Cannabidiol (CBD) in Rheumatic Diseases (Musculoskeletal Pain)

Abstract

Purpose of Review This review will address the many uncertainties surrounding the medical use of cannabidiol (CBD). We will begin with an overview of the legal and commercial environment, examine recent preclinical and clinical evidence on CBD, explore questions concerning CBD raised by healthcare professionals and patients, investigate dosing regimens and methods of administration, and address current challenges in the accumulation of sound evidence. Recent Findings CBD has potential for relief of symptoms of pain, sleep, and mood disturbance in rheumatology patients, but sound clinical evidence is lacking. CBD is safe when accessed from a regulated source, whereas wellness products are less reliable regarding content and contaminants. Dosing for symptom relief has not yet been established. Summary As many rheumatology patients are trying CBD as a self-management strategy, the healthcare community must urgently accrue sound evidence for effect.

Uso Da Cannabis Medicinal Nos Pacientes Com Dor Crônica

“…Existem dois tipos: anandamida e 2-araquidonilglicerol (2-AG). O mecanismo de ação pelo qual essas substancias exercem os seus efeitos envolve a ligação aos receptores CB1 e CB2 acoplados à proteína G em todo o corpo, estimulando o sistema canabinóide endógeno, alterando os níveis de endocanabinóides (eCBs) e inibindo a liberação de neurotransmissores como o ácido gama-aminobutírico (GABA) e glutamato (23) . Os receptores CB1 são encontrados no cérebro e na periferia (por exemplo, intestinos, fígado, células adiposas e imunológicas) (24) .…”

“…eCBs são mensageiros lipídicos neuroativos endógenos que desempenham um papel nas vias de recompensa, memória, aprendizagem e dor. Sendo assim, o sistema endocanabinóide tornou-se um local alvo potencial para futuras estratégias de intervenção na dor (23) .…”

Medicinal Cannabis Use for Rheumatic Conditions in the US Versus Canada: Rationale for Use and Patient–Health Care Provider Interactions

“…Whether these findings translate to people with rheumatic conditions is unknown because we conducted our previous studies among people using MC for any reason. As policies continue to increase MC accessibility, we and others have called for pragmatic approaches (such as harm reduction, education, and shared decision-making) for engaging clinically with people using MC for pain and other rheumatic symptoms (28)(29)(30)(31). Such approaches require current understanding of the MC use landscape to appropriately inform clinical and public health policy related to rheumatic disease management.…”

Cannabinoids dosing for osteoarthritis—authors’ reply

“…Also the World Health Organization identified pure CBD as generally well tolerated and with a good safety profile. 9 Consequently, in many countries, CBD products are freely available over the counter and marketed as food supplements or wellness products that are not subject to drug regulatory standards 10 ; e.g., in the European Union, CBD is marketed as a “novel food”. The major safety concern regarding such commercially available non-pharmaceutical grade CBD preparations remains impurities, the most common of which is THC.…”

“…The major safety concern regarding such commercially available non-pharmaceutical grade CBD preparations remains impurities, the most common of which is THC. 10 …”