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Chronic non-cancerous pain can be referred to as that moderate to severe pain that may persist for more than six months. This type of pain may include the neuropathic pain, low back pain, and pain occurring in patients with osteoarthritis. The most effective therapies used for the treatment of non-cancerous pain are scarce and they would possibly be associated with several side effects. Given the recently increased knowledge of their mechanisms in the body, cannabinoids are relatively novel compounds which have shown promising therapeutic solutions by acting on their specific receptors in the body. They can be extracted from the cannabis plant or naturally produced in the body. Additionally, chemical substances that activate or stimulate the action of cannabinoids yielded excellent treatment outcomes, including their analgesic effects. The present study evaluated the literature concerned with investigating the effects of cannabinoid treatment for non-cancerous pain.
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Plant-derived cannabinoids as potential analgesics
Studies have shown that the smoked cannabis is considered an effective approach for the treatment of neuropathic pain, including that pain reported in patients with Human Immunodeficiency Virus (HIV) when it was used for a period up to two weeks. Furthermore, the oromucosal sprays containing the extracts of cannabis flower and leaves exhibited excellent analgesic effects for neuropathic pain, and this was more apparent in the patients suffering from rheumatoid arthritis. Such sprays caused also a significant improvement of pain and the general performance of daily activities and functions in multiple sclerosis patients.
The efficacy of synthetic cannabinoids for chronic non-cancerous pain
When the patients with spinal pain, spasticity, and fibromyalgia received a daily regimen of nabilone, the drug caused a potent pain-relieving effect as compared to an opioid counterpart. Similarly, daily administration dronabinol, another synthetic cannabinoid, led to a marked reduction of pain in multiple sclerosis and a great analgesic impact in patients with chronic non-cancerous pain. Using ajulemic acid, which is a synthetic derivative of tetrahydrocannabinol (a commonly known cannabinoid), resulted in alleviating pain intensity soon after administration, but the effect was not markedly observed after 8 hours of treatment.
Side effects of the analgesic cannabinoids
In general, there are no reported severe side effects of cannabinoids that may require cessation of therapy. Further, they are transient and well-tolerated by the patients. They include drowsiness, nausea, headache, euphoria, and slight disturbances of concentration. Other patients experienced mouth dryness, paranoid thinking, and sedation. Overall, the patients are advised to be cautious as fractures may develop, which could be attributable to the cannabinoid-associated dizziness.
Cannabinoid treatment for chronic non-cancerous pain was highly efficacious with a remarkable relevance to the type of pain resistant to common analgesics, such as HIV-related pain, rheumatoid arthritis, and fibromyalgia. Additionally, cannabinoids showed a highly appreciated safety profile. It is therefore important to conduct future clinical trials based on a large number of populations for long periods of time to evaluate the analgesic effects of cannabinoids, considering the daily functional performance.