Cannabinoid effects on responses to quantitative sensory testing among individuals with and without clinical pain: a systematic review

Mun, Chung Jung; Letzen, Janelle E.; Peters, Erica N.; Campbell, Claudia M.; Vandrey, Ryan G.; Gajewski-Nemes, Julia; DiRenzo, Dana; Caufield-Noll, Christine; Finan, Patrick H.

doi:10.1097/j.pain.0000000000001720

Cited by 15 publications

(11 citation statements)

References 83 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Analyses of the endocannabinoid system suggest certain cannabinoid receptors mediate pain sensitization and hyperalgesia, possibly increasing risk of acute pain conversion to chronic pain. Cannabinoids may therefore be detrimental in the acute pain setting despite being beneficial in chronic pain management [ 150 , 153 , 154 , 404 ].…”

Section: Pain Management and Opioid Stewardship Across The Periopementioning

confidence: 99%

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

et al. 2021

View full text Add to dashboard Cite

Surgical procedures are key drivers of pain development and opioid utilization globally. Various organizations have generated guidance on postoperative pain management, enhanced recovery strategies, multimodal analgesic and anesthetic techniques, and postoperative opioid prescribing. Still, comprehensive integration of these recommendations into standard practice at the institutional level remains elusive, and persistent postoperative pain and opioid use pose significant societal burdens. The multitude of guidance publications, many different healthcare providers involved in executing them, evolution of surgical technique, and complexities of perioperative care transitions all represent challenges to process improvement. This review seeks to summarize and integrate key recommendations into a “roadmap” for institutional adoption of perioperative analgesic and opioid optimization strategies. We present a brief review of applicable statistics and definitions as impetus for prioritizing both analgesia and opioid exposure in surgical quality improvement. We then review recommended modalities at each phase of perioperative care. We showcase the value of interprofessional collaboration in implementing and sustaining perioperative performance measures related to pain management and analgesic exposure, including those from the patient perspective. Surgery centers across the globe should adopt an integrated, collaborative approach to the twin goals of optimal pain management and opioid stewardship across the care continuum.

show abstract

Section: Pain Management and Opioid Stewardship Across The Periopementioning

confidence: 99%

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

et al. 2021

View full text Add to dashboard Cite

show abstract

“…• Fifteen records were excluded (Amato et al, 2017;Bahji, Meyyappan, & Hawken, 2020;Davis, 2008;Fife, Moawad, Moschonas, Shepard, & Hammond, 2015;Gouveia, Guimarães, Santos, & Quintans-Júnior, 2019;Hasheminasab, Tajadini, & Setayesh, 2020;Kumar, Datta, Wright, Furtado, & Russell, 2013;Maldonado, Pinz on, & Martínez, 2010;Marshall & Rathbone, 2011;Meyer et al, 2010;Mücke et al, 2016;Mun et al, 2020;Orsolini et al, 2019;Torres-Moreno & Farré, 2015;Yu & Bega, 2019);…”

Section: Search Resultsmentioning

confidence: 99%

Efficacy and safety of therapeutic use of cannabis derivatives and their synthetic analogs: Overview of systematic reviews

Riera

Pacheco

Bagattini

et al. 2021

Phytotherapy Research

View full text Add to dashboard Cite

The debate on the use of cannabinoids for therapeutic purposes is constantly on the rise. This overview aimed to map the evidence on the therapeutic effects of cannabis derivatives and their synthetic analogs. Systematic reviews (SRs) of randomized trials were identified through a comprehensive search in several databases, and their methodological quality were evaluated with AMSTAR‐2. The results for main outcomes are presented, prioritizing those from updated and better quality SRs. Finally, 68 SRs, addressing 37 different health conditions, were included. The methodological quality was high for eight SRs. The evidence certainty (GRADE) for the effects of cannabinoids is not high for any of the outcomes identified. Evidence certainty was moderate for the following: (a) cannabidiol appears to be beneficial for quality of life but increases the risk of adverse events in ulcerative colitis; (b) cannabinoids in general appear to have no clinically important benefit for chronic non‐oncologic pain, spasticity‐related pain in multiple sclerosis, or for acute post‐operative pain; (c) cannabinoids in general appear to have a benefit in reducing chemotherapy‐related nausea and vomiting. For all other outcomes from remaining comparisons, the evidence certainty was low, very low, or not evaluated, which prevents recommendations for or against their routine use.

show abstract

“…In the healthy participants the use of inhaled cannabis (eight studies) showed variable effects in experienced cannabis users, primarily in heat, mechanical and electrical stimulations, with everything from null results through to hyperalgesia at higher doses. 55 Synthetic cannabinoids (15 studies, primarily dronabinol and nabilone) predominantly showed no analgesic effect across the various testing modalities, with only one study reporting an analgesic effect, and five reported hyperalgesia in response to cannabinoids.…”

Section: Chronic Neuropathic Painmentioning

confidence: 99%

“…When looking at patients with known chronic pain, inhaled cannabis (five studies) demonstrated no analgesic effect overall in relation to heat and mechanical stimulation, with only one study noting a positive effect. 55 Synthetic cannabinoids (four studies) showed a response to mechanical pain stimuli in one study of MS…”

Section: Chronic Neuropathic Painmentioning

confidence: 99%

See 1 more Smart Citation

Framing the use of cannabis as a medicine in New Zealand: Regulatory, Clinician and Patient contexts

Oldfield¹

View full text Add to dashboard Cite

A medicine is a substance developed for administration to humans for therapeutic purposes that achieves its action by pharmacological, immunological or metabolic means. Pharmaceutical medications undergo years of pre-clinical and clinical trials to establish their safety, tolerability and efficacy. Cannabis, whether in raw or processed form, sits predominantly outside this remit. Its use falls broadly into four categories; recreational, plant used for medicinal purposes, cannabis-based products marketed for medical purposes and pharmaceutical grade cannabinoid medications. The use of cannabis as a medicine involves complex interactions across social, health and political domains, at both a global and national level. New Zealand has attempted to address this with the implementation of the Medicinal Cannabis Scheme in April 2020. This research was undertaken to develop an understanding of what effect cannabis regulations have had on multiple jurisdictions enacting them and applying this to the New Zealand context, and to understand specific groups of patient-doctor interactions regarding the use of cannabis as a medicine. First, I undertook a meta-narrative qualitative review synthesising themes relating to the outcomes of cannabis regulatory change across multiple jurisdictions. Five super-ordinate themes were identified in the meta-narrative review; Normalisation, Gatekeeping, Economics, Community and Health, which were applied in framing the conclusion of this thesis. I then completed a systematic review / meta-analysis examining label accuracy and contaminants in cannabis-based products in regulated markets. Labelling accuracy ranged from 17 to ~86%. Contaminants included microbes, solvents, pesticides and adulterants. Meta-analysis of pesticide contamination showed that the overall proportion of contaminated samples was 0.25 (95% CI: 0.10 to 0.40, Heterogeneity: I2=79%, X12=4.74, p=0.03). Finally, I completed six observational studies within New Zealand to determine knowledge, beliefs and reported interactions of doctors and patients regarding the use of cannabis as a medicine in three medical disciplines; general practice (GP), oncology and neurology. Doctors reported that patients were requesting medical cannabis prescriptions (GP: 55%, Neurology: 63%. Oncology: 84% respectively), and informing them of using illicit cannabis for medical symptoms. All doctors were concerned about prescribing cannabis as a medicine due to lack of evidence and lack of understanding of the prescription processes. Despite this, the majority were willing to prescribe a funded cannabis-based product backed by evidence of efficacy in traditional clinical trials. Patients in all three disciplines indicated comfort discussing cannabis with GPs and specialists (GP patients: 91.7%, 92.1%, neurology patients: 88.2%, 90.6%, oncology patients: 85.8%, 88.2% respectively). All groups reported low levels of prescriptions received (<20%). Patients reported illicit use of cannabis for medical reasons (11.2%, 34.6% and 35.5% in GP, neurology and oncology patients respectively), with reported effectiveness of illicit cannabis for their condition ranging from 86.7 to 94.0%. Patients in all three fields wished to know the benefits, side effects and availability of cannabis-based products and had concerns regarding access and cost. The use of cannabis as a medicine remains a complex situation within the NZ context. Significant implementation issues remain for the Medicinal Cannabis Scheme to ensure the safety and wellbeing of patients in New Zealand.

show abstract

Cannabinoid effects on responses to quantitative sensory testing among individuals with and without clinical pain: a systematic review

Cited by 15 publications

References 83 publications

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

Efficacy and safety of therapeutic use of cannabis derivatives and their synthetic analogs: Overview of systematic reviews

Framing the use of cannabis as a medicine in New Zealand: Regulatory, Clinician and Patient contexts

Contact Info

Product

Resources

About