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Due in part to the illicit nature of cannabis, research is lacking and there is a significant knowledge gap in this area, and medical cannabis recommendations should always be made with careful consideration of the current health status of the patient.
As previously mentioned, individuals suffering from, or at a high risk of developing, schizophrenia or other psychotic illnesses should only be recommended the use of cannabis under well-monitored conditions. The use of strains with minimal or no THC content is recommended. Recently, Kim et al found that cannabis use was significantly associated with lower rates of remission of bipolar spectrum patients over a 2-year follow-up period.
It is estimated that C. However, mild rhinoconjunctivitis symptoms can be treated with antihistamines, intranasal steroids, and nasal decongestants.
Findings from the currently available research suggest that the safety profile of the short-term use of medical cannabis is acceptable. The most commonly reported adverse effect was dizziness Rates of serious adverse effects did not vary between the group of participants assigned to medical cannabis and controls.
A year-old, single male patient reporting chronic lower back pain due to diagnoses of spinal stenosis, degenerative disc disease, and neuropathic pain including sciatica for over 20 years presented at our clinic. The patient also had diagnoses of gastroesophageal reflux disease, irritable bowel syndrome, and anxiety.
At the time of meeting, the patient was using nabilone 0. After several unsuccessful attempts at pain control using physiotherapy, chiropractic, osteopathy, acupuncture, corticosteroid injections, oxycodone, and Percocet, the patient confided he turned to illicit cannabis for pain relief on a daily basis, primarily in the evening after work.
The patient also indicated he did not see a need for pregabalin, and had begun the process of lowering his daily dose. Surprisingly, the patient also reported far fewer symptoms of his irritable bowel syndrome, claiming near-remission. A year-old, married male patient reporting fibromyalgia for 5 years, and osteoarthritis, torn shoulder tendon, and spinal stenosis for over 20 years was referred to our clinic.
The patient also had a history of severe obesity, sleep apnea, restless legs syndrome, and anxiety. Signs of neuropathic pain included widespread allodynia and positive DN4 score.
Physiotherapy, corticosteroid injections, codeine, and a number of anti-inflammatory medications were unsuccessful at achieving adequate analgesia. The patient was inexperienced with cannabis, except for intermittent use on weekends. The patient was prescribed 1. A year-old, single female patient reporting neuropathic pain secondary to MS diagnosis of over 20 years was referred to our clinic by her pain intervention physician.
The patient was actively taking gabapentin 2, mg daily and celecoxib mg daily. The patient could not tolerate the use of opiate medications, claiming dissatisfaction with their sedative effects. Failed pain interventions included IV lidocaine and lumbar radiofrequency ablation. The patient was prescribed 1 g per day of cannabis containing 2. This review documents some of the relevant history and current research literature on medical cannabis.
It draws to attention the key concerns in the Canadian medical system and provides updated treatment approaches to help clinicians work with their patients in achieving adequate pain control, reduced narcotic and other medication use and their adverse effects , and enhanced quality of life.
RCTs using large population samples are needed in order to identify the specific strains and concentrations that will work best with selected cohorts. Cannabis-based medicine is a rapidly emerging field of which all pain physicians need to be aware. National Center for Biotechnology Information , U. Journal List J Pain Res v. Published online Sep Find articles by Sara L Bober. Find articles by Jason M Moreau. Author information Copyright and License information Disclaimer. This work is published and licensed by Dove Medical Press Limited.
The full terms of this license are available at https: By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. This article has been cited by other articles in PMC. Abstract Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to BC.
Medical cannabis in history and society Cannabis sativa cannabis has been used therapeutically for almost 5, years, beginning in traditional Eastern medicine. Open in a separate window. Cannabis and cancer Medical cannabis is also used for some cancer patients to relieve symptoms including nausea and vomiting often caused by some cancer treatments such as chemotherapy and radiation therapy , loss of appetite, and pain.
Pharmacokinetics To date, most pharmacokinetic studies of cannabinoids have focused on the bioavailability of inhaled THC, which varies substantially in the literature, likely due to differences in factors such as breath-hold length, source of cannabis material, and method of inhalation.
Acquisition cost Medical cannabis is not typically covered by insurance plans in Canada. Social stigma Many chronic pain patients considering medical cannabis anticipate disapproval from their friends and family. Lack of understanding of route of administration Many chronic pain patients have limited or no experience using cannabis. Physicians Credibility—criminality—clinical evidence In , upward of 1, studies were published on cannabinoids.
Prescribing considerations As mentioned, prescription and recommendation of medical cannabis at this point is largely nonspecific.
Amount MMPR requires the recommending physician allot a set amount of cannabis to which a patient will have access on a daily basis. Strain selection and recommendation Given that evidence supporting the use of specific medical cannabis strains for various pain ailments is lacking, recommending a strain type to a patient can be difficult. Route of administration Many patients have concerns about medical cannabis smoke, which contains many of the same carcinogenic chemicals as tobacco smoke.
Follow-up frequency When introducing a patient to medical cannabis for the first time, it is important to schedule frequent follow-ups until a strain has been selected that meets the treatment goals of both patient and physician. Contraindications Several contraindications have been identified for medical cannabis recommendations. Psychosis As previously mentioned, individuals suffering from, or at a high risk of developing, schizophrenia or other psychotic illnesses should only be recommended the use of cannabis under well-monitored conditions.
Bipolar disorder Recently, Kim et al found that cannabis use was significantly associated with lower rates of remission of bipolar spectrum patients over a 2-year follow-up period. Cannabis allergies It is estimated that C.
Adverse effects Findings from the currently available research suggest that the safety profile of the short-term use of medical cannabis is acceptable. Case studies Neuropathic low-back pain A year-old, single male patient reporting chronic lower back pain due to diagnoses of spinal stenosis, degenerative disc disease, and neuropathic pain including sciatica for over 20 years presented at our clinic.
Fibromyalgia — widespread neuropathic pain A year-old, married male patient reporting fibromyalgia for 5 years, and osteoarthritis, torn shoulder tendon, and spinal stenosis for over 20 years was referred to our clinic. MS-related neuropathic pain A year-old, single female patient reporting neuropathic pain secondary to MS diagnosis of over 20 years was referred to our clinic by her pain intervention physician.
Conclusion This review documents some of the relevant history and current research literature on medical cannabis. Footnotes Disclosure The authors report no conflicts of interest in this work. History of cannabis as a medicine: Examining the roles of cannabinoids in pain and other therapeutic indications: Pharmacology and potential therapeutic uses of cannabis. History of therapeutic cannabis. Cannabis in Medical Practice: The effectiveness of cannabinoids in the management of chronic nonmalignant neuropathic pain: J Oral Facial Pain Headache.
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PhD, King's College, London, Potency of delta 9-THC and other cannabinoids in cannabis in England in Effects of the essential oil from Citrus aurantium L. Cannabinoids as pharmacotherapies for neuropathic pain: You will not receive a reply. Skip to main content Skip to "About government". Learn about cannabis marijuana , its uses, and forms. The Cannabis Act currently permits the sale of: Report a problem or mistake on this page. Please select all that apply: A link, button or video is not working.
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I can't find what I'm looking for. Other issue not in this list. Thank you for your help! Highly concentrated cannabis extract dissolved in petroleum-based solvent for example, butane. Shatter, budder and wax most highly concentrated.
Medical cannabis – the Canadian perspective
For something that's meant to relax you, buying cannabis oil can be a It's also critical to make sure that only the highest-quality cannabis is used in any oil that you decide to buy. As discussed earlier, THC and CBD have different effects on the body. . Hours: Monday – Friday am – am EST. From high-profile campaigns like Vera Twomey's to numerous other personal the HPRA, CBD products will continue to be sold in Ireland, even if they are not being prescribed by doctors. “Some of these preparations are referred to as CBD oil or cannabis oil, Jul 22nd , AM .. 44, When HBJ published the inaugural CBD Industry Outlook are based on expec- . liable to the purchaser or any other person or sales data and the best currently available compound in full-spectrum hemp oil, and the . 30%. 40%. 50%. 60%. $1, U.S. TOTAL CBD PRODUCT SALES,