Cannabis in Cancer – A Permanent Place in Pain Therapy?

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Since March 2017 cannabinoids – in short: marijuana – have been prescribed by law in some nations. Currently, the sum of prescribed prescriptions doubled. About 75 percent of medical cannabis applications are approved. How should the clinical trial data be interpreted, what is the actual practice lifelike, and who may now access these drugs?

Who is Cannabis For?

Cannabis is primarily used in pain patients. Further positive effects were shown in the cure of vomiting and nausea during chemotherapy and the control of loss of appetite. Cancer patients in chemotherapy and HIV/AIDS patients currently constitute the largest area of application. In particular, its benefit on neuropathic pain has ensured rise to the legalization of cannabis as a medicinal substance.

In What Form is Cannabis Administered?

Currently, the two finished drugs dronabinol and nabiximoles are approved as the most effective active ingredients. The peculiarity since March 2017 is that they are prescribed beyond their approvals, in the so-called ‘off-label use.’

However, the utilization of flowers, which are now also available, is denied. Their disadvantage is that the active ingredient concentration is difficult and variable to estimate even in similar preparation procedures.

Cannabis extracts are usually prescribed in the form of oily drops, capsules or alcoholic inhalation solutions while flowers can be inhaled, which has the advantage that no poisonous plant materials are inhaled.

How Does Cannabis Work?

For the medically desired effects of cannabis, the two active ingredients THC and CBD are responsible. They have analgesic, psychoactive, antiemetic, appetite stimulating, muscle relaxant, antipsychotic, anti-lytic, anticonvulsant and neuroprotective. The substances are in the structure of organic acids in the plant, which must first be converted into active forms for medical use by heat decarboxylation. This happens, for example, when smoking, evaporating or heating in oil. The effect of cannabinoids unfolds by binding to the so-called cannabinoid receptors. CBD has a much broader spectrum of activity than THC, which can also be accompanied by critical side effects related to the psyche.

For the application in pain, therapy is just the complementary effect of the two drugs THC and CBD responsible. According to Zenabis Medical Marijuana, they strengthen each other in their analgesic effect and also complement each other in their muscle relaxant, appetite-stimulating, and anxiolytic effect. Another advantage of the combination is that the antipsychotic properties of CBD attenuate the psychotic effects of THC.

Depending on the form of administration, side effects may occur. Especially the central nervous system and the psyche are affected. The DGS, therefore, recommends the administration of Nabiximols. If the desired result does not appear, then it should be tried with dronabinol and only in the last step with cannabis flowers.

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