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 22 February 2018

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News

Cannabis for control of pain and chemotherapy-related sickness

Cannabinoids are no more effective than conventional analgesics in controlling pain, but they are more effective in preventing nausea and vomiting in patients undergoing chemotherapy, according to two separate studies in this week's BMJ.

News image

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In the first study, Fiona Campbell and colleagues, from the UK, established whether cannabinoids are an effective and safe option in the treatment of acute or chronic pain. They reviewed 9 trials, involving over 200 patients.

In all trials, cannabinoids were given either as tablets or by intramuscular injection. The authors found no studies on smoked cannabis.

In 8 of the 9 trials, cannabinoids were found to be no more effective than codeine tablets in controlling acute and chronic pain.

Cannabinoids are the active substances in cannabis.
British Medical Journal
Furthermore, side-effects associated with the cannabinoids were common, and sometimes severe.

In acute postoperative pain, cannabinoids are unlikely to be useful. However, they may be effective in chronic non-cancer pain, say the authors.

Cannabis is clearly unlikely to usurp existing effective treatments for postoperative pain, they conclude.

In the second study, a team from Switzerland investigated the effectiveness and safety of cannabis in preventing sickness induced by chemotherapy.

They analyzed 30 trials, involving over 1,300 patients. Three different cannabinoids were given, either as tablets or by intramuscular injection.

Across all trials, cannabinoids were found to be more effective than conventional anti-sickness drugs. However, no difference was found for patients receiving very low or very high levels of chemotherapy.

Most patients also preferred cannabinoids for future chemotherapy cycles.

Patients reported more side-effects with cannabinoids than with conventional drugs. Although some were potentially beneficial (euphoria, "high", sedation. or drowsiness), others were harmful (dizziness, depression, hallucinations).

These results offer arguments both for and against the use of cannabinoids in chemotherapy patients, say the authors.

They suggest that, in selected patients, cannabinoids may be useful as mood-enhancing aids for controlling chemotherapy-related sickness.

BMJ 2001; 323: 13-16, 16-21
06 July 2001

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