Cannabis alleviates neuropathic pain and reverses weight loss in diabetic neuropathic cachexia in a previous heroin abuser

Abstract

Summary Ten years after the successful withdrawal from heroin abuse, a person with diabetes suffered intractable pain and severe muscular emaciation consistent with the syndrome of diabetic neuropathic cachexia. Anti-neuropathic medications failed neither to alleviate suffering and reverse weight loss, nor to stop muscular emaciation. Vigilant evaluation for weight loss aetiologies revealed no responsible aetiology. Prescribing medical cannabis became mandatory, with the intention to alleviate neuropathic pain, regain muscular mass and strengthen legs, enable standing upright and walking normally. Medical cannabis for pain-relief, and the orexigenic properties of tetrahydrocannabinol (THC) ingredient successfully achieved these goals. Learning points: Medical cannabis can serve to promptly alleviate severe diabetic neuropathic pain. Past history of heroin abuse was not an absolute contraindication to medical cannabis use. Medical cannabis increased appetite and reversed muscular emaciation. Medical cannabis decreased chronic pain and hence, its catabolic consequences.

Insulin acts as an atypical KCNQ1/KCNE1‐current activator and reverses long QT in insulin‐resistant aged rats by accelerating the ventricular action potential repolarization through affecting the β3‐adrenergic receptor signaling pathway

“…This study also is supporting nicely our present data in the aged rat heart. In addition, the authors comprehensively documented the cardioprotective effects of insulin by pointing how intensive insulin therapy can provide benefits in cardiac function such as in patients with cardiac surgery or diabetes (Naccache, 2020; Ng et al, 2012). All the above benefits with insulin application can be related, at least, with its stimulative action on membrane conductance (Kilic et al, 2001).…”

Emerging roles of circular RNAs in neuropathic pain

“…Although the exact prevalence of neuropathic pain varies from country to country, it has been estimated that up to 10% of the general population is afflicted with this potentially disabling condition 12‐16 . Different medical treatments (eg tricyclic antidepressants, selective serotonin noradrenaline reuptake inhibitors, opioids, lidocaine) have been used clinically for the treatment of neuropathic pain, but up to half of the patients with neuropathic pain are refectory to these drugs 17‐22 . The ineffectiveness of medical interventions arises partly due to the poorly understood molecular mechanism of neuropathic pain.…”

“… 12 , 13 , 14 , 15 , 16 Different medical treatments (eg tricyclic antidepressants, selective serotonin noradrenaline reuptake inhibitors, opioids, lidocaine) have been used clinically for the treatment of neuropathic pain, but up to half of the patients with neuropathic pain are refectory to these drugs. 17 , 18 , 19 , 20 , 21 , 22 The ineffectiveness of medical interventions arises partly due to the poorly understood molecular mechanism of neuropathic pain. Both peripheral and central sensitization are known to be implicated in the pathogenesis of neuropathic pain.…”