Pain Therapy

Cannabinoids in anaesthesia and pain therapy

Azad S.C., Rammes G.

Department of Anaesthesiology, Pain Management Unit, Klinikum Grosshadern, Ludwig-Maximilians-Universitat Munchen, Munich, Germany Department of Anaesthesiology, Klinikum rechts der Isar, Technische Universitat Munchen, Munich, Germany Clinical Neuropharmacology Group, Max-Planck-Institut fur Psychiatrie, Munich, Germany.

Cannabinoids have been known for their analgesic, anxiolytic, antiemetic and antispastic properties for many centuries. Since an endogenous cannabinoid system has been identified in the past two decades, cannabinoids have also become the focus of interest in western medicine. This review summarizes preclinical and clinical studies on the role of the endocannabinoid system and exogenous cannabinoids in anaesthesia and pain management.
RECENT FINDINGS: It has recently been shown that the endocannabinoid system is involved in the effects of the widely used anaesthetic drug propofol. In terms of nociception, preclinical data suggest that the endocannabinoid system plays an important role in the control of synaptic transmission and synaptic plasticity in pain pathways. In patients, the treatment of acute pain often requires relatively high doses of cannabinoids, which are associated with considerable side-effects such as dizziness and sedation. In contrast, preclinical and clinical data suggest that lower doses of cannabinoids may be effective for the treatment of allodynia and hyperalgesia in neuropathic pain. In multiple sclerosis, cannabinoids have been shown to have beneficial effects on spasticity, pain, tremor and bladder dysfunction.
SUMMARY: In general, the results of the very few well-conducted clinical trials often diverge from the highly interesting and promising findings of preclinical studies. Taken together, the most recent preclinical and clinical data suggest that cannabinoids should be applied as low-dose co-analgesics to inhibit neuroplasticity and central sensitization rather than as analgesics in acute pain.

Opinions in Anaesthesia, August 2005

Cannabinioids in medicine

Cannabinoids in medicine: A review of their therapeutic potential

Ben Amar M.

Substance Abuse Program, Faculties of Continuing Education and Graduate Studies, University of Montreal, C.P. 6128, succursale Centre-ville, Montreal, Que. H3C 3J7, Canada.

In order to assess the current knowledge on the therapeutic potential of cannabinoids, a meta-analysis was performed through Medline and PubMed up to July 1, 2005. The key words used were cannabis, marijuana, marihuana, hashish, hashich, haschich, cannabinoids, tetrahydrocannabinol, THC, dronabinol, nabilone, levonantradol, randomised, randomized, double-blind, simple blind, placebo-controlled, and human. The research also included the reports and reviews published in English, French and Spanish. For the final selection, only properly controlled clinical trials were retained, thus open-label studies were excluded. Seventy-two controlled studies evaluating the therapeutic effects of cannabinoids were identified. For each clinical trial, the country where the project was held, the number of patients assessed, the type of study and comparisons done, the products and the dosages used, their efficacy and their adverse effects are described. Cannabinoids present an interesting therapeutic potential as antiemetics, appetite stimulants in debilitating diseases (cancer and AIDS), analgesics, and in the treatment of multiple sclerosis, spinal cord injuries, Tourette's syndrome, epilepsy and glaucoma.

Journal of Ethnobotanicals, March 2006

By CLIFFORD KRAUSS

ORONTO, July 9 — The Canadian government announced an interim plan today that will provide marijuana on a regular basis to several hundred people who are authorized to use the drug for medical reasons.

Coming six weeks after the federal government introduced a bill decriminalizing possession of small amounts of marijuana and only days after it approved a trial "safe injection site" in Vancouver for intravenous drug users, the marijuana plan was one more sign that Ottawa is moving in a very different direction on drug policy from the Bush administration.

Thousands of Canadians already visit so-called "compassion clubs" in Vancouver and a few other cities, which distribute marijuana to those who come with a note from a doctor saying that the drug can help their condition. The police have occasionally entered some of the clinics and seized marijuana, but for the most part they function in the open.

The decision to allow the government to provide marijuana to people with illnesses ranging from cancer to arthritis to epilepsy was forced by a ruling in January by the Ontario Superior Court that federal marijuana access regulations were unconstitutional because they did not provide patients with a legal distribution system.

The government is appealing the ruling, meaning that the announcement may not stand.

"It was never our intention to sell the product," said Health Minister Anne McClellan, a skeptic of medical marijuana use.

The cabinet is divided on whether the government should be growing and distributing marijuana, an activity that is otherwise illegal. Ms. McClellan noted today that there is a lack of clinical evidence that marijuana has medicinal benefits. She added that the government will conduct its own clinical trials, scheduled to begin this fall, to gauge possible benefits.

The government says it intends to distribute the marijuana through doctors. Some officials of doctors associations have raised cautions about doing so before there is more study about the impact of marijuana use on people's health.

While the courts decide on the government's appeal, Ottawa will provide as many as 500 people, who have received letters from doctors saying the drug offered them medical benefits, with dried marijuana and marijuana seeds for their own planting.

The marijuana will cost patients almost $4 a gram, or about half the black market price. The bags of seeds will cost about $15. The marijuana will come from an underground laboratory situated in an old mine in Flin Flon, Manitoba.

"This is a very small victory but a victory nevertheless," said Alison Myrden, a multiple sclerosis patient who appeared before television cameras today in front of the Parliament building holding a marijuana plant and smoking a marijuana cigarette.

Marijuana Cafe Owner Says Cannabis Laws Should Be Done Away With

Marijuana Cafe Owner Says
Cannabis Laws Should Be Done Away With

by Jeremy Hainsworth
Canadian Press
Thursday, September 2, 2004

VANCOUVER (CP) - A Vancouver cafe operator who offers marijuana on her menu says people need a crime-free method of getting the weed and she's going public to raise awareness on the issue.

"Every law to do with cannabis has to be taken off the books," said Carol Gwilt, owner of Da Kine Smoke and Beverage Shop on Vancouver's hip Commercial Drive. "There's nothing criminal about cannabis."

Normally, Gwilt's customers can get a menu and select some pot before someone goes into the back to get the order.

But there was no pot on the premises Wednesday, Gwilt said.

"I want to protect my assets," she said.

The store, which has been open for four months, is decorated in an Egyptian motif. Display cases contain multi-coloured glass pipes for smoking pot. Plant food sits on shelves opposite.

A plate of cookies is on the counter next to the till. Gwilt won't say if they contain marijuana or not.

"I'm just trying to be a business person," Gwilt said. "There's obviously a huge market.

"I don't consider what we're doing illegal. We want a lot of these stores. We want these across Canada."

She said she gets her marijuana from the Canadian Sanctuary Society, a group formed by former B.C. Marijuana Party candidate Donald Briere to help people legally acquire marijuana for medical use.

Gwilt claims crime in the area has dropped since she opened. She said people needing medicinal marijuana should be able to get it in a non-criminal situation.

And, she said, it will keep people away from pushers dealing in heroin or crack cocaine.

That's something she knows about. She said her son died of a heroin overdose two years ago at age 24.

The Vancouver Police Department, which has raided other city marijuana cafes in the past, is watching Da Kine.

"This is a business that is on our radar," spokeswoman Const. Sarah Bloor said. "We're in discussion with the city and our hope is to have the (business) licence removed."

But city Coun. Jim Green said yanking Gwilt's business licence is pretty low on the city's list of priorities.

"We've not had any complaints," he said. "I never heard of it (the cafe) until yesterday."

Green also noted there's a tolerance in Vancouver to these kinds of establishments.

"We're looked at as the enlightened part of Canada."

Customer Andy Kale thinks the police should worry about bigger drug problems than a marijuana cafe.

"This is a great safe inhalation site," he said. "I don't have to be bothered by crackheads."

Kale and Gwilt say the situation will also draw attention to the plight of B.C. Marijuana Party founder Marc Emery.

The activist was jailed last in August after being convicted of trafficking for passing a joint while speaking at a University of Saskatchewan political rally.

Across the street from Gwilt's store, Angela Vane runs The Spirit Within. She sells psychotropic drugs such as the vision-inducing ayahuasca or kava kava, which can produce a mild narcotic effect.

Vane agrees that street crime in the area has diminished since Da Kine opened.

Vane, who's been open for two years and gets her plant drugs from South America, wants other drugs legalized as well.

"We're giving people what they need - mind medicine, body medicine," she said.

Vane expects Gwilt's store to be raided. She said two undercover police officers were in her store Tuesday night.

Gwilt, though, says she willing to discuss options with the police.

"I want to work this out," she said.

Vancouver is home to Canada's only government-sponsored safe injection site for intravenous drug users.

Signs demanding activist Emery's release cover the outside of B.C. Marijuana Party headquarters in downtown Vancouver.

Inside, the smell of pot wafts through the party's store. Piles of cut marijuana sit on desks. Next door at The New Amsterdam Cafe, about a dozen people are rolling joints.

Party spokesman Chris Bennett wouldn't be surprised if Da Kine gets raided by police. He said he hopes her large clientele stands by her when it happens.

"They're definitely cracking down across the country," Bennett said, noting a cafe in Hamilton, Ont was recently raided.

Bennett said the police should not even be part of the equation.

"They're servants of public policy," he said. "They should do their job and leave policy to the public and the politicians

Federal Regulations Stuck Down

All medical users can take a deep breath,the powers to be has had there butt kicked.This ruling will allow groups of users with the proper papers to now grow as a larger unit.This will help those that can not afford to purchase their weekly medicine at a more reasonable price..The new cash crop is Medical Marijuana ,if you are a user with a permit to grow time to get together and start helping yourself...If you are interested in hooking up with a grower with a permit and a location email me I am setting up a co-op for growers...Also looking for investers to make a return on their investment,far better then the banks and stocks ..

With two level of users there is profit to be made for the investor.This will be the best investment you could have ,Government approved easy product ,Built in customers,With 1750 a month applying to get medical medicine.There are 5000 people in on Vancouver Island alone that need this service..
Some compassion clubs charge up to 210 per oz ,that is robbery for them that need this service.
Still they are helping to drive the street price up .Some purchase the product at high prices $2200-$2600 a pound .Then sell to medical users for up to 15 dollars a gram were as the government cannabis sells for 5 dollars a gram.But it is junk not worth price of a stamp..