Cannabinoid Analgesia as a Potential New Therapeutic Option in the Treatment of Chronic Pain

Burns, Tammy L.; Ineck, Joseph R.

doi:10.1345/aph.1g217

Cited by 76 publications

(41 citation statements)

References 61 publications

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“…There are numerous case reports on the beneficial effects of cannabis or synthetic derivatives of THC in pain associated with multiple sclerosis, cancer, neuropathies, and HIV infection (Noyes et al, 1975a,b;Martyn et al, 1995;Consroe et al, 1997;Hamann and di Vadi, 1999;Ware et al, 2003;Rudich et al, 2003;Ware and Beaulieu, 2005;Berlach et al, 2006; reviewed in Burns and Ineck, 2006) (Table 1). The results of randomized studies conducted before 1999 on the analgesic effect of orally administered synthetic cannabinoids in patients with postoperative, post-traumatic, cancer, or spastic pain had been subjected to a meta-analysis.…”

Section: B Pain and Inflammationmentioning

confidence: 99%

The Endocannabinoid System as an Emerging Target of Pharmacotherapy

2006

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Section: B Pain and Inflammationmentioning

confidence: 99%

The Endocannabinoid System as an Emerging Target of Pharmacotherapy

2006

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“…Another potential limitation to the use of cannabinoids for pain is the development of tolerance and dependence, an issue that impacts the therapeutic potential of opioids. Although tolerance to the analgesic effects of cannabinoids may require escalating doses over time, CB1 agonists have a favorable safety profile (Burns and Ineck, 2006) relative to opioids, which can have respiratory depressant effects at high doses (Smith and Bruckenthal, 2010). A primary caveat of these findings is that the study population consisted of daily marijuana smokers; this study limitation should be considered when interpreting the findings and placing them within the context of the potential therapeutic feasibility of cannabinoids.…”

Section: Discussionmentioning

confidence: 96%

Comparison of the Analgesic Effects of Dronabinol and Smoked Marijuana in Daily Marijuana Smokers

Cooper

Comer

Haney

2013

Neuropsychopharmacol

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Recent studies have demonstrated the therapeutic potential of cannabinoids to treat pain, yet none have compared the analgesic effectiveness of smoked marijuana to orally administered D 9 -tetrahydrocannabinol (THC; dronabinol). This randomized, placebocontrolled, double-dummy, double-blind study compared the magnitude and duration of analgesic effects of smoked marijuana and dronabinol under well-controlled conditions using a validated experimental model of pain. Healthy male (N ¼ 15) and female (N ¼ 15) daily marijuana smokers participated in this outpatient study comparing the analgesic, subjective, and physiological effects of marijuana (0.00, 1.98, or 3.56% THC) to dronabinol (0, 10, or 20 mg). Pain response was assessed using the cold-pressor test (CPT): participants immersed their left hand in cold water (4 1C), and the time to report pain (pain sensitivity) and withdraw the hand from the water (pain tolerance) were recorded. Subjective pain and drug effect ratings were also measured as well as cardiovascular effects. Compared with placebo, marijuana and dronabinol decreased pain sensitivity (3.56%; 20 mg), increased pain tolerance (1.98%; 20 mg), and decreased subjective ratings of pain intensity (1.98, 3.56%; 20 mg). The magnitude of peak change in pain sensitivity and tolerance did not differ between marijuana and dronabinol, although dronabinol produced analgesia that was of a longer duration. Marijuana (1.98, 3.56%) and dronabinol (20 mg) also increased abuse-related subjective ratings relative to placebo; these ratings were greater with marijuana. These data indicate that under controlled conditions, marijuana and dronabinol decreased pain, with dronabinol producing longer-lasting decreases in pain sensitivity and lower ratings of abuse-related subjective effects than marijuana.

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“…Although cannabinoid analgesia has been reasonably well studied in humans (Pertwee, 2001;Burns et al, 2006;Huskey, 2006;Manzanares et al, 2006) the exact contributions of the cannabinoid receptors is still under investigation. Many preclinical studies have shown that cannabinoids produce analgesia by acting in both the central and peripheral nervous system (Pertwee, 2001), via CB1 receptors in the brain, but also by both CB1 and CB2 receptors in the spinal cord and periphery (Agarwal et al, 2007).…”

Section: Cannabinoid Receptorsmentioning

confidence: 99%