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Medicines 2018, 5(3), 67; https://doi.org/10.3390/medicines5030067

Plant-Based Cannabinoids for the Treatment of Chronic Neuropathic Pain

Pain Management Research Institute, Kolling Institute of Medical Research, Northern Clinical School, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales 2065, Australia
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Received: 6 June 2018 / Revised: 27 June 2018 / Accepted: 27 June 2018 / Published: 1 July 2018
(This article belongs to the Special Issue Cannabinoids for Medical Use)
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Abstract

Chronic neuropathic pain is a prevalent condition that places a heavy burden on individuals and the healthcare system. Current medications have limitations and new approaches are needed, particularly given the current opioid crisis. There is some clinical evidence that the plant Cannabis sativa produces relief from neuropathic pain. However, current meta-analyses suggest that this efficacy is limited and there are problems with side effects. Most of this clinical research has examined whole cannabis, the psychoactive phytocannabinoid 9-tetrahydrocannabinol (THC), and nabiximols, which are a mixture of THC and the non-psychoactive phytocannabinoid cannabidiol. In the past, there has been little evidence based, preclinical animal research to guide clinical studies on phytocannabinoids. Recent animal studies indicate that while THC and high dose nabiximols are effective in animal neuropathic pain models, significant pain relief is only achieved at doses that produce substantial side effects. By contrast, cannabidiol and low dose nabiximols have moderate pain relieving efficacy, but are devoid of cannabinoid-like side effects. This animal data suggests that cannabidiol and low dose nabiximols warrant consideration for clinical studies, at least as adjuvants to current drugs. Preclinical research is also required to identify other phytocannabinoids that have therapeutic potential. View Full-Text
Keywords: cannabinoids; Cannabis sativa; phytocannabinoids; neuropathic pain; delta-9-tetrahydrocannabinol (THC); cannabidiol cannabinoids; Cannabis sativa; phytocannabinoids; neuropathic pain; delta-9-tetrahydrocannabinol (THC); cannabidiol
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Casey, S.L.; Vaughan, C.W. Plant-Based Cannabinoids for the Treatment of Chronic Neuropathic Pain. Medicines 2018, 5, 67.

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