Use of Cannabis for chronic pain treatment: a systematic review
DOI:
https://doi.org/10.33448/rsd-v11i3.26586Keywords:
Cannabis; Chronic Pain; Medical marijuana.Abstract
This study aims to assess the use of medicinal Cannabis for donor treatment, analyzing topics such as better donor and collateral effects. It is a systematic review carried out through the SciELO, LILACS and Medline/PubMed databases with observational studies published in the last 5 years. Not total, forams found 13,910 items, after applying the criteria of inclusion and exclusion subtract 18 studies to compare based on data. Forams analyzed 7,389 patients, with a predominance of the female sex (n=3,623). Chronic pain was the most mentioned in the studies (n=1,492 cases), followed by neuropathic pain (n=870 cases) and pain after injury/trauma (n=794 cases). In 10 studies, with a sample of 4,611 patients, 3,579 (77.62%) reported an improvement in their sleep level after starting Cannabis use. Other benefits of this treatment were improved sleep, reduced use of opioids, and improved quality of life. For chronic refractory or low response to conventional treatment, the use of Cannabis is a good option, since it is capable of relieving pain, as well as its associated symptoms, or that it improves the quality of life of the patient and also reduces the opioid use.
References
Abrams, D.L. (2016). Integração da Cannabis no Tratamento Clínico do Câncer. Oncologia Atual, 23 (2).
Abuhasira, R., Ron, A., Sikorin, I. & Novack, V. (2019). Medical Cannabis for Older Patients-Treatment Protocol and Initial Results. J Clin Med., 8(11):1819. 10.3390/jcm8111819.
Aguiar, D. D. (2020). Avaliação do efeito antinociceptivo do canabidiol no tratamento agudo da dor neuropática e mecanismos antinociceptivos endógenos envolvidos nesse evento. 157 f. Tese: Doutorado no Programa de Pós-Graduação de Fisiologia e Farmacologia. Universidade Federal de Minas Gerais. Belo Horizonte.
Alan, N.S. (1999). Controle da dor no período perioperatório. Clin Cirurg Am Norte, 79:197-211.
Almog, S., Aharon-Peretz, J., Vulfsons, S., Ogintz, M., Abalia, H., Lupo, T., Hayon, Y. & Eisenberg, E. (2020). The pharmacokinetics, efficacy, and safety of a novel selective-dose cannabis inhaler in patients with chronic pain: A randomized, double-blinded, placebo-controlled trial. Eur J Pain., 24(8):1505-1516. 10.1002/ejp.1605.
Ameri, A. (1999). The eff of cannabinoids on the brain. Prog Neurobiol., 58(4):315-48.
Bellnier, T., Brown, G. W. & Ortega, T. R. (2018). Preliminary evaluation of the efficacy, safety, and costs associated with the treatment of chronic pain with medical cannabis. Ment Health Clin., 8(3):110-115. 10.9740/mhc.2018.05.110.
Bigand, T., Anderson, C. L., Roberts, M. L., Shaw, M. R. & Wilson, M. (2019). Benefits and adverse effects of cannabis use among adults with persistent pain. Nurs Outlook, 67:223–31. 10.1016/j.outlook.2018.12.014
Bobitt, J. & Kang, H. (2020). Characteristics of Older Veterans Enrolled in the Illinois Medical Cannabis Patient Program. Innov Aging., 4(Suppl 1):477–8. 10.1093/geroni/igaa057.1546.
Bonfa, L., Vinagre, R. C. & de Figueiredo, N. V. (2008). Cannabinoids in chronic pain and palliative care. Rev Bras Anestesiol., 58(3):267-79.
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Protocolo Clínico e Diretrizes Terapêuticas da Dor Crônica. Rio de Janeiro, 2012. Disponível em http://conitec.gov.br/images/Protocolos/DorCronica.pdf
Brucki, S. M. D., Frota, N. A., Schestatsky, P., Souza, A. H., Carvalho, V. N., Manreza, M. L. G., Mendes, M. F., Comini-Frota, E., Vasconcelos, C., Tumas, V., Ferraz, H. B., Barbosa, E. & Jurno, M. E. (2015). Cannabinoids in neurology – Brazilian Academy of Neurology. Arquivos de Neuro-Psiquiatria. Arq. Neuro-Psiquiatr. 2015, 73 (4):371-374.
Burstein, S., Levin, E. & Varanelli, C. (1973). Prostaglandins and cannabis- II- Inhibition of biosynthesis by the naturally occurring cannabinoids. Biochem Pharmacol., 22(22):2905-10.
Carvalho, V. M., Aguiar, A. F., Baratto, L. C., Souza, F. L. C. & Rocha, E. D. (2020). Quantificação de canabinoides em extratos medicinais de Cannabis por cromatografia líquida de alta eficiência. Quím. Nova, 43 (1). 10.21577/0100-4042.20170457
Carneiro, D. A. (2018). Uso medicinal da Cannabis Sativa. 45f. Monografia (Curso de Direito) – UniEvangélica, Anápolis.
Erridge, S., Salazar, O., Kawka, M., Holvey, C., Coomber, R., Usmani, A., Sajad, M., Beri, S., Hoare, J., Khan, S., Weatherall, M. W., Platt, M., Rucker, J. J. & Sodergren, M. H. (2021). An initial analysis of the UK Medical Cannabis Registry: Outcomes analysis of first 129 patients. Neuropsychopharmacol Rep., 41(3):362-370. 10.1002/npr2.12183.
Fanelli, G., De Carolis, G., Leonardi, C., Longobardi, A., Sarli, E., Allegri, M. & Schatman, M. E. (2017). Cannabis and intractable chronic pain: an explorative retrospective analysis of Italian cohort of 614 patients. J Pain Res., 10:1217-1224. 10.2147/JPR.S132814.
Goodell, E. M. A., Nordeck, C., Finan, P. H., Vandrey, R., Dunn, K. E. & Thrul, J. (2021). Feasibility and acceptability of using smartphone-based EMA to assess patterns of prescription opioid and medical cannabis use among individuals with chronic pain. Internet Interv., 26:100460. 10.1016/j.invent.2021.100460.
Gulbransen, G., Xu, W. & Arroll, B. (2020). Cannabidiol prescription in clinical practice: an audit on the first 400 patients in New Zealand. BJGP Open., 4(1):bjgpopen20X101010. 10.3399/bjgpopen20X101010.
Guzz, E. C., Vieira, P. F. G., Soldatelli, M. D. & Musse, C. A. I. (2018). Manejo da Dor Crônica. Bvsalud.org. Disponível em: https://docs.bvsalud.org/biblioref/2018/02/879720/manejo-da-dor-cronica-eduardo-guzzo.pdf
Habib, G., Khazin, F. & Artul, S. (2021). The Effect of Medical Cannabis on Pain Level and Quality of Sleep among Rheumatology Clinic Outpatients. Pain Res Manag, 2021:1756588. 10.1155/2021/1756588.
Heng, M., McTague, M. F., Lucas, R. C. Harris, M., Vrahas, M. & Weaver, M. (2018). Patient perceptions of the use of medical marijuana in the treatment of pain after musculoskeletal trauma: a survey of patients at 2 trauma centers in Massachusetts. J Orthop Trauma, 32:e25–30. 10.1097/BOT.0000000000001002
Honório, K. M., Arroio, A., da Silva, A. B. F. (2006). Aspectos terapêuticos de compostos da planta Cannabis sativa. Quím. Nova, 29 (2). 10.1590/S0100-40422006000200024
Hill, M. (2015). Be clear about the real risks. Nature, 525: 14.
Ibrahim, M. M., Porreca, F., Lai, J., Albrecht, P. J., Rice, F. L., Khodorova, A., Davar, G., Makriyannis, A., Vanderah, T. W., Mata, H. P. & Malan, T. P. Jr. (2005). CB2 cannabinoid receptor activation produces antinociception by stimulating peripheral release of endogenous opioids. Proc Natl Acad Sci U S A. 2005, 102(8):3093-8.
Kosiba, J. D., Mitzel, L. D., Zale, E. L., Zvolensky, M. J. & Ditre, J. W. (2020). Um Estudo Preliminar de Associações entre Intolerância ao Desconforto, Severidade / Interferência da Dor e Frequência do Uso de Cannabis entre Indivíduos com Dor Crônica. Teoria do Addict Res., 28 (1): 76-81. 10.1080 / 16066359.2019.1590557.
Landis, J. R. & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1):159-174.
Lessa, M. A., Cavalcanti, I. L. & Figueiredo, N. V. (2016). Derivados canabinóides e o tratamento farmacológico da dor. Rev. Dor., 17 (1): 47-51.
Lintzeris, N., Mills, L., Suraev, A., Bravo, M., Arkell, T., Arnold, J. C., Benson, M. J. & McGregor, I. S. (2020). Medical cannabis use in the Australian community following introduction of legal access: the 2018-2019 Online Cross-Sectional Cannabis as Medicine Survey (CAMS-18). Harm Reduct J., 17(1):37. 10.1186/s12954-020-00377-0.
Lucas, C. J., Galettis, P. & Schneider, J. (2018). The pharmacokinetics and the pharmacodynamics of cannabinoids. Br J Clin Pharmacol., 84(11):2477-2482. 10.1111/bcp.13710.
Martin, E. L., Strickland, J. C., Schlienz, N. J., Munson, J., Jackson, H., Bonn-Miller, M. O. & Vandrey, R. (2021). Antidepressant and Anxiolytic Effects of Medicinal Cannabis Use in an Observational Trial. Front Psychiatry., 12:729800. 10.3389/fpsyt.2021.729800.
Martins, B., Corvelo, M., Lourenço, A. C., Souza, E. A. & Marina, E. (2012). Dor crônica: terapias externas antroposóficas associadas a medicamentos injetáveis. Perspectivas Médicas, 23 (2): 11-15.
Munro, S., Thomas, K. L. & Abu-Shaar, M. (1993). Molecular characterization of a peripheral receptor for cannabinoids. Nature, 365(6441):61-5.
Notcutt, W., Price, M., Miller, R., Newport, S., Phillips, C., Simmons, S. & Sansom, C. (2004). Initial experiences with medicinal extracts of cannabis for chronic pain: results from 34 'N of 1' studies. Anaesthesia, 59(5):440-52.
Nugent, S. M., Morasco, B. J., O'Neil, M. E., Freeman, M., Low, A., Kondo, K., Elven, C., Zakher, B., Motu'apuaka, M., Paynter, R. & Kansagara, D. (2017). The Effects of Cannabis Among Adults With Chronic Pain and an Overview of General Harms: A Systematic Review. Ann Intern Med., 167(5):319-331. 10.7326/M17-0155.
Piper, B. J., Beals, M. L., Abess, A. T., Nichols, S. D., Martin, M., Coob, C. M. & DeKeuster, R. M. (2017). Chronic pain patients' perspectives of medical cannabis. Pain, 158(7):1373-1379. 10.1097/j.pain.0000000000000899.
Porter, A. C. & Felder, C. C. (2001). The endocannabinoid nervous system: unique opportunities for therapeutic intervention. Pharmacol Ther., 90(1):45-60.
Raichlen, D. A., Foster, A. D., Gerdeman, G. L., Seillier, A. & Giuffrida, A. (2012). Wired to run: exercise-induced endocannabinoid signaling in humans and cursorial mammals with implications for the 'runner's high'. J Exp Biol., 215(Pt 8):1331-6. 10.1242/jeb.063677.
Raja, S. N., Carr, D. B., Cohen, M., Finnerup, N. B., Flor, H., Gibson, S., Keefe, F. J., Mogil, J. S., Ringkamp, M., Sluka, K. A., Song, X. J., Stevens, B., Sullivan, M. D., Tutelman, P. R., Ushida, T. & Vader, K. (2020). The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain, 23. 10.1097/j.pain.0000000000001939.
Rahn, E. J. & Hohmann, A. G. (2009). Cannabinoids as pharmacotherapies for neuropathic pain: from the bench to the bedside. Neurotherapeutics., 6(4):713-37.
Rahn, E. J., Makriyannis & A., Hohmann, A. G. (2007). Activation of cannabinoid CB1 and CB2 receptors suppresses neuropathic nociception evoked by the chemotherapeutic agent vincristine in rats. Br J Pharmacol., 152(5):765-77.
Richardson, J. D., Aanonsen, L. & Hargreaves, K. M. (1997). SR 141716A, a cannabinoid receptor antagonist, produces hyperalgesia in untreated mice. Eur J Pharmacol., 319(2-3):R3-4.
Rocha, A. P. C., Kraychete, D. C., Lemonica, L., Carvalho, L. R., Barros, G. A. M., Garcia, J. B. S. & Sakata, R. K. (2007). Dor: aspectos atuais da sensibilização periférica e central. Rev. Bras. Anestesiol., 57 (1):94-105.
Rodrigues, F. P. (2019). Uso de canabinóides para o manejo da dor crônica. Rev Cient UMC, 4 (3).
Russo, E. B., Guy, G. W. & Robson, P. J. (2007). Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine. Chem Biodivers, 4(8):1729-43.
Sagy I, Bar-Lev Schleider L, Abu-Shakra M & Novack, V. (2019). Safety and Efficacy of Medical Cannabis in Fibromyalgia. J Clin Med. 2019, 8(6):807. 10.3390/jcm8060807.
Schestatsky, P., Vidor, L., Winckler, P. B., Araujo, T. G. & Caumo, W. (2014). Promising treatments for neuropathic pain. Arq Neuropsiquiatr, 72: 881-8.
Takakuwa, K. M. & Sulak, D. (2020). A Survey on the Effect That Medical Cannabis Has on Prescription Opioid Medication Usage for the Treatment of Chronic Pain at Three Medical Cannabis Practice Sites. Cureus, 12(12):e11848. 10.7759/cureus.11848.
Ueberall, M. A., Essner, U. & Mueller-Schwefe, G. H. (2019). Effectiveness and tolerability of THC:CBD oromucosal spray as add-on measure in patients with severe chronic pain: analysis of 12-week open-label real-world data provided by the German Pain e-Registry. J Pain Res, 12:1577-1604. 10.2147/JPR.S192174.
Vasconcelos, F. H. & Araújo, G. C. (2019). Prevalência de dor crônica no Brasil: estudo descritivo. Revista Dor, 1 (2): 176179.
Vigil, J. M., Stith, S. S., Adams, I. M. & Reeve, A. P. (2017). Associations between medical cannabis and prescription opioid use in chronic pain patients: A preliminary cohort study. PLoS One., 12(11): e0187795. 10.1371/journal.pone.0187795.
Wade, D. T, Robson, P., House, H., Makela, P. & Aram, J. (2003). A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clin Rehabil, 17(1):21-9.
Wang, Y., Jean Jacques, J., Li, Z., Sibille, K. T. & Cook, R. L. (2021). Health Outcomes among Adults Initiating Medical Cannabis for Chronic Pain: A 3-month Prospective Study Incorporating Ecological Momentary Assessment (EMA). Cannabis, 4(2):69-83. 10.26828/cannabis/2021.02.006.
Williamson, E. M. (2004). The breeding of cannabis cultivars for pharmaceutical end uses. In: Guy GW, Whittle BA. editors. Medicinal uses of cacannabis and cannabinoids. London: Pharmaceutical Press: 55-70.
Woolf, C. J. (1989). Recent advances in the pathophysiology of acute pain. Br J Anaesth., 63(2):139-46. 10.1093/bja/63.2.139.
Zeng, L., Lytvyn, L., Wang, X., Kithulegoda, N., Agterberg, S., Shergill, Y., Esfahani, M. A., Heen, A. F., Agoritsas, T., Guyatt, G. H. & Busse, J. W. (2021). Values and preferences towards medical cannabis among people living with chronic pain: a mixed-methods systematic review. BMJ Open., 11(9):e050831. doi:10.1136/bmjopen-2021-050831
Zhang, H. Y., Gao, M., Shen, H., Bi, G. H., Yang, H. J., Liu, Q. R., Wu, J., Gardner, E. L., Bonci, A. & Xi, Z. X. (2017). Expression of functional cannabinoid CB2 receptor in VTA dopamine neurons in rats. Addict Biol., 22(3):752-765. 10.1111/adb.12367.
Zimmermann, M. (2001). Pathobiology of neuropathic pain. Eur J Pharmacol, 429:23-37.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Gabriel Ferreira Setton Matias; Maria Adriely Cunha Lima; Tiago Almeida Costa; Mariana Soares Faria; Isabella Bittencourt Oliveira Nascimento ; Alejandra Debbo
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
