Al-Husinat Lou'i, Obeidat Shrouq, Azzam Saif, Al-Gwairy Yara, Obeidat Fatima, Al Sharie Sarah, Haddad Deema, Haddad Fadi, Rekatsina Martina, Leoni Matteo Luigi Giuseppe, Varrassi Giustino
Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan.
Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan.
Clin Pract. 2025 Jan 13;15(1):16. doi: 10.3390/clinpract15010016.
Chronic non-cancer pain, defined by the Center for Disease Control and Prevention (CDC) as lasting beyond three months, significantly affects individuals' quality of life and is often linked to various medical conditions or injuries. Its management is complex. Cannabis, containing the key compounds Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), has garnered interest for its potential in pain management, though it remains controversial due to its psychoactive effects and illegal status in many countries. THC provides pain relief by blocking nociceptive stimuli but has psychoactive effects and may potentially induce dependency. CBD has calming and antipsychotic properties. The inhalation of cannabis offers quick relief but poses respiratory risks, while its oral administrations are safer but act more slowly. Short-term cannabis use can impair cognition and motor skills, while long-term use may lead to dependency and cognitive decline, especially if used from an early age. Adverse effects vary by gender and prior use, with addiction mainly linked to THC and influenced by genetics. Despite these risks, patients often report more benefits, such as improved quality of life and reduced opioid use, although the evidence remains inconclusive. The legal landscape for medical cannabis varies globally, with some positive public health outcomes like reduced opioid-related issues in areas where it is legalized. Cannabis shows promise in managing chronic pain, but its psychoactive effects and dependency risks necessitate cautious use. Future research should prioritize long-term clinical trials to establish optimal dosing, efficacy, and safety, aiding in the development of informed guidelines for safe cannabis use in chronic pain management. This review examines the use of cannabis in managing chronic non-cancer pain, focusing on its benefits, drawbacks, mechanisms, delivery methods, and impact on quality of life.
慢性非癌性疼痛被美国疾病控制与预防中心（CDC）定义为持续超过三个月的疼痛，它会显著影响个人生活质量，且常常与各种医疗状况或损伤相关联。其管理颇为复杂。大麻含有关键化合物Δ-9-四氢大麻酚（THC）和大麻二酚（CBD），因其在疼痛管理方面的潜力而引发关注，不过由于其精神活性作用以及在许多国家的非法地位，它仍然存在争议。THC通过阻断伤害性刺激来缓解疼痛，但具有精神活性作用，且可能会导致依赖。CBD具有镇静和抗精神病特性。吸入大麻能迅速缓解疼痛，但存在呼吸道风险，而口服则更安全，但起效较慢。短期使用大麻会损害认知和运动技能，长期使用可能导致依赖和认知能力下降，尤其是从早年就开始使用的情况下。不良反应因性别和既往使用情况而异，成瘾主要与THC相关，并受遗传因素影响。尽管存在这些风险，但患者常常报告有更多益处，比如生活质量提高以及阿片类药物使用减少，不过证据仍不确凿。医用大麻的法律状况在全球各地各不相同，在其合法化的地区会有一些积极的公共卫生成果，比如与阿片类药物相关的问题减少。大麻在慢性疼痛管理方面显示出前景，但其精神活性作用和依赖风险需要谨慎使用。未来的研究应优先开展长期临床试验，以确定最佳剂量、疗效和安全性，有助于制定关于在慢性疼痛管理中安全使用大麻的明智指南。这篇综述探讨了大麻在慢性非癌性疼痛管理中的应用，重点关注其益处、缺点、作用机制、给药方式以及对生活质量的影响。
