humulene and Spasm

Cannabis use in the United States is growing at an unprecedented pace. Most states in the United States have legalized medical cannabis use, and many have legalized nonmedical cannabis use. In this setting, health care professionals will increasingly see more patients who have questions about cannabis use, its utility for medical conditions, and the risks of its use. This narrative review provides an overview of the background, pharmacology, therapeutic use, and potential complications of cannabis.

Topics: Adult; Cachexia; Cannabis; Endocannabinoids; Female; Health Personnel; Humans; Legislation, Drug; Male; Medical Marijuana; Nausea; Neurobiology; Opioid-Related Disorders; Seizures; Severity of Illness Index; Somatoform Disorders; Spasm; Stress Disorders, Post-Traumatic; United States

Cannabis, or marijuana, has been used for medicinal purposes for many years. Several types of cannabinoid medicines are available in the United States and Canada. Dronabinol (schedule III), nabilone (schedule II), and nabiximols (not U.S. Food and Drug Administration approved) are cannabis-derived pharmaceuticals. Medical cannabis or medical marijuana, a leafy plant cultivated for the production of its leaves and flowering tops, is a schedule I drug, but patients obtain it through cannabis dispensaries and statewide programs. The effect that cannabinoid compounds have on the cannabinoid receptors (CB(1) and CB(2) ) found in the brain can create varying pharmacologic responses based on formulation and patient characteristics. The cannabinoid Δ(9) -tetrahydrocannabinol has been determined to have the primary psychoactive effects; the effects of several other key cannabinoid compounds have yet to be fully elucidated. Dronabinol and nabilone are indicated for the treatment of nausea and vomiting associated with cancer chemotherapy and of anorexia associated with weight loss in patients with acquired immune deficiency syndrome. However, pain and muscle spasms are the most common reasons that medical cannabis is being recommended. Studies of medical cannabis show significant improvement in various types of pain and muscle spasticity. Reported adverse effects are typically not serious, with the most common being dizziness. Safety concerns regarding cannabis include the increased risk of developing schizophrenia with adolescent use, impairments in memory and cognition, accidental pediatric ingestions, and lack of safety packaging for medical cannabis formulations. This article will describe the pharmacology of cannabis, effects of various dosage formulations, therapeutics benefits and risks of cannabis for pain and muscle spasm, and safety concerns of medical cannabis use.

Topics: Animals; Cannabis; Clinical Trials as Topic; Dronabinol; Humans; Pain; Phytotherapy; Receptor, Cannabinoid, CB1; Spasm; Treatment Outcome

Research of the cannabinoid system has many similarities with that of the opioid system. In both instances, studies into drug-producing plants led to the discovery of an endogenous control system with a central role in neurobiology. Few compounds have had as much positive press from patients as those of the cannabinoid system. While these claims are investigated in disorders such as multiple sclerosis spasticity and pain, basic research is discovering interesting members of this family of compounds that have previously unknown qualities, the most notable of which is the capacity for neuroprotection. Large randomised clinical trials of the better known compounds are in progress. Even if the results of these studies are not as positive as many expect them to be, that we are only just beginning to appreciate the huge therapeutic potential of this family of compounds is clear.

Topics: Cannabinoids; Cannabis; Clinical Trials as Topic; Humans; Pain; Phytotherapy; Receptors, Cannabinoid; Receptors, Drug; Spasm; Urinary Bladder Diseases

There is a large amount of evidence to support the view that the psychoactive ingredient in cannabis, delta9-tetrahydrocannabinol (delta9-THC), and cannabinoids in general, can reduce muscle spasticity and pain under some circumstances. Cannabinoid (CB1) receptors in the CNS appear to mediate both of these effects and endogenous cannabinoids may fulfil these functions to some extent under normal circumstances. However, in the context of multiple sclerosis (MS), it is still questionable whether cannabinoids are superior to existing, conventional medicationsfor the treatment of spasticity and pain. In the case of spasticity, there are too few controlled clinical trials to draw any reliable conclusion at this stage. In the case of pain, most of the available trials suggest that cannabinoids are not superior to existing treatments; however, few trials have examined chronic pain syndromes that are relevant to MS. Whether or not cannabinoids do have therapeutic potential in the treatment of MS, a further issue will be whether synthetic cannabinoids should be used in preference to cannabis itself. Smoking cannabis is associated with significant risks of lung cancer and other respiratory dysfunction. Furthermore, delta9-THC, as a broad-spectrum cannabinoid receptor agonist, will activate both CB1 and CB2 receptors. Synthetic cannabinoids, which target specific cannabinoid receptor subtypes in specific parts of the CNS, are likely to be of more therapeutic use than delta9-THC itself. If rapid absorption is necessary, such synthetic drugs could be delivered via aerosol formulations.

Topics: Analgesics, Non-Narcotic; Animals; Cannabinoid Receptor Modulators; Cannabinoids; Cannabis; Disease Models, Animal; Dronabinol; Fatty Acids, Unsaturated; Humans; Multiple Sclerosis; Muscle Weakness; Pain; Receptors, Cannabinoid; Receptors, Drug; Spasm

To determine whether plant-derived cannabis medicinal extracts (CME) can alleviate neurogenic symptoms unresponsive to standard treatment, and to quantify adverse effects.. A consecutive series of double-blind, randomized, placebo-controlled single-patient cross-over trials with two-week treatment periods.. Patients attended as outpatients, but took the CME at home.. Twenty-four patients with multiple sclerosis (18), spinal cord injury (4), brachial plexus damage (1), and limb amputation due to neurofibromatosis (1).. Whole-plant extracts of delta-9-tetrahydrocannabinol (THC), cannabidiol (CBD), 1:1 CBD:THC, or matched placebo were self-administered by sublingual spray at doses determined by titration against symptom relief or unwanted effects within the range of 2.5-120 mg/24 hours. Measures used: Patients recorded symptom, well-being and intoxication scores on a daily basis using visual analogue scales. At the end of each two-week period an observer rated severity and frequency of symptoms on numerical rating scales, administered standard measures of disability (Barthel Index), mood and cognition, and recorded adverse events.. Pain relief associated with both THC and CBD was significantly superior to placebo. Impaired bladder control, muscle spasms and spasticity were improved by CME in some patients with these symptoms. Three patients had transient hypotension and intoxication with rapid initial dosing of THC-containing CME.. Cannabis medicinal extracts can improve neurogenic symptoms unresponsive to standard treatments. Unwanted effects are predictable and generally well tolerated. Larger scale studies are warranted to confirm these findings.

Topics: Administration, Oral; Analgesics, Non-Narcotic; Cannabidiol; Cannabis; Cross-Over Studies; Double-Blind Method; Dronabinol; Humans; Hypotension; Muscle Spasticity; Nervous System Diseases; Pain; Phytotherapy; Placebos; Plant Preparations; Severity of Illness Index; Spasm; Urination Disorders

Little is known about the risks and benefits of cannabis use in the context of cancer care. This study characterized the prevalence, reasons for use, and perceived benefits of cannabis and compared symptoms and perceived risks between those who reported past 30-day cannabis use and those who did not.. Adults undergoing cancer treatment at a National Cancer Institute-designated cancer center completed measures of sociodemographic characteristics, cannabis use, use modalities, reasons for use, perceived harms/benefits of use, physical and psychological symptoms, and other substance/medication use. Analyses compared patients who used or did not use cannabis in the past 30 days.. Participants (N = 267) were 58 years old on average, primarily female (70%), and predominantly White (88%). Over a quarter of respondents (26%) reported past 30-day cannabis use, and among those, 4.5% screened positive for cannabis use disorder. Participants who used cannabis most often used edibles (65%) or smoked cannabis (51%), and they were younger and more likely to be male, Black, and disabled, and to have lower income and Medicaid insurance than participants who did not use cannabis. Those who used cannabis reported more severe symptoms and perceived cannabis as less harmful than those who did not use cannabis. The most common medical reasons for cannabis use were pain, cancer, sleep problems, anxiety, nausea/vomiting, and poor appetite. Participants reported the greatest cannabis-related symptom relief from sleep problems, nausea/vomiting, headaches, pain, muscle spasms, and anxiety.. Patients with cancer who used cannabis perceived benefits for many symptoms, although they showed worse overall symptomatology.. Among adults undergoing cancer treatment, 26% reported cannabis use in the past 30 days. Those who used cannabis were more likely to be male and disabled and to have lower income and Medicaid insurance than those who did not use cannabis. Participants most commonly reported using cannabis for pain, cancer, sleep, anxiety, and nausea/vomiting and reported the greatest perceived benefits for sleep, nausea/vomiting, headaches, pain, muscle spasms, and anxiety, yet participants who used cannabis also reported feeling worse physically and psychologically compared to those who did not use cannabis. Participants who used cannabis were more likely to report that cannabis was less risky to their health than alcohol, smoking, and opioids than those who did not use cannabis.

Topics: Adult; Cancer Pain; Cannabis; Female; Headache; Humans; Male; Medical Marijuana; Middle Aged; Nausea; Neoplasms; Pain; Sleep Wake Disorders; Spasm; Vomiting

Painful tonic spasm (PTS) is a common yet debilitating symptom in patients with neuromyelitis optica spectrum disorder (NMOSD), especially those with longitudinally extensive transverse myelitis. Although carbamazepine is an effective treatment, it poses the risk of severe adverse reactions, such as Steven-Johnson syndrome (SJS). In this case report, we describe an NMOSD patient with severe PTS suffering from carbamazepine-induced SJS who responded well to cannabis extract. Since cannabinoids can ameliorate spasticity in an experimental autoimmune encephalomyelitis model through cannabinoid 1 (CB1) receptor activation, cannabis extract which includes delta-9-tetrahydrocannabinol (THC) is a potential treatment option for PTS in NMOSD patients.

Topics: Aquaporin 4; Cannabis; Humans; Myelitis, Transverse; Neuromyelitis Optica; Plant Extracts; Spasm

Topics: Cannabis; Humans; Marijuana Smoking; Nausea; Pain; Spasm

Topics: Cannabis; Drug and Narcotic Control; Government Agencies; Humans; Nausea; Needs Assessment; Patient Advocacy; Phytotherapy; Risk; Seizures; Spasm; State Government; Substance-Related Disorders; Treatment Outcome; United States

The plant Cannabis sativa has a long history of medical use in the treatment of pain and spasms, the promotion of sleep, and the suppression of nausea and vomiting. However, in the early 70s cannabis was classified in the Narcotic Acts in countries all over the world as having no therapeutic benefit; therefore, it cannot be prescribed by physicians or dispensed by pharmacists. In the light of this contradictory situation an increasing number of patients practices a self-prescription with cannabis products for relieving a variety of symptoms. An anonymous standardized survey of the medical use of cannabis and cannabis products of patients in Germany, Austria and Switzerland was conducted by the Association for Cannabis as Medicine (Cologne, Germany). During about one year 170 subjects participated in this survey; questionnaires of 128 patients could be included into the evaluation. 68% of these participants were males, 32% females, with a total mean age of 37.5 (+/- 9.6) years. The most frequently mentioned indications for medicinal cannabis use were depression (12.0%), multiple sclerosis (10.8%), HIV-infection (9.0%), migraine (6.6%), asthma (6.0%), back pain (5.4%), hepatitis C (4. 8%), sleeping disorders (4.8%), epilepsy (3.6%), spasticity (3.6%), headache (3.6%), alcoholism (3.0%), glaucoma (3.0%), nausea (3.0%), disk prolapse (2.4%), and spinal cord injury (2.4%). The majority of patients used natural cannabis products such as marihuana, hashish and an alcoholic tincture; in just 5 cases dronabinol (Marinol) was taken by prescription. About half of the 128 participants of the survey (52.4%) had used cannabis as a recreational drug before the onset of their illness. To date 14.3% took cannabis orally, 49.2% by inhalation and in 36.5% of cases both application modes were used. 72.2% of the patients stated the symptoms of their illness to have 'much improved' after cannabis ingestion, 23.4% stated to have 'slightly improved', 4.8% experienced 'no change' and 1.6% described that their symptoms got 'worse'. Being asked for the satisfaction with their therapeutic use of cannabis 60.8% stated to be 'very satisfied', 24.0% 'satisfied', 11.2% 'partly satisfied' and 4.0% were 'not satisfied'. 70.8% experienced no side effects, 26.4% described 'moderate' and 3.3% 'strong' side effects. 84.1% of patients have not felt any need for dose escalation during the last 3 months, 11.0% had to increase their cannabis dose 'moderately' and 4.8% 'strongly' in order to maint

Topics: Adolescent; Adult; Aged; Austria; Cannabinoids; Cannabis; Data Collection; Female; Germany; Humans; Male; Middle Aged; Pain Management; Phytotherapy; Spasm; Surveys and Questionnaires; Switzerland

Topics: Adult; Cannabis; Female; Humans; Male; Muscle Spasticity; Spasm

Topics: Cannabis; Florida; Humans; Male; Pain; Research Design; Self Concept; Self-Assessment; Spasm; Spinal Cord Injuries; Substance-Related Disorders

Topics: Accommodation, Ocular; Adolescent; Adult; Cannabis; Ciliary Body; Cornea; Eye; Eye Manifestations; Eyelid Diseases; Humans; Intraocular Pressure; Photosensitivity Disorders; Spasm; Substance-Related Disorders; Uveitis; Visual Acuity

Topics: Animals; Cannabis; Charcoal; Dronabinol; Drug Antagonism; Gastrointestinal Motility; Ileum; Intestine, Small; Jejunum; Kinetics; Lethal Dose 50; Male; Mice; Pain; Parasympathomimetics; Quaternary Ammonium Compounds; Rats; Reaction Time; Spasm; Stereoisomerism; Tail; Vas Deferens

Topics: Analgesics; Animals; Benzopyrans; Blood Pressure; Blood-Brain Barrier; Cannabis; Dogs; Drug Synergism; Epinephrine; Heterocyclic Compounds; Hot Temperature; Male; Mice; Norepinephrine; Quinones; Reaction Time; Respiration; Spasm; Time Factors

Topics: Animals; Anura; Barium; Blood Pressure; Cannabis; Carbachol; Dogs; Female; Guinea Pigs; Heart; Histamine; Humans; Ileum; Intestine, Small; Muscle, Smooth; Muscles; Oxytocin; Pharmacology; Rabbits; Rats; Research; Respiration; Spasm; Spectrophotometry; Uterus