ABSTRACT
BACKGROUND AND OBJECTIVES:
Several studies have shown the growing interest and consumption of cannabinoids and medical cannabis (MC), with management of chronic pain being one of its main therapeutic recommendations. The objective of this study was to review and analyze the results of the most recent preclinical and clinical research on the application of MC and cannabinoids to understand their analgesic efficacy.
CONTENTS:
A literature review was performed in Pubmed. Preclinical research has shown the role of the endocannabinoid system in pain pathways through the identification of its action sites and pain modulation mechanisms. Numerous clinical studies have endeavored to demonstrate the efficacy of CM and cannabinoids in the management of various pain syndromes. Some international guidelines have already incorporated the use of MC and cannabinoids, but as third or fourth-line treatment and, in most cases, with weak recommendation.
CONCLUSION:
Despite the growing production of scientific knowledge, the data currently available still lack high-quality evidence to define the efficacy and analgesic potency of cannabinoids. Larger preclinical and clinical research are needed to understand the status of cannabinoids in pain management, as well as to generate high-quality evidence to include or not the use of MC and cannabinoids in guidelines for the management of the various pain syndromes.
Keywords:
Cannabis; Cannabinoids; Medical marijuana; Pain; Pain management
HIGHLIGHTS
The participation of the endocannabinoid system in nociceptive pathways has been postulated since the 19th century and is supported by robust evidence in medical literature.
International guidelines have already incorporated the use of medical cannabis and cannabinoid drugs for the management of chronic pain, but as third or fourth-line treatments and, in most cases, with weak recommendations.
Current evidence does not point to the use of cannabinoids in the management of acute and postoperative pain.