Generality
The use of marijuana for the treatment of pain has been widespread and legalized in many countries for a very long time. In Italy, however, the use of marijuana to combat pain has been permitted by law for just over ten years (2006).
Of course, the use of marijuana for the treatment of pain is legal only if this substance is prescribed by the doctor and only if it is produced by the authorities in accordance with strict criteria regulated by law.
In Italy, the only factory authorized to produce marijuana for pain treatment is the military chemical chemist in Florence.
Did you know that ...
Pain relief is not the only approved therapeutic indication of marijuana. In fact, marijuana for therapeutic use (therefore, that produced by the aforementioned establishment) can also be used for:
- Counteracting nausea and vomiting induced by chemotherapy and radiotherapy.
- Stimulate the appetite in AIDS patients, in cancer patients and in patients with anorexia nervosa.
- Counteract involuntary movements in patients with Tourette syndrome.
- Counteract the excessive intraocular pressure in patients with glaucoma resistant to conventional therapies.
Composition
What are the active principles contained in the marijuana for pain relief?
The active ingredients of medical-pharmaceutical interest present within marijuana are cannabinoids and, in particular, THC (or delta-9-tetrahydrocannabinol, a psychoactive cannabinoid ) and CBD (cannabidiol, a non-psychoactive cannabinoid ).
Many of the properties attributed to the plant are attributed to THC, including those painkillers that justify the use of marijuana for pain relief. CBD, on the other hand, is able to increase the pain-relieving action of THC and prolong its duration of action, at the same time reducing its side effects, especially those caused by the respiratory tract and by cardiovascular disease.
Since the cannabinoids considered important for the therapeutic effect are THC and CBD, the marijuana for the treatment of pain used in therapy must be titrated and standardized in these active ingredients.
In this regard, we recall that there are many varieties of marijuana that can be used in the medical field, each of which has a certain content of THC and CBD. The marijuana for pain treatment produced in Italy is called Cannabis FM-2 and has a THC content of between 5% and 8% and a CBD content of between 7.5% and 12%.
Action mechanism
How do the Active Principles of Marijuana for Pain Cure work?
The active ingredients present in marijuana for the treatment of pain are able to exert their pain-relieving action through interaction with particular endogenous receptors: the so-called cannabinoid receptors . More specifically, these receptors are inhibitory receptors coupled to G proteins.
Currently, two different receptor subtypes are known: cannabinoid receptors of type 1 ( CB1 ) and receptors for type 2 cannabinoids ( CB2 ).
CB1 receptors are located mainly in the spinal cord, in the brain and along the pain pathways and are involved in the regulation of various biological functions, including the transmission of pain stimulus. More precisely, their activation gives rise to a cascade of signals that leads to the reduction of the pain signal. CB2 receptors, on the other hand, are mostly located in the periphery and are thought to be involved in immunomodulatory activity.
The active ingredients of marijuana - as cannabinoids - seem to exert their pain-relieving action through the bond with the CB1 receptor which leads to its activation. However, this mechanism of action is questioned by some studies according to which the analgesic action would be exercised through the interaction of THC and CBD with other types of receptors.
Effectiveness
Is Marijuana for Pain Treatment Effective?
The answer to the question is yes. Marijuana for the treatment of pain has proven to be effective in reducing painful stimuli in many studies, so much so that its use in this area has been officially recognized by medicine and approved by law.
However, it is important to point out that marijuana has proved useful only in the treatment of chronic pain; while it did not produce the same positive results in case of acute pain. Furthermore, it should be pointed out that marijuana is especially useful in the treatment of chronic neuropathic pain, ie in chronic pain that is triggered by spinal cord injuries or diseases such as multiple sclerosis, amyotrophic lateral sclerosis or fibromyalgia.
Administration route
How do you take Marijuana for Pain Cure?
Marijuana for the treatment of pain can be administered orally or by inhalation, through different methods. However, most probably, the most widespread method of administration is represented by tea intake obtained by boiling the plant inflorescences in water. Alternatively, marijuana for the treatment of pain can be taken through the method of vaporization which consists in inserting the substance inside an electric vaporizer and in inhaling the vapors.
However, it will be the doctor who will tell each patient the method of administration through which to take marijuana for pain treatment.
Side effects
What Side Effects Can Marijuana Cause for Pain Cure?
Generally, marijuana for pain relief is well tolerated by most patients. However, this does not mean that it cannot cause side effects.
In fact, similarly to what happens with any other drug, marijuana for treating pain can cause side effects, even if not all patients manifest them, or manifest them differently from one another. The possible side effects induced by marijuana for the treatment of pain, in fact, can vary according to different factors, such as the duration of treatment, the dose taken, the route of administration chosen and the sensitivity of the patient towards the same marijuana.
Acute side effects
The acute side effects induced by the intake of marijuana for the treatment of pain generally occur shortly after administration and tend to disappear within a few hours, or 2-3 days at the most, from the end of the intake. These effects depend - in addition to the sensitivity of the patient - on the dose of marijuana taken and consist of:
- Euphoria or dysphoria;
- Sedation;
- Loss of control;
- Memory decrease;
- Cognitive and psychomotor alterations;
- Altered perception of time;
- Hallucinations;
- Depression;
- Dry mouth;
- Dizziness;
- Difficulty of language;
- Increased heart rate;
- Hypotension and dizziness;
- Nausea;
- Headache.
The psychic effects induced by the consumption of marijuana for the treatment of pain are attributable to psychoactive cannabinoids such as THC; while non-psychoactive ones such as CBD are not involved in these effects, but may be involved in the onset of physical side effects.
Long-term side effects
Long-term side effects may occur following the prolonged use of marijuana for pain relief.
In particular, tolerance can be developed for some of the effects induced by the substance, such as: psychic effects, anti-emetic effects, effects on intraocular pressure, effects on psychomotor function and effects on the cardiovascular system.
Furthermore, the use of marijuana for the treatment of pain in long-term therapies can potentially favor the onset of addiction, although generally the risk is minimal in the context of therapeutic use. The risk, on the other hand, tends to increase when marijuana is taken for recreational purposes (use that is still illegal in Italy).
Finally, in predisposed individuals, the use of marijuana for the treatment of pain could favor the appearance of psychosis or other psychiatric disorders.
Contraindications
Are there any contraindications to the use of marijuana for pain treatment?
The use of marijuana for the treatment of pain presents several contraindications that are mostly linked to the patient's state of health or to particular phases of life. Indeed, the use of marijuana in pain therapy is generally contraindicated:
- In children and adolescents, due to the possible negative effects that marijuana can exert on the brain development of these patients;
- In pregnancy and during lactation;
- In patients suffering from cardiovascular diseases;
- In patients with respiratory diseases;
- In patients suffering from renal and / or hepatic disorders;
- In patients who suffer - or who have suffered in the past - from psychiatric disorders;
- In patients with drug addiction (even past);
- In patients receiving antipsychotic, antidepressant or other psychoactive drugs.
However, despite the aforementioned general contraindications, it will be the doctor - after a careful evaluation of the relationship between the potential risks and the expected benefits for the patient - to decide, case by case, whether to prescribe or not the administration of marijuana for the treatment of pain.
