Societal issues and policy implications related to the use of cannabinoids, cannabis, and cannabis-based medicines for pain management

Haroutounian, Simon; Gilron, Ian; Belton, Joletta; Degenhardt, Louisa; Forti, Marta Di; Finn, David P.; Fogarty, Alexandra E.; Kalso, Eija; Krane, Elliot J.; Moore, Richard A.; Wallace, Mark; Rice, Andrew S.C.

doi:10.1097/j.pain.0000000000002001

Cited by 17 publications

(25 citation statements)

References 80 publications

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“…The Δ 9 -THC remains the principal psychoactive ingredient, while trace amounts (i.e., <0.2%) and the CBD are legal for medical uses in many countries such as several US states and other jurisdictions in Europe and South and Central America (Portugal, Spain, Belgium, Portugal, Argentina, Colombia, Jamaica) and Asia (Thailand) [ 15 , 77 ]. Non-medical use has only been legalized at a federal level in two countries, Uruguay and Canada, while decriminalized personal use had been legislated in the Netherlands [ 78 , 79 ]. Growing cannabis plants that contain <0.2% Δ 9 -THC (referred to as hemp) is legal, and the sale of hemp-based products, if they contain any detectable amount, are also allowed in some countries like Thailand [ 15 , 78 ].…”

Section: Legal Consumptionmentioning

confidence: 99%

“…Non-medical use has only been legalized at a federal level in two countries, Uruguay and Canada, while decriminalized personal use had been legislated in the Netherlands [ 78 , 79 ]. Growing cannabis plants that contain <0.2% Δ 9 -THC (referred to as hemp) is legal, and the sale of hemp-based products, if they contain any detectable amount, are also allowed in some countries like Thailand [ 15 , 78 ]. The legalization framework focuses on the appropriate regulations concerning the legal age of possession, retail structures, the home growing of cannabis plants, permitted places for consumption, and cannabis-specific impaired driving laws [ 76 ], while less attention has been paid particularly to the psychoactive activity of the phytocannabinoids from non-cannabis organisms [ 71 , 80 ].…”

Section: Legal Consumptionmentioning

confidence: 99%

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Mass Spectrometry-Based Metabolomics of Phytocannabinoids from Non-Cannabis Plant Origins

et al. 2022

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Phytocannabinoids are isoprenylated resorcinyl polyketides produced mostly in glandular trichomes of Cannabis sativa L. These discoveries led to the identification of cannabinoid receptors, which modulate psychotropic and pharmacological reactions and are found primarily in the human central nervous system. As a result of the biogenetic process, aliphatic ketide phytocannabinoids are exclusively found in the cannabis species and have a limited natural distribution, whereas phenethyl-type phytocannabinoids are present in higher plants, liverworts, and fungi. The development of cannabinomics has uncovered evidence of new sources containing various phytocannabinoid derivatives. Phytocannabinoids have been isolated as artifacts from their carboxylated forms (pre-cannabinoids or acidic cannabinoids) from plant sources. In this review, the overview of the phytocannabinoid biosynthesis is presented. Different non-cannabis plant sources are described either from those belonging to the angiosperm species and bryophytes, together with their metabolomic structures. Lastly, we discuss the legal framework for the ingestion of these biological materials which currently receive the attention as a legal high.

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Section: Legal Consumptionmentioning

confidence: 99%

Section: Legal Consumptionmentioning

confidence: 99%

Mass Spectrometry-Based Metabolomics of Phytocannabinoids from Non-Cannabis Plant Origins

et al. 2022

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“…Most plant-based cannabis products reach dispensary shelves without due diligent testing or regulatory oversight. 25 There is a neglect of the teratogenic and carcinogenic effects of cannabis published in the early literature. [26][27][28][29][30][31][32][33] Cannabis marketing is allowed to make claims without sufficient concern for conventional and well-established safeguards and standards for medicines.…”

Section: Quality and Informed Consentmentioning

confidence: 99%

“…24 High-quality clinical trials with cannabinoids are needed and long-term and short-term safety of cannabis and cannabinoids needs to be addressed. 24,25,50 Does Cannabis Exhibit Opioid Sparing Effects and Does Cannabis Use Reduce Opioid Morbidity and Mortality?…”

Section: Social Attitudesmentioning

confidence: 99%

Do We Have Structure, Process and Outcomes to Support Cannabis as Supportive Therapy in Cancer?

Davis

Case

Cyr

2022

Am J Hosp Palliat Care

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“…Cannabis preparations have been used by humans for millennia [14] as a remedy for a range of ailments, including pain [15]. In Africa, a growing number of countries (e.g., Malawi, South Africa and Zimbabwe) have developed legislations on medicinal cannabis and some have regulations for patient access [16].…”

Section: Introductionmentioning

confidence: 99%

Cannabis use for pain relief in the context of health service barriers: Accounts of street‐involved Nigerian women suffering chronic pain

Nelson

Kitchen

2022

Drug and Alcohol Review

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Introduction: This study explored cannabis use for pain relief among socially marginalised Nigerian women in the context of barriers to pain management. Methods:The study was designed as a qualitative exploratory study of pain experience and management. Sixteen in-depth, individual interviews were conducted with street-involved women who use drugs and had chronic pain. Transcripts were coded and analysed thematically.Results: Pain was experienced as a pervasive feature of everyday life that disrupted daily routines, affected economic activities, strained social relationships and had adverse effects on health and wellbeing. Participants sought treatment in health facilities, but faced social and health system barriers to service utilisation including financial cost of services, dismissal of symptoms by providers, stigma due to physical appearance, substance use and lack of social support. These barriers encouraged disengagement from services and reliance on cannabis (along with heroin and diverted prescription opioids) for pain management. Cannabis use relieved pain and improved daily functioning, enabling participants to undertake economic activities. However, using cannabis to enhance the effects of opioids and heavy and long-term use owing to pain chronicity and disability generated concerns about harms. Discussion and Conclusions: Findings show the therapeutic benefits of cannabis in the face of barriers to pain management. This support calls to explore the potentials of cannabis for pain management for socially marginalised populations and to develop medical guidelines to reduce the risk of adverse health consequences. Therapeutic cannabis, provided based on medical guidance, could improve pain management for socially marginalised populations.

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Societal issues and policy implications related to the use of cannabinoids, cannabis, and cannabis-based medicines for pain management

Cited by 17 publications

References 80 publications

Mass Spectrometry-Based Metabolomics of Phytocannabinoids from Non-Cannabis Plant Origins

Mass Spectrometry-Based Metabolomics of Phytocannabinoids from Non-Cannabis Plant Origins

Do We Have Structure, Process and Outcomes to Support Cannabis as Supportive Therapy in Cancer?

Cannabis use for pain relief in the context of health service barriers: Accounts of street‐involved Nigerian women suffering chronic pain

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