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Cannabis has been used in medicine for thousands of years for various medical conditions. Over the last decade it is increasingly
getting used in the treatment of chronic pain. Cannabis has been shown to have some positive efficacy in the reduction of pain as
an adjunct in therapy combined with opioids. Clinical studies published are mostly small in number and solely for neuropathic pain.
Most studies that showed a clinical benefit were short in duration. Longer-term studies for more than 4 weeks have reported psychosis
in the patients with percentages ranging from 36.3% to even 80%. Most patients report a long list of side effects associated with the use
of cannabis. Symptoms reported are memory problems, problems with motor coordination and impaired judgment and more serious
medical problems like cancer or cardiac ischemia. Cannabis consists of more than 60 pharmacologically active cannabinoids. The
primary cannabinoids in marijuana are delta9-tetrahydrocannabinol (THC) and cannabidiol. Not all cannabinoids are yet identified
or understood. The dosing of cannabis and its metabolism are problematic in the treatment as well. Cannabis is liposoluble and
tends to accumulate in adipose tissue together with its derivates. Therefore the substance gets released into the body long after last
ingestion, resulting in even more potent effects and adverse effects in the users. Cannabis is a Schedule I substance and the attempt to
discontinue does create a set of symptoms called â??marijuana abstinence syndromeâ?. Symptoms of marijuana withdrawal are consistent
of: anxiety, depression, decreased appetite, headaches, insomnia, irritability, muscle tension, nausea, nightmares and unpleasant vivid
dreams. Lastly, patients develop tolerance to cannabis as well, similar to alcohol, meaning over time are larger doses required to
achieve the same clinical response.
Biography
Thersilla Oberbarnscheidt is a resident Psychiatrist from Central Michigan University. She received her medical degree from the University of Kiel Germany and Yale University School of Medicine. Her PhD thesis in Neuroscience was on “Phenazone in the treatment of the acute migraine attack”. She is involved in research regarding pain management and addiction.