Highlights
- •Tetrahydrocannabinol (THC), cannabidiol (CBD) and cannabinol (CBN) affect the human endocannabinoid system.
- •Cannabinoids reduce chemotherapy induced nausea or vomiting (CINV) and neuropathic pain.
- •Each state has its own regulations for medical and recreational cannabis use.
- •Effects of cannabinoids on chemotherapy, immunotherapy, and tumor growth remain under investigation.
- •Providers should focus indications, alternatives, risks and benefits of medical cannabis use to make appropriate referrals.
Keywords
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References
- The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research.National Academies Press, Washington, D.C2017
- Medical board expectations for physicians recommending marijuana.JAMA. 2016; 316: 577-578
- PDQ Rating System.
- Safety and toxicology of cannabinoids.Neurotherapeutics: The Journal of the American Society for Experimental NeuroTherapeutics. 2015; 12: 735-746
- Molecular characterization of a peripheral receptor for cannabinoids.Nature. 1993; 365: 61-65
- Medical marijuana for treatment of chronic pain and other medical and psychiatric problems: a clinical review.Jama. 2015; 313: 2474-2483
- Endocannabinoid binding to the cannabinoid receptors: what is known and what remains unknown.Curr. Med. Chem. 2010; 17: 1468-1486
- Marijuana and the Cannabinoids: Chapter 2 - Chemistry and Analysis of Phytocannabinoids and Other Cannabis Constituents.2007
- Cannabis pharmacology: the usual suspects and a few promising leads.Adv. Pharmacol. 2017; 80 (San Diego, Calif): 67-134
- The pharmacologic and clinical effects of medical cannabis.Pharmacotherapy. 2013; 33: 195-209
- Hemp & cannabidiol: what is a medicine?.Mo. Med. 2018 Jul-Aug; 115: 306-309
- Dosing medical marijuana: rational guidelines on trial in Washington state.MedGenMed: Medscape General Medicine. 2007; 9: 52
- Cannabis use among patients at a comprehensive cancer center in a state with legalized medicinal and recreational use.Cancer. 2017; 123 (Nov 15. (Epub 2017 Sep 25)): 4488-4497https://doi.org/10.1002/cncr.30879
- Integrating cannabis into clinical cancer care.Curr. Oncol. 2016 Mar; 23 (Epub 2016 Mar 16): S8-S14https://doi.org/10.3747/co.23.3099
- Regulation of nausea and vomiting by cannabinoids.Br. J. Pharmacol. 2011; 163: 1411-1422
Garcia, JM, et al. doi:https://doi.org/10.1016/j.amjmed.2017.12.041.
- Cannabinoids for medical use: a systematic review and meta-analysis.JAMA. 2015; 313 (Jun 23–30): 2456-2473https://doi.org/10.1001/jama.2015.6358
- Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy.Cochrane Database Syst. Rev. 2015 Nov 12; 11 (pub2. Review., PMID: 26561338): CD009464https://doi.org/10.1002/14651858.CD009464
- BMJ Open. 2018; 8e020745
- Can medical herbs stimulate regeneration or neuroprotection and treat neuropathic pain in chemotherapy-induced peripheral neuropathy?.Evid. Based Complement. Alternat. Med. 2013; 2013423713
- Recommendations for the pharmacological management of neuropathic pain: an overview and literature update.Mayo Clin. Proc. 2010; 85: S3-14
- Cannabinoids as pharmacotherapies for neuropathic pain: from the bench to the bedside.Neurotherapeutics. 2009; 6: 713-737
- Plant-based cannabinoids for the treatment of chronic neuropathic pain.Medicines (Basel). 2018; 5
- Effects of delta-9-tetrahydrocannabinol and cannabidiol on cisplatin-induced neuropathy in mice.Planta Med. 2016; 82: 1169-1172
- Single and combined effects of Delta(9) -tetrahydrocannabinol and cannabidiol in a mouse model of chemotherapy-induced neuropathic pain.Br. J. Pharmacol. 2017; 174: 2832-2841
- Cannabidiol inhibits paclitaxel-induced neuropathic pain through 5-HT(1A) receptors without diminishing nervous system function or chemotherapy efficacy.Br. J. Pharmacol. 2014; 171: 636-645
- Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial.Neurology. 2007; 68: 515-521
- Low-dose vaporized cannabis significantly improves neuropathic pain.J. Pain. 2013; 14: 136-148
- Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial.Neuropsychopharmacology. 2009; 34: 672-680
- Therapeutic potential of medicinal marijuana: an educational primer for health care professionals.Drug Healthc Patient Saf. 2018; 10 (Pergam SA, see listed ref): 45-66
- Cannabidiol fails to reverse hypothermia or locomotor suppression induced by Delta(9) -tetrahydrocannabinol in Sprague-Dawley rats.Br. J. Pharmacol. 2015; 172: 1783-1791
- Sativex successfully treats neuropathic pain characterised by allodynia: a randomised, double-blind, placebo-controlled clinical trial.Pain. 2007; 133: 210-220
- Efficacy of two cannabis based medicinal extracts for relief of central neuropathic pain from brachial plexus avulsion: results of a randomised controlled trial.Pain. 2004; 112: 299-306
- A multicentre, open-label, follow-on study to assess the long-term maintenance of effect, tolerance and safety of THC/CBD oromucosal spray in the management of neuropathic pain.J. Neurol. 2015; 262: 27-40
- A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatment.Eur. J. Pain. 2014; 18: 999-1012
- A double-blind, randomized, placebo-controlled, parallel-group study of THC/CBD oromucosal spray in combination with the existing treatment regimen, in the relief of central neuropathic pain in patients with multiple sclerosis.J. Neurol. 2013; 260: 984-997
- Randomized placebo-controlled double-blind clinical trial of cannabis-based medicinal product (Sativex) in painful diabetic neuropathy: depression is a major confounding factor.Diabetes Care. 2010; 33: 128-130
- Efficacy, tolerability and safety of cannabis-based medicines for chronic pain management - an overview of systematic reviews.Eur. J. Pain. 2018; 22: 455-470
- Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies.Pain. 2018; 159: 1932-1954
- Cannainoids in palliative medicine.J. Palliat. Med. 2017; 20 (Published Online:1 Jul)https://doi.org/10.1089/jpm.2017.0197
- The intersection between cannabis and cancer in the United States.Crit. Rev. Oncol. Hematol. 2012; 83: 1-10
- Cannabis as a substitute for opioid-based pain medication: patient self-report.Cannabis Cannabinoid Res. 2017; 2: 160-166
- The effect of cannabis use on tumor response to nivolumab in patients with advanced malignancies.in: Oral Presentation at: ESMO 2017 Congress. Madrid, Spain. 2017
- Turning over a new leaf: cannabinoid and endocannabinoid modulation of immune function.J. NeuroImmune Pharmacol. 2015; 10: 193-203
- Cannabinoid receptor 2: potential role in immunomodulation and neuroinflammation.J. NeuroImmune Pharmacol. 2013; 8: 608-620
- (a)Immunoregulatory role of cannabinoids during infectious disease.Neuroimmunomodulation. 2017; 24: 183-199
- (b)Cannabis in cancer care.Clin. Pharmacol. Ther. 2015; 97: 575-586
- (a)Targeting cannabinoid signaling in the immune system: “high”-ly exciting questions, possibilities, and challenges.Front. Immunol. 2017; 8: 1487
- (b)Integrating cannabis into clinical cancer care.Curr. Oncol. 2016; 23: S8-S14
- What every pediatric gynecologist should know about Cannabis use in adolescents.J. Pediatr. Adolesc. Gynecol. 2019 Mar 26; (pii: S1083-3188(19)30167-6)https://doi.org/10.1016/j.jpag.2019.03.004
- Medical Cannabis for older patients.Drugs Aging. 2019 Jan; 36: 39-51https://doi.org/10.1007/s40266-018-0616-5
- Positive and negative effects of cannabis and cannabinoids on health.Clin. Pharmacol. Ther. 2019 May; 105 (Epub 2019 Mar 12): 1139-1147https://doi.org/10.1002/cpt.1381
- Medical marijuana use in oncology: a review.JAMA Oncol. 2016; (Mar 17. [Epub aheaed of print])https://doi.org/10.1001/jamaoncol.2016.0155
- Initial reactions to tobacco and cannabis smoking: a twin study.Addiction. 2014 Apr; 109 (Epub 2014 Jan 23): 663-671https://doi.org/10.1111/add.12449
- The analgesic properties of delta-9-tetrahydrocannabinol and codeine.Clin. Pharmacol. Ther. 1975 Jul; 18: 84-89
- Schizophr. Bull. 2016; 42: 1262-1269
- World J. Gastroenterol. 2009; 15: 1264-1266
- Society of Cannabis Clinicians, the Medical Cannabis Institute.
Article info
Publication history
Published online: January 13, 2020
Accepted:
December 11,
2019
Received:
October 24,
2019
Footnotes
☆Clinical Practice Committee and Palliative Care Task Force authors include: Drs. Bradford Whitcomb, Christopher Lutman, Michael Pearl, Erin Medlin, Emily Prendergast, Katina Robison and William Burke.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.