Back to Browse Journals » Therapeutics and Clinical Risk Management » Volume 4 » Issue 1

Cannabinoids in the management of difficult to treat pain

Authors Ethan B Russo

Published Date May 2008 Volume 2008:4(1) Pages 245—259

DOI http://dx.doi.org/10.2147/TCRM.S1928

Published 13 May 2008

Ethan B Russo

GW Pharmaceuticals, Vashon, WA, USA

Abstract: This article reviews recent research on cannabinoid analgesia via the endocannabinoid system and non-receptor mechanisms, as well as randomized clinical trials employing cannabinoids in pain treatment. Tetrahydrocannabinol (THC, Marinol®) and nabilone (Cesamet®) are currently approved in the United States and other countries, but not for pain indications. Other synthetic cannabinoids, such as ajulemic acid, are in development. Crude herbal cannabis remains illegal in most jurisdictions but is also under investigation. Sativex®, a cannabis derived oromucosal spray containing equal proportions of THC (partial CB1 receptor agonist) and cannabidiol (CBD, a non-euphoriant, anti-inflammatory analgesic with CB1 receptor antagonist and endocannabinoid modulating effects) was approved in Canada in 2005 for treatment of central neuropathic pain in multiple sclerosis, and in 2007 for intractable cancer pain. Numerous randomized clinical trials have demonstrated safety and efficacy for Sativex in central and peripheral neuropathic pain, rheumatoid arthritis and cancer pain. An Investigational New Drug application to conduct advanced clinical trials for cancer pain was approved by the US FDA in January 2006. Cannabinoid analgesics have generally been well tolerated in clinical trials with acceptable adverse event profiles. Their adjunctive addition to the pharmacological armamentarium for treatment of pain shows great promise.

Keywords: cannabinoids, tetrahydrocannabinol, cannabidiol, analgesia, pain management, multiple sclerosis

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

A cross-sectional study on perception of stigma by Chinese schizophrenia patients [Expression of concern]

Ren ZB, Wang HQ, Feng B, Gu CY, Ma YC, Chen H, Li BL, Liu LY

Neuropsychiatric Disease and Treatment 2014, 10:1333-1334

Published Date: 18 July 2014

Corrigendum

Mizoguchi T, Ozaki M, Unoki K, Dake Y, Eto T, Arai M

Clinical Ophthalmology 2012, 6:1717-1718

Published Date: 26 October 2012

Retraction

Cárdenas WH, Mamani JB, Sibov TT, Caous CA, Amaro E Jr, Gamarra LF

International Journal of Nanomedicine 2012, 7:5107-5108

Published Date: 21 September 2012

Erratum

Todd Levine

Drug Design, Development and Therapy 2012, 6:163-164

Published Date: 21 June 2012

Corrigendum

Chen ZQ, Liu Y, Zhao JH, Wang L, Feng NP

International Journal of Nanomedicine 2012, 7:1709-1710

Published Date: 30 March 2012

Further data on the association between Helicobacter pylori infection and primary open-angle glaucoma

Zavos C, Kountouras J

Clinical Ophthalmology 2012, 6:243-245

Published Date: 10 February 2012

Corrigendum

Schneider EW, Johnson MW

Clinical Ophthalmology 2011, 5:1315-1316

Published Date: 16 September 2011