Cannabis-based Medications as Therapies for Adult Patients Suffering from Chronic

Neuropathic Pain

The emphasis of this paper is an innovative approach to treating and managing persistent neuropathic pain. Only a small percentage of persons receive significant relief from current pharmacological treatments (medication) for neuropathic pain, and they frequently have side effects that outweigh the advantages.

• Between 6% and 10% of the population is thought to experience chronic pain with neuropathic elements.

For the treatment of disorders involving chronic neuropathic pain, it is now urgently necessary to investigate further alternative therapy alternatives with various mechanisms of action. For thousands of years, people have used cannabis to ease pain. Currently, some patients and their supporters are aggressively advocating the use of herbal cannabis to treat all forms of chronic pain.

Introduction

One of the substances that is used the most frequently worldwide is cannabis. More than 100 of the more than 400 chemical components found in the cannabis plant. chemicals that are specific to the cannabis plant are cannabinoids.

• Many nations have adopted new cannabis laws during the past 20 years, including decriminalizing cannabis possession and legalizing it for both medical and recreational use.

Cannabis has been investigated as a potential treatment for a number of incapacitating medical problems, including neuropathic pain, in many nations during this time of increased discussion about the hazards and advantages of marijuana.

Neuropathic Pain

The International Association for the Study of Pain (IASP) describes neuropathic pain as “pain induced by a lesion or disease of the somatosensory nerve system.”

The term dysfunction in the previous definition was deemed to be overly inclusive and to not accurately describe the pathophysiology, thus it was evaluated and modified. Furthermore, neuropathic pain is a complex network of diseases or lesions with a variety of symptoms and indicators, and our understanding of its etiology is still developing.

Cannabis and Neuropathic Pain Treatment

Numerous cannabis-based medications have been proposed as remedies for pain, particularly neuropathic pain. These items include herbal cannabis inhalation as well as a variety of sprays and tablets with real or synthetic active cannabis components.

It is frequently reported in the media that some persons with neuropathic pain claim that cannabis-based medicines are helpful for them. For instance, a 2017 clinical trial looked at the effectiveness of cannabis-related medications for treating adult patients with persistent neuropathic pain. The study’s findings suggested that:

• When all cannabis-based treatments were combined, they outperformed placebos in terms of significant and moderate pain alleviation and overall improvement. When all cannabis-based medications were combined, they reduced pain intensity, psychological discomfort and sleep issues, more than a placebo.

Additionally, cannabis has been utilized historically by numerous cultures to treat a wide range of unpleasant conditions. Neuropathic pain is a complex illness that is difficult to treat with the drugs we currently have available.

The complex function of the endocannabinoid system in the pathophysiology of neuropathic pain has been clarified by recent scientific research. There is increased interest in the use of medical cannabis for neuropathic pain as cultural opinions shift and medical marijuana laws loosen.

Disorders with Ranging from Moderate-to-High Efficacy

Current basic scientific studies and information from recent randomized controlled trials (RCTs) investigating medical cannabis for the treatment of neuropathic pain have been evaluated by researchers.

These trials used medical cannabis with various THC concentrations and administration methods, as well as individuals with a range of neuropathic pain etiologies. Numerous RCTs showed medical marijuana to be effective in treating neuropathic pain, with number required to treat (NNT) values comparable to those of the most popular pharmaceutical treatments.

Chronic and Neuropathic Pain

There are only a few indications for which there is strong evidence for the effectiveness of cannabis-based medicine. For instance, multiple studies have demonstrated that cannabis can be a useful pharmaceutical treatment for both chronic pain and neuropathic pain.

Preclinical research first showed that cannabis was useful at treating pain. Animal pain models were used to support the concept that the endocannabinoid system actively participates in pain management.

• THC has been demonstrated to have analgesic and anti-hyperalgesic properties in mice. Anecdotal evidence from people with chronic pain has supported these analgesic effects, and numerous clinical investigations have attempted to test these effects in human models.
• A systematic review and meta-analysis of randomized therapeutic studies including cannabis and cannabinoids was carried out by Whiting and colleges. In total, 2,454 people across 28 studies measuring chronic pain were examined in this study. Comparing cannabis to a placebo, there was a greater overall decrease in pain measurements with cannabinoids.

There is “conclusive or significant evidence,” according to a recent assessment by the National Academy of Science, Engineering, and Medicine in the United States, that cannabis or cannabinoids are effective treatments for chronic pain.

• Lastly, another study found “excellent quality evidence” to support the use of cannabis or cannabinoid pharmacotherapy for treating chronic pain and neuropathic pain, as shown by numerous successful randomized placebo-controlled trials.

MS Spasticity

At least 14 randomized clinical trials have been conducted to demonstrate the effectiveness of cannabis as a treatment for multiple sclerosis-related spasticity. Numerous studies demonstrated that using cannabis or cannabinoids to treat MS patients’ spasticity was effective.

These positive findings were noted by the American Academy of Neurology, which prompted the publication of evidence-based recommendations for doctors to prescribe an oral cannabis extract containing both THC and cannabidiol (CBD) for the treatment of spasticity and pain brought on by multiple sclerosis. Cannabis was most frequently shown to relieve the following symptoms:

• Muscular spasm,
• Sleep problems, and
• Stiffness

Neurological Conditions

Adolescents

Self-reports and anecdotal evidence have been the foundation of much of the evidence supporting the use of cannabis to treat childhood epilepsy. Studies on the alleged efficacy of CBD-rich cannabis use in epilepsy patients have revealed a significant decrease in seizure frequency and intensity across a range of seizure disorders.

• Dravet syndrome, Lennox-Gastaut syndrome, and idiopathic epilepsy were diagnosed in 19 children aged 2 to 16 years in research. Complete seizure freedom and an improvement in seizures were found in 11% and 84% of patients, respectively.
• In a survey-based study of 117 parents of kids with infantile spasms and Lennox-Gastaut syndrome, 14% of youngsters were seizure-free in total, and 85% of parents reported a decrease in seizure frequency after cannabis administration.
• Children with epileptic syndromes who use CBD also experience improved sleep, alertness, and mood as well as an uptick in hunger. Children with epileptic syndromes who use CBD also experience improved sleep, alertness, and mood as well as an uptick in hunger.

Adults

Studies on the efficacy of cannabis in treating adults with epilepsy have produced conflicting findings. It has been demonstrated that males who used cannabis up to 90 days before admission to the hospital had a much lower probability of developing a new seizure than men who did not. In different research of individuals with epilepsy, the majority of participants believed that using cannabis would lessen their seizures’ intensity and frequency.

In conclusion, greater scientific investigation is needed to better understand the efficacy of cannabis in treating adult seizure disorders.

Future Implications

Medical experts should stay up to date on these results as cannabis research and its suitability as medicine progress. In several medical fields, cannabis and cannabinoids hold great medicinal potential. Medical professionals should base their choices on facts and research, not on what the general population thinks.

Although cannabis is frequently used for recreational purposes, this fact shouldn’t influence how doctors interpret research on its effectiveness in treating certain medical problems.

Summation

Short-term, low-dose cannabis vaporization and oral mucosal delivery for the treatment of neuropathic pain appear to be safe and effective, according to the data. The findings imply that medicinal marijuana may be as bearable and effective as the neuropathic medications currently available; however, further research is required to evaluate the long-term effects of medical marijuana use.

Additionally, ongoing studies to improve dosage, cannabinoid ratios, and other routes of administration may assist to hone medical cannabis’ medicinal potential for treating neuropathic pain.