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Opioid Sparing

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Opioid Sparing Effect of Cannabis as Adjunct Medication

Pain is the number one reason people seek medical attention, and patients seeking pain relief are the most prevalent group employing cannabis medicines. Chronic pain seriously interferes with the quality of life for many patients. For some, strong prescription pain medications (opioids) have provided them relief. Unfortunately several problems can follow with the use of opioids on a long term basis. Patients may soon develop a tolerance to the analgesic effects, thus requiring ever increasing doses. Chronic use of opioids also causes unwanted side effects that include such problems as constipation, feeling drugged, nauseated, and depressed. Countless self-reports from chronic pain patients who use cannabis for pain management show a common theme. These patients report that they are able to either significantly decrease their dose of opioids or discontinue opioid use completely. They also report the benefit of no longer having to deal with opioid side effects such as constipation, nausea or depression. A typical observation by patients is that their use of cannabis doesn’t necessarily take away the pain, but that they are no longer preoccupied with the pain; they are able to ignore it. Research is beginning to show that there is a synergy between cannabinoids and opioids and thus, a patient could decrease the amount of opioids necessary to manage pain due to the opioid sparing effect of cannabis. Since opioids carry the risk of overdose along with other unwanted side effects, adding cannabis to their treatment regime allows patients to achieve more comfort with a lower amount or no opioid medication.

Faculty Presentations on the Opioid Sparing Effect

img 1 welch04Interaction between Opiates and Cannabinoids, by Sandra Welch, PhD – Sandra Welch, Professor of Pharmacology and Toxicology, Virginia Commonwealth University, examines the analgesic effects of combining Cannabinoids and Opiates. at 2004 Cannabis Therapeutics Conference, held in Charlottesville, VA in May of 2008. A synergistic effect was found that required must less opiate drugs to be used for acute and chronic pain.

The opioid sparing effect of phytocannabinoids (plant-derived) became evident during trials for Sativex – the sub-lingual spray produced by GW Pharmaceuticals. Dr. Geoffrey Guy, President of GW, details this synergy at the Charlottesville conference.

img 2guy04Oromuscosal Cannabis-based Medicine, Geoffrey Guy, MD  – “From Plant to Prescription Medicine” – Introduced by Don Wirtshafter, Geoffrey Guy, Founder and Executive Chairman, GW Pharmaceuticals, UK, explains why extracts of Phyto-Cannabinoids THC & CBD need to represent the natural balance of the Cannabis plant. Describing Cannabinoid action as a “Super-Modulator”, Dr. Guy discusses clinical trials involving Multiple Sclerosis (MS), spinal cord injury and neuropathic pain.

Research Articles on the Opioid Sparing Effect of Cannabis and Cannabinoids

Lynch, M. E., & Clark, A. J. (2003). Cannabis reduces opioid dose in the treatment of chronic non-cancer pain. J Pain Symptom Manage, 25(6), 496-498.

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