Medical cannabis: A forward vision for the clinician

Medical cannabis has entered mainstream medicine and is here to stay. Propelled by public advocacy, the media and mostly anecdote rather than sound scientific study, patients worldwide are exploring marijuana use for a vast array of medical conditions including management of chronic pain. Contrary to the usual path of drug approval, medical cannabis has bypassed traditional evidence-based study and has been legalized as a therapeutic product by legislative bodies in various countries. While there is a wealth of basic science and preclinical studies demonstrating effects of cannabinoids in neurobiological systems, especially those pertaining to pain and inflammation, clinical study remains limited.

Medical Cannabis for Neuropathic Pain

Many cultures throughout history have used cannabis to treat a variety of painful ailments. Neuropathic pain is a complicated condition that is challenging to treat with our current medications. Recent scientific discovery has elucidated the intricate role of the endocannabinoid system in the pathophysiology of neuropathic pain. As societal perceptions change, and legislation on medical cannabis relaxes, there is growing interest in the use of medical cannabis for neuropathic pain. The results suggest medical cannabis may be as tolerable and effective as current neuropathic agents; however, more studies are needed to determine the long-term effects of medical cannabis use. Furthermore, continued research to optimize dosing, cannabinoid ratios, and alternate routes of administration may help to refine the therapeutic role of medical cannabis for neuropathic pain.

Do medical marijuana laws reduce addictions and deaths related to pain killers?

Recent work finds that medical marijuana laws reduce the daily doses filled for opioid analgesics among Medicare Part-D and Medicaid enrollees, as well as population-wide opioid overdose deaths. We replicate the result for opioid overdose deaths and explore the potential mechanism. These findings suggest that broader access to medical marijuana facilitates substitution of marijuana for powerful and addictive opioids.

It’s high time archaic cannabis prohibition went up in smoke

The largest greenhouse in Britain is currently growing some 23 football pitches worth in Norfolk. British Sugar’s site uses the excess heat from the sugar plant to make the process highly economical, and now supplies GW Pharmaceuticals with cannabis for use in the drug Epidiolex. But our weirdly restrictive and complex pharmaceutical approval regime here means that they’re producing a drug that will actually be for sale in the US.