Cannabinoid-Opioid Interaction in Chronic Pain, A Review

Everyone knows that cannabis delivers various medical benefits, perhaps the most important one being pain relief.  Other drugs relieve pain, and doctors normally prescribe opiates or opioids to relieve severe pain.  However, opioid side effects include sedation, nausea and vomiting, and addiction. Nevertheless, the medical and cannabis communities have good cause to learn more about the combined use of cannabis and opioids.  Research has shown that cannabis enhances the pain relief of opioids while reducing nausea (Narang, 2008).  Patients may benefit from the cannabis-opioid combination by being able to reduce their use of the opioids and the side effects they cause.  Many patients already augment their opioid pain relief regimen with cannabis, so the interaction deserves close examination. For some patients, psychoactivity poses the most serious side effect of cannabis.  Beyond that, patients can safely obtain pain relief from cannabis precisely because it has few other side effects.  The inherent safety of THC is due to the scarcity of cannabinoid receptors in the parts of the brain that control metabolism and breathing. In 2010, Dr. Donald Abrams conducted a study using 24 patients at the San Francisco General Hospital.  The patients normally consumed morphine or oxycodone for significant pain due to various conditions (cancer, multiple sclerosis, migraine, etc.).  The study examined the subjective effects on the patients following the addition of inhaled cannabis vapor to their opioid regimen.  The patients inhaled vaporized cannabis three times a day for five days.  The patients also continued their prescriptions of sustained release tablets…

Cannabis & Pregnancy

A review of cannabis use during pregnancy, published in the journal Future Neurology on July 1, 2011, clearly indicates that there are risks of long term cognitive effects when exposing unborn children to cannabis. [Developing Brain CME Chia-Shan Wu, PhD; Christopher P. Jew; Hui-Chen Lu, PhD CME] Abstract Cannabis is the most commonly used illicit substance among pregnant women. Human epidemiological and animal studies have found that prenatal cannabis exposure influences brain development and can have long-lasting impacts on cognitive functions. Exploration of the therapeutic potential of cannabis-based medicines and synthetic cannabinoid compounds has given us much insight into the physiological roles of endogenous ligands (endocannabinoids) and their receptors. In this article, we examine human longitudinal cohort studies that document the long-term influence of prenatal exposure to cannabis, followed by an overview of the molecular composition of the endocannabinoid system and the temporal and spatial changes in their expression during brain development. How endocannabinoid signaling modulates fundamental developmental processes such as cell proliferation, neurogenesis, migration and axonal pathfinding are also summarized. Introduction Cannabis is the world’s third most popular recreational drug, after alcohol and tobacco.[201] The hallmarks of its effects are euphoria and relaxation, perceptual alterations, time distortion, appetite inducement and the intensification of ordinary sensory experiences.[1] Cannabis preparations are largely derived from the female plant of Cannabis sativa, and consist of approximately 60 plant-derived cannabinoid compounds (phytocannabinoids), with ∆9-tetrahydrocannabinol (THC) being the predominant psychoactive constituent.[2] Efforts aimed at understanding how THC produces its psychoactive effects have led to the…