The Role of Cannabidiol (CBD) in Chronic Pain Management: An Assessment of Current Evidence

被引:68
作者
Boyaji, Shafik [1 ,2 ]
Merkow, Justin [1 ,2 ]
Elman, R. Noel M. [3 ]
Kaye, Alan D. [4 ,5 ,6 ]
Yong, R. Jason [1 ,2 ]
Urman, Richard D. [1 ]
机构
[1] Brigham & Womens Hosp, Dept Anesthesiol Perioperat & Pain Med, 75 Francis St, Boston, MA 02115 USA
[2] Brigham & Womens Hosp, Dept Anesthesiol Perioperat & Pain Med, Div Pain Med, 75 Francis St, Boston, MA 02115 USA
[3] GearJump Technol LLC, POB 1600, Brookline, MA USA
[4] Louisiana State Univ, Sch Med, Dept Anesthesiol & Pharmacol Toxicol & Neurosci, Shreveport, LA USA
[5] Louisiana State Univ, Sch Med, Acad Affairs, Shreveport, LA USA
[6] Louisiana State Univ, Sch Med, Shreveport, LA USA
关键词
Cannabidiol; CBD; Pain; Treatment; Efficacy; Cannabinoids; THC; CONSTITUENT CANNABIDIOL; ENDOCANNABINOID SYSTEM; OROMUCOSAL SPRAY; CANCER-PATIENTS; DOUBLE-BLIND; NABIXIMOLS; TETRAHYDROCANNABINOL; SPASTICITY; EFFICACY; SATIVEX;
D O I
10.1007/s11916-020-0835-4
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose of Review Given the growing challenges in chronic pain management coupled with the ongoing consequences of the opioid epidemic, pain management practitioners are looking into more effective, innovative, and safer alternatives to treat pain. Cannabis-based medicine had been described for hundreds of years but only recently have we seen the more scientific, evidence-based approach to its use, and ongoing investigations continue to explore its potential medical benefits. While historically more attention has been paid to the psychoactive component of the cannabis plant Delta(9)-tetrahydrocannabinol (THC), there have been fewer scientific studies on the medical use of the cannabidiol (CBD) - a non-psychoactive component of the cannabis plant. Recent Findings By examining recent literature, we investigated the use of CBD and its potential role in pain management. Since there are currently no approved pharmaceutical products that contain CBD alone for the management of pain, this review focused on nabiximols (which is a combined product of THC/CBD in a 1:1 ratio) as the only pharmaceutical product available that contains CBD and is being used for the management of pain. It is difficult to definitely attribute the therapeutic properties to CBD alone since it is always administered with THC. Based on the available literature, it is difficult to make a recommendation for the use of CBD in chronic pain management. It is also important to note that there are many CBD products currently available as supplements, but these products are non-pharmaceuticals and lack the appropriate clinical studies to support their efficacy claims.
引用
收藏
页数:6
相关论文
共 26 条
[1]   Targeting CB2 receptors and the endocannabinoid system for the treatment of pain [J].
Anand, Praveen ;
Whiteside, Garth ;
Fowler, Christopher J. ;
Hohmann, Andrea G. .
BRAIN RESEARCH REVIEWS, 2009, 60 (01) :255-266
[2]  
[Anonymous], 2016, Cannabinoid Buccal Spray for Chronic Non-Cancer or Neuropathic Pain: A Review of Clinical Effectiveness, Safety, and Guidelines, Canadian Agency for Drugs and Technologies in Health Copyright (c) 2016
[3]   Oral cannabidiol does not produce a signal for abuse liability in frequent marijuana smokers [J].
Babalonis, Shanna ;
Haney, Margaret ;
Malcolm, Robert J. ;
Lofwall, Michelle R. ;
Votaw, Victoria R. ;
Sparenborg, Steven ;
Walsh, Sharon L. .
DRUG AND ALCOHOL DEPENDENCE, 2017, 172 :9-13
[4]   Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis [J].
Blake, DR ;
Robson, P ;
Ho, M ;
Jubb, RW ;
McCabe, CS .
RHEUMATOLOGY, 2006, 45 (01) :50-52
[5]  
Bridgeman Mary Barna, 2017, P T, V42, P180
[6]   The non-psychoactive cannabis constituent cannabidiol is an orally effective therapeutic agent in rat chronic inflammatory and neuropathic pain [J].
Costa, Barbara ;
Trovato, Anna Elisa ;
Comelli, Francesca ;
Giagnoni, Gabriella ;
Colleoni, Mariapia .
EUROPEAN JOURNAL OF PHARMACOLOGY, 2007, 556 (1-3) :75-83
[7]   Pharmacotherapeutic considerations for use of cannabinoids to relieve pain in patients with malignant diseases [J].
Darkovska-Serafimovska, Marija ;
Serafimovska, Tijana ;
Arsova-Sarafinovska, Zorica ;
Stefanoski, Sasho ;
Keskovski, Zlatko ;
Balkanov, Trajan .
JOURNAL OF PAIN RESEARCH, 2018, 11 :837-842
[8]   Efficacy and safety of nabiximols (Sativex®) on multiple sclerosis spasticity in a real-life Italian monocentric study [J].
Ferre, Laura ;
Nuara, Arturo ;
Pavan, Giulia ;
Radaelli, Marta ;
Moiola, Lucia ;
Rodegher, Mariaemma ;
Colombo, Bruno ;
Sarmiento, Ignacio Juan Keller ;
Martinelli, Vittorio ;
Leocani, Letizia ;
Boneschi, Filippo Martinelli ;
Comi, Giancarlo ;
Esposito, Federica .
NEUROLOGICAL SCIENCES, 2016, 37 (02) :235-242
[9]   Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis [J].
Hammell, D. C. ;
Zhang, L. P. ;
Ma, F. ;
Abshire, S. M. ;
McIlwrath, S. L. ;
Stinchcomb, A. L. ;
Westlund, K. N. .
EUROPEAN JOURNAL OF PAIN, 2016, 20 (06) :936-948
[10]   An Open-Label Extension Study to Investigate the Long-Term Safety and Tolerability of THC/CBD Oromucosal Spray and Oromucosal THC Spray in Patients With Terminal Cancer-Related Pain Refractory to Strong Opioid Analgesics [J].
Johnson, Jeremy R. ;
Lossignol, Dominique ;
Burnell-Nugent, Mary ;
Fallon, Marie T. .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2013, 46 (02) :207-218