Cannabis in palliative care: current challenges and practical recommendations

Pain and symptom control challenges are common in palliative care, and the search for other therapeutic strategies is ongoing. Unfortunately, patients and their caregivers are receiving little information or support from healthcare providers regarding the increasingly popular cannabinoid-based medicines (CBM). Clinicians, meanwhile, feel understandably perplexed by the discrepancy between the available evidence and the rapid interest in which patients and their families have demonstrated for CBM.

New UK Expo Puts CBD Centre Stage

“People are starting to realize the potential of CBD ,” says expo organizer, Tom Prendergrast. “A significant knock-on effect of that is a change in perception. CBD is a way for people to realize that you don’t need to have the psychoactive element to enjoy cannabis. CBD has so many benefits for people across the age range. It’s like the PG version of cannabis.”

The therapeutic potential of cannabis and cannabinoids

Cannabis-based medications exert their effects mainly through the activation of cannabinoid receptors (CB1 and CB2). More than 100 controlled clinical trials of cannabinoids or whole-plant preparations for various indications have been conducted since 1975. The findings of these trials have led to the approval of cannabis-based medicines (dronabinol, nabilone, and a cannabis extract [THC:CBD=1:1]) in several countries. In Germany, a cannabis extract was approved in 2011 for the treatment of moderate to severe refractory spasticity in multiple sclerosis.

Medical cannabis for the treatment of chronic pain and other disorders: misconceptions and facts

Recently, many countries have enacted new cannabis policies, including decriminalization of cannabis possession as well as legalization of medical and recreational cannabis. In this context, patients and their physicians have had an increasing number of conversations about the risks and benefits of cannabis. While cannabis and cannabinoids continue to be evaluated as pharmacotherapy for medical conditions, the best evidence currently exists for the following medical conditions: chronic pain, neuropathic pain, and spasticity resulting from multiple sclerosis.

Cannabinoids in late-onset Alzheimer’s disease

Given the lack of effective treatments for late-onset Alzheimer’s disease (LOAD) and the substantial burden on patients, families, health care systems, and economies, finding an effective therapy is one of the highest medical priorities. Several in vitro and in vivo studies have demonstrated that cannabinoids can reduce oxidative stress, neuro-inflammation, and the formation of amyloid plaques and neurofibrillary tangles, the key hallmarks of LOAD.

The Antitumor Activity of Plant-Derived Non-Psychoactive Cannabinoids

As a therapeutic agent, most people are familiar with the palliative effects of the primary psychoactive constituent of Cannabis sativa (CS), Δ(9)-tetrahydrocannabinol (THC), a molecule active at both the cannabinoid 1 (CB1) and cannabinoid 2 (CB2) receptor subtypes. Through the activation primarily of CB1 receptors in the central nervous system, THC can reduce nausea, emesis and pain in cancer patients undergoing chemotherapy. During the last decade, however, several studies have now shown that CB1 and CB2 receptor agonists can act as direct anti-tumor agents in a variety of aggressive cancers.