.5%; P < 0.001) and current recreational cannabis use (17.5% vs. 3.1%; P < 0.001) than nonusers. Most patients used multiple methods of administration, including smoking, vaporizing, and using oral oil preparations, but were poorly knowledgeable of product content, which was bought solely via the legal medical route by only 20%, and only one-third disclosed their use to the rheumatologist.Conclusion. Medical cannabis use has tripled for rheumatology patients since recreational legalization, with users being younger, not working, and having recreational cannabis experience. Concerning issues are the poor knowledge of the product being used, access via the nonmedical route, and nondisclosure to the physician.

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Section: Discussionmentioning

confidence: 99%

Medical Cannabis Use by Rheumatology Patients Following Recreational Legalization: A Prospective Observational Study of 1000 Patients in Canada

Fitzcharles

Rampakakis²,

Sampalis

et al. 2020

ACR Open Rheumatology

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“…The majority of European Union member-states have authorized the use of cannabis-derived medications [6]. However, laws can vary widely between nations with respect to legal status and insurance coverage [7,8]. Furthermore, even within countries there can be gaps between the legal status of a drug and its actual availability to patients [6].…”

Section: Introductionmentioning

confidence: 99%

Clinical uses of cannabis and cannabinoids in the United States

Levinsohn

Hill

2020

Journal of the Neurological Sciences

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“…The Canadian Pain Society has recently recommended cannabinoids as third-line drugs for the treatment of chronic neuropathic pain (37). Additionally, the German and Israeli Pain Society recommends the use of cannabinoids as third-line drugs in the treatment of chronic pain (38). At the supraspinal level, stimulation of the CB1 receptor has a signifi cant analgesic effect.…”

Section: Cannabinoids In the Treatment Of Pain And As A Symptomatic Tmentioning

confidence: 99%

The role of cannabinoids in the treatment of cancer

Večeřa¹,

Gabrhelik²,

Prášil³

et al. 2020

BLL

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The aim of this review article is to summarize current knowledge about the role of cannabinoids and cannabinoid receptors in tumor disease modulation and to evaluate comprehensively the use of cannabinoids in cancer patients. METHOD: According to the PRISMA protocol, we have included data from a total of 105 articles. RESULTS: Cannabinoids affect cancer progression by three mechanisms. The most important mechanism is the stimulation of autophagy and affecting the signaling pathways leading to apoptosis. The most important mechanism of this process is the accumulation of ceramide. Cannabinoids also stimulate apoptosis by mechanisms independent of autophagy. Other mechanisms by which cannabinoids affect tumor growth are inhibition of tumor angiogenesis, invasiveness, metastasis, and the modulation of the anti-tumor immune response. CONCLUSION: In addition to the symptomatic therapy of cancer patients, the antitumor effects of cannabinoids (whether in monotherapy or in combination with other cancer therapies) have promising potential in the treatment of cancer patients. More clinical trials are needed to demonstrate the antitumor effect of cannabinoids (Tab. 1, Fig. 1, Ref. 167).

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Availability and approval of cannabis‐based medicines for chronic pain management and palliative/supportive care in Europe: A survey of the status in the chapters of the European Pain Federation

Cited by 87 publications

References 15 publications

Medical Cannabis Use by Rheumatology Patients Following Recreational Legalization: A Prospective Observational Study of 1000 Patients in Canada

Medical Cannabis Use by Rheumatology Patients Following Recreational Legalization: A Prospective Observational Study of 1000 Patients in Canada

Clinical uses of cannabis and cannabinoids in the United States

The role of cannabinoids in the treatment of cancer

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