The Cannabinoids as Therapeutic Agents in the Management of Pain

Objective: This review focussed on the role of the endocannabinoid system in relation to pain transmission and modulation. Various facets of both naturally occurring and synthetic cannabinoids (CBs) were explored in an effort to ascertain their suitability in the treatment and management of pain. Methods: The endocannabinoid system and the physiology of CBs were reviewed in isolation and in relation to their hypothesized role in treating pain. Results: Cannabinoids have a more significant effect in instances of chronic pain than acute pain. Inhibitory mechanisms may be more effective than direct activation of the cannabinoid receptors. Many clinical trials of both genuine and synthetic cannabis-mediated analgesia have provided negative or equivocal results. Conclusion: Medications prepared with cannabinoid receptor agonists or with drugs that enhance endocannabinoid function (by either increasing release or diminishing reuptake of endocannabinoids) may afford the novel therapeutic approaches demanded by disorders in which pain is a prominent symptom.