Sharon Haggai, Goldway Noam, Goor-Aryeh Itay, Eisenberg Elon, Brill Silviu
Institute of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel,
Center for Brain Functions, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel,
J Pain Res. 2018 Jul 31;11:1411-1419. doi: 10.2147/JPR.S159852. eCollection 2018.
The scientific study of the role of cannabis in pain medicine still lags far behind the growing use driven by public approval. Accumulated clinical experience is therefore an important source of knowledge. However, no study to date has targeted physicians who actually use cannabis in their daily practice.
Registered, active, board-certified pain specialists in Israel (n=79) were asked to complete a Web-based survey. The survey was developed using the Qualtrics Online Survey Software. Questions were formulated as multiple-choice questions, and these addressed three areas of interest: 1) doctors' personal experience; 2) the role of cannabis in pain medicine; and 3) cannabis medicalization and legalization.
Sixty-four percent of all practicing pain specialists in Israel responded. Almost all prescribe cannabis. Among them, 63% find cannabis moderately to highly effective, 56% have encountered mild or no side effects, and only 5% perceive it as significantly harmful. Common indications are neuropathic pain (65%), oncological pain (50%), arthralgias (25%), and any intractable pain (29%). Leading contraindications are schizophrenia (76%), pregnancy/breastfeeding (65%), and age <18 years (59%). Only 12% rated cannabis as more hazardous than opiates. On a personal note, 45% prefer cannabis for themselves or a family member. Lastly, 54% would like to see cannabis legalized in Israel.
In this survey, pain clinicians experienced in prescribing cannabis over prolonged periods view it as an effective and relatively safe treatment for chronic pain, based on their own experience. Their responses suggest a possible change of paradigm from using cannabis as the last resort.
大麻在疼痛医学中作用的科学研究仍远远落后于公众认可所推动的日益增长的使用量。因此，积累的临床经验是重要的知识来源。然而，迄今为止尚无针对在日常实践中实际使用大麻的医生的研究。
邀请以色列注册的、活跃的、获得委员会认证的疼痛专科医生（n = 79）完成一项基于网络的调查。该调查使用Qualtrics在线调查软件开展。问题以多项选择题的形式呈现，涉及三个感兴趣的领域：1）医生的个人经验；2）大麻在疼痛医学中的作用；3）大麻的医学化和合法化。
以色列所有执业疼痛专科医生中有64%做出了回应。几乎所有人都开具大麻处方。其中，63%的人认为大麻有中度到高度疗效，56%的人遇到过轻微或无副作用的情况，只有5%的人认为其有显著危害。常见适应症为神经性疼痛（65%）、肿瘤性疼痛（50%）、关节痛（2
