Medical marijuana is becoming one of the most popular alternative treatments for chronic The history of cannabis: Weed and pain control. Medicinal cannabis, or medicinal marijuana, is a therapy that has garnered much .. institutions control and dispense cannabis much like opioids for pain. As more patients turn to cannabis for pain relief, there is a need for additional It was not until the early 19th century that cannabis started to be.
pain of The history cannabis: control and Weed
However, the trials produced low to moderate quality evidence and reflected chemotherapy agents and antiemetics that were available in the s and s. With regard to the management of neurological disorders, including epilepsy and MS, a Cochrane review of four clinical trials that included 48 epileptic patients using CBD as an adjunct treatment to other antiepileptic medications concluded that there were no serious adverse effects associated with CBD use but that no reliable conclusions on the efficacy and safety of the therapy can be drawn from this limited evidence.
In older patients, medical cannabinoids have shown no efficacy on dyskinesia, breathlessness, and chemotherapy-induced nausea and vomiting. Some evidence has shown that THC might be useful in treatment of anorexia and behavioral symptoms in patients with dementia.
The most common adverse events reported during cannabinoid treatment in older adults were sedation-like symptoms. Despite limited clinical evidence, a number of medical conditions and associated symptoms have been approved by state legislatures as qualifying conditions for medicinal cannabis use.
Table 1 contains a summary of medicinal cannabis indications by state, including select disease states and qualifying debilitating medical conditions or symptoms. A total of 28 states, the District of Columbia, Guam, and Puerto Rico now allow comprehensive public medical marijuana and cannabis programs.
Medicinal Cannabis Indications for Use by State 10 , 60 , Table adapted with permission from the Marijuana Policy Project; 60 table is not all-encompassing and other medical conditions for use may exist. The reader should refer to individual state laws regarding medicinal cannabis for specific details of approved conditions for use.
In addition, states may permit the addition of approved indications; list is subject to change. Some of the most common policy questions regarding medical cannabis now include how to regulate its recommendation and indications for use; dispensing, including quality and standardization of cultivars or strains, labeling, packaging, and role of the pharmacist or health care professional in education or administration; and registration of approved patients and providers.
The regulation of cannabis therapy is complex and unique; possession, cultivation, and distribution of this substance, regardless of purpose, remain illegal at the federal level, while states that permit medicinal cannabis use have established individual laws and restrictions on the sale of cannabis for medical purposes. In a U. Department of Justice memorandum to all U.
Cole noted that despite the enactment of state laws authorizing marijuana production and sale having a regulatory structure that is counter to the usual joint efforts of federal authorities working together with local jurisdictions, prosecution of individuals cultivating and distributing marijuana to seriously ill individuals for medicinal purpose has not been identified as a federal priority.
There are, however, other regulatory implications to consider based on the federal restriction of cannabis. Medical cannabis expenses are not reimbursable through government medical assistance programs or private health insurers. As previously described, the Schedule I listing of cannabis according to federal law and DEA regulations has led to difficulties in access for research purposes; nonpractitioner researchers can register with the DEA more easily to study substances in Schedules II—V compared with Schedule I substances.
For example, the Center for Medicinal Cannabis Research at the University of California—San Diego had access to funding, marijuana at different THC levels, and approval for a number of clinical research trials, and yet failed to recruit an adequate number of patients to conduct five major trials, which were subsequently canceled.
The limited availability of clinical research to support or refute therapeutic claims and indications for use of cannabis for medicinal purposes has frequently left both state legislative authorities and clinicians to rely on anecdotal evidence, which has not been subjected to the same rigors of peer review and scrutiny as well-conducted, randomized trials, to validate the safety and efficacy of medicinal cannabis therapy. Furthermore, although individual single-entity pharmaceutical medications, such as dronabinol, have been isolated, evaluated, and approved for use by the FDA, a plant cannot be patented and mass produced by a corporate entity.
The Schedule I designation of cannabis causes hospitals and other care settings that receive federal funding, either through Medicare reimbursement or other federal grants or programs, to pause to consider the potential for loss of these funds should the federal government intercede and take action if patients are permitted to use this therapy on campus. Similarly, licensed practitioners registered to certify patients for state medicinal cannabis programs may have comparable concerns regarding jeopardizing their federal DEA registrations and ability to prescribe other controlled substances as well as jeopardizing Medicare reimbursements.
Attorney General Eric Holder recommended that enforcement of federal marijuana laws not be a priority in states that have enacted medicinal cannabis programs and are enforcing the rules and regulations of such a program; despite this, concerns persist. The argument for or against the use of medicinal cannabis in the acute care setting encompasses both legal and ethical considerations, with the argument against use perhaps seeming obvious on its surface.
States adopting medical cannabis laws may advise patients to utilize the therapy only in their own residence and not to transport the substances unless absolutely necessary. Canada has adopted national regulations to control and standardize dried cannabis for medical use.
The argument can be made that an herb- or plant-based entity cannot be identified by pharmacy personnel as is commonly done for traditional medicines, although medicinal cannabis dispensed through state programs must be labeled in accordance with state laws. Dispensing and storage concerns, including an evaluation of where and how this product should be stored e.
Inpatient use of medicinal cannabis also carries implications for nursing and medical staff members. The therapy cannot be prescribed, and states may require physicians authorizing patient use to be registered with local programs. Despite the complexities in the logistics of continuing medicinal cannabis in the acute care setting, proponents of palliative care and continuity of care argue that prohibiting medicinal cannabis use disrupts treatment of chronic and debilitating medical conditions.
Patients have been denied this therapy during acute care hospitalizations for reasons stated above. Legislation in Minnesota, as one example, has been amended to permit hospitals as facilities that can dispense and control cannabis use; similar legislative actions protecting nurses from criminal, civil, or disciplinary action when administering medical cannabis to qualified patients have been enacted in Connecticut and Maine.
Despite lingering controversy, use of botanical cannabis for medicinal purposes represents the revival of a plant with historical significance reemerging in present day health care. Legislation governing use of medicinal cannabis continues to evolve rapidly, necessitating that pharmacists and other clinicians keep abreast of new or changing state regulations and institutional implications.
Ultimately, as the medicinal cannabis landscape continues to evolve, hospitals, acute care facilities, clinics, hospices, and long-term care centers need to consider the implications, address logistical concerns, and explore the feasibility of permitting patient access to this treatment. Whether national policy—particularly with a new presidential administration—will offer some clarity or further complicate regulation of this treatment remains to be seen.
The authors report no commercial or financial interests in regard to this article. National Center for Biotechnology Information , U. Journal List P T v. Author information Copyright and License information Disclaimer.
This article has been cited by other articles in PMC. Open in a separate window. Access to marijuana through home cultivation, dispensaries, or some other system that is likely to be implemented;. Allows either smoking or vaporization of some kind of marijuana products, plant material, or extract.
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Only July 1, , recreational marijuana also called cannabis will be legalized and regulated in Canada. The federal Cannabis Act creates a legal framework for producing, possessing and selling marijuana across Canada, meaning that each Canadian province will set its own rules to oversee its distribution, subject to federal government conditions.
Provincial and federal governments will share in the responsibility for the oversight of this new system, and will also share in the tax revenue. Different provinces are taking different approaches, similar to how alcohol purchases vary between jurisdictions. The Canadian government authorized the sale of marijuana for that purpose, while it simultaneously emphasizes that cannabis is not an approved therapeutic product.
The medical market, for many, appears to simply be a means to access products for recreational, or non-medical use , and has generated wildly unsubstantiated claims about the medical merits of marijuana for conditions like autism and the treatment of cancer.
Dispensaries have appeared across Canada and the US, usually with very easy referrals for prescriptions. Some dispensaries ignore any prescription requirement entirely and will sell marijuana directly to the public without any medical assessment or advice.
Should use for medical purposes be treated like recreational use, where consumers make their own selections, and purchases are taxed like other consumer products? Or should some forms or uses of marijuana be treated like prescription drugs, where a health professional remains involved, and products may be even be covered by insurance plans? With marijuana becoming much more accessible, physicians, other health professionals, and their patients need high-quality information about its value for different medical conditions.
Now, three new documents prepared for Canadian physicians and health professionals concisely summarize the current evidence base for medical marijuana. The argument being made by the pharmacy profession seems to be that 1 marijuana is a legitimate drug for medical purposes, and should be treated as such, which includes 2 a pharmacy and pharmacist being involved in the provision. The latter we can set aside for now, and focus first on whether or not marijuana is indeed a drug that should be treated like other prescription drugs.
Before I continue, I should state my personal position on marijuana. I am fully supportive of the legalization of marijuana for recreational use and support regulation and taxation, treating it along the lines of alcohol or tobacco. This prescription via the Smithsonian Institute could be used by physicians to prescribe alcohol for an array of ailments:. Naturally, the prescription market for alcohol disappeared once Prohibition ended.
But marijuana is not alcohol. It contains an array of potentially medically useful chemical substances, several of which have been clinically investigated for the treatment of different medical conditions.
As David Gorski has pointed out in previous posts , there are a number of biologically active chemicals in marijuana. Cannabinoids are produced in the stalk, leaves, flowers, seeds and resin of marijuana plants. Marijuana can be smoked, vaporized, or eaten, among other forms of ingestion. THC is rapidly absorbed, and when inhaled, reaches the brain within minutes. To obtain a price quote, email moc. Please include the article's title or DOI, quantity, and delivery destination in your email.
This article has been cited by other articles in PMC. Promising Compounds, Changing Landscape Cannabis has been used around the world for centuries and the purpose for its use has varied throughout that time.
The subjective experience of pain Pain has long been characterized as a subjective experience encompassing sensory-physiological, motivational-affective, and cognitive-evaluative components. Substances Used for Pain Cannabis is rarely the first drug that a patient takes to mitigate pain.
Open in a separate window. The endocannabinoid system and mechanisms of pain reduction Neural and nonneural cells in injured tissues produce arachidonic acid derivatives called endocannabinoids. Cannabis and pain studies Results from studies evaluating cannabis pharmacotherapy for pain demonstrate the complex effects of cannabis-related analgesia. Clinical issues According to the DSM 5 heuristic, 76 a diagnosis of cannabis use disorder CUD requires a pattern of cannabis use leading to clinically significant impairment or distress characterized by the presence of two or more of 11 prototypical symptoms within a month period.
Cannabis and Opioid Interactions As more states introduce medical and recreational cannabis policies, we continue to learn more about the relationship between cannabis and opioids. Conclusions This is a pivotal time in the history of cannabis and cannabinoid research.
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Cannabinoids versus Opioids for Chronic Pain Care
Pot. Weed. Dope, grass, reefer. Blunts, dabs and shatter. The list of names for the drug others are finding it brings them relief from chronic pain and other conditions. Cannabis has been around for millions of years, and historical writings. Historical & Regulatory Background. The use of medical marijuana dates back more than 5, years, specifically to relieve headache pain. Despite its. If you're considering trying medical cannabis for pain relief, here's how to speak with your doctor about getting a recommendation for the substance how to speak with your doctor about medical marijuana Getting Started.