scholarly journals The Intricate Influence of the Placebo Effect on Medical Cannabis and Cannabinoids

2018 ◽  
Vol 1 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Jürg Gertsch
Keyword(s):  
Placebo Effect ◽  
Manufacturing Industry ◽  
Cannabis Sativa ◽  
Endocannabinoid System ◽  
Therapeutic Effects ◽  
Medical Cannabis ◽  
Double Blind ◽  
Botanical Drug ◽  
Bona Fide ◽  
Preclinical Animal Models

The botanical drug cannabis flos (inflorescence of Cannabis sativa L.) has a unique popular status as being a potent recreational drug and bona fide universal remedy (panacea). Generally, cannabinoids exert therapeutic effects in a broad range of pathophysiologies related to inflammation, pain, metabolic and stress-related conditions in preclinical animal models. However, the translation of such data to humans still lacks an evidence-based foundation. Motivated by the booming cannabis manufacturing industry and the increasing worldwide self-therapy by patients, there are cumulative accounts about broad therapeutic effects of cannabis and legal cannabinoids like cannabidiol (CBD) beyond statistical evidence. The numerous affirming anecdotal reports by patients pose a challenge to physicians and legal authorities. Moreover, the lack of standardization of cannabis products and widely missing randomized double-blind placebo-controlled clinical trials largely hinder the scientific assessment of medical cannabis in humans. Given the recent insight that the endocannabinoid system is mediating, at least in part, a placebo effect, psychoactive cannabis and cannabinoids could exert complex neuropharmacological actions. As discussed in this commentary, the meaning response may play a role in the broad palliative and therapeutic effects of medical cannabis unprecedented by other phytopharmaceuticals.

scholarly journals Medical Cannabis for Autism Spectrum Disorder, is it an option?

2019 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Autism Spectrum Disorder ◽  
Literature Review ◽  
Endocannabinoid System ◽  
Autism Spectrum ◽  
The Body ◽  
Spectrum Disorder ◽  
Adjunctive Treatment ◽  
Medical Cannabis ◽  
Double Blind ◽  
Medical Test

Objective: A literature review was conducted to evaluate the validity of medical cannabis as an adjunctive treatment in the management of individuals with Autism Spectrum Disorders. Background: Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication and behavioral challenges. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Since there is no medical test to diagnose the disorders, the provider must listen to the parent/ caretaker and look at the child’s behavior and development to make a diagnosis. Unfortunately, many children do not receive a final diagnosis until much older. A deficiency in the endocannabinoid system in the body is considered as the reason for many disorders and recent researchers’ state that it might help in the treatment of autism. The chronic neuroinflammation can be eased with the help of the antioxidants which are present in the cannabis plant. The theory of Clinical Endocannabinoid Deficiency (CED) was based on the concept that many brain disorders are associated with neurotransmitter deficiencies, affecting acetylcholine in Alzheimer's disease, dopamine in Parkinsonian Syndromes, serotonin and norepinephrine in depression, and that a comparable deficiency in endocannabinoid levels might be manifest similarly in certain disorders that display predictable clinical features as sequelae of this deficiency. Design/Methods: A literature review was conducted of the National Center for Biotechnology Information, U.S. National Library of Medicine PubMed from 2012-2018 specific to the topic of medical cannabis and autism spectrum disorder. Conclusion: This literature review supports the feasibility of cannabis based medicine as a promising treatment option in children with ASD. Based on the promising results, it is recommended that large, double blind, placebo controlled cross-over trials be launched in jurisdictions where medical cannabis can be studied without limitations from the federal government.

scholarly journals Targeting Endocannabinoid Signaling: FAAH and MAG Lipase Inhibitors

2021 ◽  
Vol 61 (1) ◽  
pp. 441-463
Author(s):  
Noëlle van Egmond ◽  
Verena M. Straub ◽  
Mario van der Stelt
Keyword(s):  
Cannabis Sativa ◽  
Fatty Acid Amide Hydrolase ◽  
Acid Amide ◽  
Endocannabinoid System ◽  
Principal Component ◽  
Therapeutic Effects ◽  
Receptor Stimulation ◽  
Adverse Side Effects ◽  
Medicinal Properties ◽  
Amide Hydrolase

Inspired by the medicinal properties of the plant Cannabis sativa and its principal component (−)- trans-Δ9-tetrahydrocannabinol (THC), researchers have developed a variety of compounds to modulate the endocannabinoid system in the human brain. Inhibitors of fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL), which are the enzymes responsible for the inactivation of the endogenous cannabinoids anandamide and 2-arachidonoylglycerol, respectively, may exert therapeutic effects without inducing the adverse side effects associated with direct cannabinoid CB1 receptor stimulation by THC. Here we review the FAAH and MAGL inhibitors that have reached clinical trials, discuss potential caveats, and provide an outlook on where the field is headed.

scholarly journals Medical cannabis for orthopaedic patients with chronic musculoskeletal pain: does evidence support its use?

2020 ◽  
Vol 12 ◽  
pp. 1759720X2093796
Author(s):  
Herman Johal ◽  
Christopher Vannabouathong ◽  
Yaping Chang ◽  
Meng Zhu ◽  
Mohit Bhandari
Keyword(s):  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Endocannabinoid System ◽  
Current Evidence ◽  
Therapeutic Effects ◽  
Current Guideline ◽  
Medical Cannabis ◽  
Orthopaedic Patients ◽  
Effectiveness Factors ◽  
Chronic Pain Conditions

The treatment of chronic, non-cancer musculoskeletal pain has become a topic growing interest as it is believed to be one of the reasons for the current opioid epidemic. The medicinal use of cannabis has a long history as a number of active compounds in cannabis have been shown to interact with the body’s endocannabinoid system to reduce pain. This position paper provides a history on the evolution of cannabis, the science behind its therapeutic effects, and review of the evidence and current guideline recommendations on its use as a treatment for patients with chronic, non-cancer musculoskeletal pain. Results from systematic reviews have demonstrated a statistically significant reduction in chronic pain conditions with cannabinoids, compared with placebo, although the effects might be considered small and did not reach the minimally important difference. More adverse events were reported in the cannabinoid group than in the placebo group with longer than 2 weeks of treatment. There is a lack of evidence on dependence. With changes to policies, patients’ perception has changed to be more positive toward the use of medical cannabis. Current recommendations from North America, Latin America, Europe, Australia and Iran support the use of medical cannabis for chronic, non-cancer pain. Based on the current evidence, it is our position that cannabinoids may be considered as an adjunctive therapy after recommended first- and second-line therapies have failed to provide sufficient efficacy or tolerability. Patients should consider the balance between the desirable and undesirable effects of taking cannabis for chronic pain, and comprehensively consider their own values and preferences, as well as cost-effectiveness factors, based on the information provided by their physician.

scholarly journals The Endocannabinoid System: A Potential Target for the Treatment of Various Diseases

2021 ◽  
Vol 22 (17) ◽  
pp. 9472
Author(s):  
Henry Lowe ◽  
Ngeh Toyang ◽  
Blair Steele ◽  
Joseph Bryant ◽  
Wilfred Ngwa
Keyword(s):  
Cannabis Sativa ◽  
Endocannabinoid System ◽  
The Body ◽  
Medical Cannabis ◽  
Medicine Research ◽  
Therapeutic Drugs ◽  
Physiological Processes ◽  
System A ◽  
Environment Temperature ◽  
Emotional Behaviour

The Endocannabinoid System (ECS) is primarily responsible for maintaining homeostasis, a balance in internal environment (temperature, mood, and immune system) and energy input and output in living, biological systems. In addition to regulating physiological processes, the ECS directly influences anxiety, feeding behaviour/appetite, emotional behaviour, depression, nervous functions, neurogenesis, neuroprotection, reward, cognition, learning, memory, pain sensation, fertility, pregnancy, and pre-and post-natal development. The ECS is also involved in several pathophysiological diseases such as cancer, cardiovascular diseases, and neurodegenerative diseases. In recent years, genetic and pharmacological manipulation of the ECS has gained significant interest in medicine, research, and drug discovery and development. The distribution of the components of the ECS system throughout the body, and the physiological/pathophysiological role of the ECS-signalling pathways in many diseases, all offer promising opportunities for the development of novel cannabinergic, cannabimimetic, and cannabinoid-based therapeutic drugs that genetically or pharmacologically modulate the ECS via inhibition of metabolic pathways and/or agonism or antagonism of the receptors of the ECS. This modulation results in the differential expression/activity of the components of the ECS that may be beneficial in the treatment of a number of diseases. This manuscript in-depth review will investigate the potential of the ECS in the treatment of various diseases, and to put forth the suggestion that many of these secondary metabolites of Cannabis sativa L. (hereafter referred to as “C. sativa L.” or “medical cannabis”), may also have potential as lead compounds in the development of cannabinoid-based pharmaceuticals for a variety of diseases.

scholarly journals Cannabis: A Toxin-Producing Plant with Potential Therapeutic Uses

Toxins ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 117
Author(s):  
Zeinab Breijyeh ◽  
Buthaina Jubeh ◽  
Sabino A. Bufo ◽  
Rafik Karaman ◽  
Laura Scrano
Keyword(s):  
Multiple Sclerosis ◽  
Adverse Effects ◽  
Cannabinoid Receptors ◽  
Cannabis Sativa ◽  
Therapeutic Effects ◽  
Medical Cannabis ◽  
Conjunctival Hyperemia ◽  
Main Compound ◽  
Therapeutic Uses ◽  
Recreational Use

For thousands of years, Cannabis sativa has been utilized as a medicine and for recreational and spiritual purposes. Phytocannabinoids are a family of compounds that are found in the cannabis plant, which is known for its psychotogenic and euphoric effects; the main psychotropic constituent of cannabis is Δ9-tetrahydrocannabinol (Δ9-THC). The pharmacological effects of cannabinoids are a result of interactions between those compounds and cannabinoid receptors, CB1 and CB2, located in many parts of the human body. Cannabis is used as a therapeutic agent for treating pain and emesis. Some cannabinoids are clinically applied for treating chronic pain, particularly cancer and multiple sclerosis-associated pain, for appetite stimulation and anti-emesis in HIV/AIDS and cancer patients, and for spasticity treatment in multiple sclerosis and epilepsy patients. Medical cannabis varies from recreational cannabis in the chemical content of THC and cannabidiol (CBD), modes of administration, and safety. Despite the therapeutic effects of cannabis, exposure to high concentrations of THC, the main compound that is responsible for most of the intoxicating effects experienced by users, could lead to psychological events and adverse effects that affect almost all body systems, such as neurological (dizziness, drowsiness, seizures, coma, and others), ophthalmological (mydriasis and conjunctival hyperemia), cardiovascular (tachycardia and arterial hypertension), and gastrointestinal (nausea, vomiting, and thirst), mainly associated with recreational use. Cannabis toxicity in children is more concerning and can cause serious adverse effects such as acute neurological symptoms (stupor), lethargy, seizures, and even coma. More countries are legalizing the commercial production and sale of cannabis for medicinal use, and some for recreational use as well. Liberalization of cannabis laws has led to increased incidence of toxicity, hyperemesis syndrome, lung disease cardiovascular disease, reduced fertility, tolerance, and dependence with chronic prolonged use. This review focuses on the potential therapeutic effects of cannabis and cannabinoids, as well as the acute and chronic toxic effects of cannabis use on various body systems.

Comparing Intradermal Sterile Water with Intravenous Morphine in Reducing Pain in Patients with Renal Colic: A Double-Blind Randomized Clinical Trial

2020 ◽  
Vol 15 (1) ◽  
pp. 76-82
Author(s):  
Javad Mozafari ◽  
Mohammadreza Maleki Verki ◽  
Fatemeh Tirandaz ◽  
Reza Mahjouri
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Renal Colic ◽  
Therapeutic Effects ◽  
Sterile Water ◽  
Morphine Group ◽  
Double Blind ◽  
Water Group ◽  
Intravenous Morphine ◽  
Painful Area

Objective: The present study was conducted to investigate the effect of intradermal administration of sterile water compared to intravenous morphine on patients with renal colic. Methods: This double-blind, randomized clinical trial study was conducted in 2017 to compare the therapeutic effects of intradermal sterile water with those of intravenous morphine on patients with renal colic presenting to the emergency departments (ED) of Imam Khomeini and Golestan Hospitals in Ahvaz, Iran. The first group received 0.5 ml of intradermal sterile water, and the second group 0.1mg/kg of intravenous morphine plus 0.5 ml of intradermal sterile water in the most painful area or the center of the painful area in the flank. The pain severity was measured using a visual analogue scale (VAS), and the medication side-effects were recorded at the beginning of the study and minutes 15, 30,45 and 60. Result: A total of 94 patients were studied in two groups. The mean severity of pain was 2.97 ± 1.51 in the sterile water group and 2.34 ± 1.89 in the morphine group at minute 30 (P=0.042), 2.58 ± 1.43 in the sterile water group and 1 ± 1.23 in the morphine group at minute 45 (p<0.001), and 1.89 ± 1.7 in the sterile water group and 0.52 ± 0.79 in the morphine group at minute 60 (p<0.001). Conclusion: Morphine reduces pain faster and more effectively than intradermal sterile water; nevertheless, treatment with intradermal sterile water can be used as an appropriate surrogate or adjunct therapy for pain control, particularly in special patients or in case of medication scarcity.

Placebos and Movies: What Do They Have in Common?

2021 ◽  
pp. 096372142110038
Author(s):  
Fabrizio Benedetti
Keyword(s):  
Everyday Life ◽  
Common Sense ◽  
Placebo Effect ◽  
Psychological Factors ◽  
General Framework ◽  
Physiological Responses ◽  
Therapeutic Effects ◽  
Physiological Effects ◽  
Placebo Effects ◽  
What Matters

Placebos are fake therapies that can induce real therapeutic effects, called placebo effects. It goes without saying that what matters for inducing a placebo effect is not so much the fake treatment itself, but rather the therapeutic ritual that is carried out, which is capable of triggering psychobiological mechanisms in the patient’s brain. Both laypersons and scientists often accept the phenomenon of the placebo effect with reluctance, as fiction-induced clinical improvements are at odds with common sense. However, it should be emphasized that placebo effects are not surprising after all if one considers that fiction-induced physiological effects occur in everyday life. Movies provide one of the best examples of how fictitious reality can induce psychological and physiological responses, such as fear, love, and tears. In the same way that a horror movie induces fear-related physiological responses, even though the viewer knows everything is fake, so the sight of a syringe may trigger the release of pain-relieving chemicals in the patient’s brain, even if the patient knows there is a fake painkiller inside. From this perspective, placebos can be better conceptualized as rituals, actions, and fictions within a more general framework that emphasizes the power of psychological factors in everyday life, including the healing context.

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