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大麻与疼痛治疗——基于不确定性的临床效用综述及实用方法

Cannabis and Pain Treatment-A Review of the Clinical Utility and a Practical Approach in Light of Uncertainty.

作者信息

Vulfsons Simon, Minerbi Amir, Sahar Tali

机构信息

Institute for Pain Medicine, Rambam Health Care Campus, Haifa, Israel.

Rappaport School of Medicine, Technion Institute of Technology, Haifa, Israel.

出版信息

Rambam Maimonides Med J. 2020 Jan 30;11(1):e0002. doi: 10.5041/RMMJ.10385.

Abstract

Over the past decade the phenomenon of cannabis as a legitimate form of treatment for pain has overwhelmed the medical community, especially in the field of pain. From a status of a schedule 1 substance having no currently accepted medical use and being considered to have high potential for abuse, its use has mushroomed to over 50,000 legal medical users per year in Israel alone. There appear to be many reasons behind this phenomenon-medical, sociological, and economical. Thus, what is cannabis? An abusive substance or a medication? Should it be incorporated into current biomedical practice, and how should it be administered? Finally, what is the evidence for the beneficial and detrimental effects of cannabis? This article reviews and discusses the current literature regarding the beneficial and the detrimental effects of medical cannabis in the treatment of pain. We further discuss the problems and challenges facing the medical community in this domain and offer a practical approach to deal with these challenges.

摘要

在过去十年里,大麻作为一种合法的疼痛治疗方式的现象席卷了医学界,尤其是在疼痛领域。从一种被列为一类且目前没有被认可的医疗用途、被认为具有很高滥用潜力的物质,其使用量在以色列就已迅速增长到每年超过50000名合法医疗使用者。这一现象背后似乎有许多原因——医学、社会学和经济方面的。那么,大麻是什么?一种滥用物质还是一种药物?它是否应该被纳入当前的生物医学实践,又该如何给药?最后,大麻有益和有害影响的证据是什么?本文回顾并讨论了当前关于医用大麻治疗疼痛的有益和有害影响的文献。我们还进一步讨论了医学界在这一领域面临的问题和挑战,并提供了应对这些挑战的实用方法。

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