Department of Anesthesiology, Pain Mechanisms Laboratory, Anesthesiology, Wake Forest University School of Medicine, 1 Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, 307 N. Broad St, Clinton, SC, 29325, USA.
Curr Rheumatol Rep. 2017 Oct 5;19(11):67. doi: 10.1007/s11926-017-0693-1.
The purpose of this study was to provide the most up-to-date scientific evidence of the potential analgesic effects, or lack thereof, of the marijuana plant (cannabis) or cannabinoids, and of safety or tolerability of their long-term use.
We found that inhaled (smoked or vaporized) cannabis is consistently effective in reducing chronic non-cancer pain. Oral cannabinoids seem to improve some aspects of chronic pain (sleep and general quality of life), or cancer chronic pain, but they do not seem effective in acute postoperative pain, abdominal chronic pain, or rheumatoid pain. The available literature shows that inhaled cannabis seems to be more tolerable and predictable than oral cannabinoids. Cannabis or cannabinoids are not universally effective for pain. Continued research on cannabis constituents and improving bioavailability for oral cannabinoids is needed. Other aspects of pain management in patients using cannabis require further open discussion: concomitant opioid use, medical vs. recreational cannabis, abuse potential, etc.
本研究旨在提供关于大麻植物（大麻）或大麻素潜在镇痛作用（或缺乏）及其长期使用的安全性或耐受性的最新科学证据。
我们发现，吸入（吸烟或蒸发）大麻可有效缓解慢性非癌性疼痛。口服大麻素似乎可改善慢性疼痛（睡眠和总体生活质量）或癌症慢性疼痛的某些方面，但对急性术后疼痛、腹部慢性疼痛或类风湿性疼痛无效。现有文献表明，吸入大麻似乎比口服大麻素更耐受和可预测。大麻或大麻素并非对所有疼痛都有效。需要进一步研究大麻成分并提高口服大麻素的生物利用度。需要进一步公开讨论使用大麻的患者疼痛管理的其他方面：阿片类药物的同时使用、医疗用大麻与娱乐用大麻、滥用潜力等。
