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Medical cannabis for chronic pain management: questions and answers between clinical and medico-legal issues

Abstract Medical cannabis (MC) has gained prominence in recent years as a potential therapeutic option for various diseases, with a particular focus on chronic pain syndromes. While its efficacy remains uncertain, the global prescription rates of MC are significantly increasing. Therefore, pain therapists must be well-informed about several aspects of MC treatments, including efficacy, safety, indications, contraindications, pharmacological interactions, dosages, possible adverse events (AEs), such as the risk of addiction, and medico-legal considerations. Based on the available literature, the efficacy of MC on pain of different origins was described by the majority of Authors as statistically significant compared to placebo, with a mean reduction...
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The Entourage Effect in Cannabis Medicinal Products: A Comprehensive Review

Abstract This study explores the complementary or synergistic effects of medicinal cannabis constituents, particularly terpenes, concerning their therapeutic potential, known as the entourage effect. A systematic review of the literature on cannabis “entourage effects” was conducted using the PRISMA model. Two research questions directed the review: (1) What are the physiological effects of terpenes and terpenoids found in cannabis? (2) What are the proven “entourage effects” of terpenes in cannabis? The initial approach involved an exploratory search in electronic databases using predefined keywords and Boolean phrases across PubMed/MEDLINE, Web of Science, and EBSCO databases using Medical Subject Headings (MeSH). Analysis of published studies shows...
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The impact of cannabis use on erectile dysfunction and sex hormones: a Mendelian randomization analysis

Please use this link to access this publication. Abstract Previous study has highlighted an association between cannabis use (CU) and an increased risk of erectile dysfunction (ED), potentially due to indirect effects on sex hormonal balance. However, the evidence remains controversial, and the causal relationship is unclear. This study utilized genome-wide association study (GWAS) data to investigate the causal relationships between cannabis use disorder (CUD), lifetime cannabis use (LCU), and ED, as well as levels of sex hormones including estradiol (E2), bioavailable testosterone (BT), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) through Mendelian randomization (MR) analysis. The primary method of analysis was the inverse...
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Retinal arterial macroaneurysm rupture in a 17-year-old: Could cannabis consumption be a risk factor?Macroanévrisme artériel rétinien rompu chez un homme de 17 ans ayant consommé du cannabis

Please use this link to access this publication. Case report We report a rare case of a 17-year-old patient who presented to our ophthalmology department with a sudden onset decreased visual acuity in the right eye. His best corrected visual acuity (BCVA) was 0.5/10 in the right eye and 10/10 in the left eye. No relevant medical history was noted except for cannabis consumption the day before his presentation. There was no history of trauma as well. Slit-lamp examination of the anterior segment was unremarkable. Fundus examination revealed a peripapillary Discussion Retinal arterial macroaneurysms are localized dilatations of retinal arteries, measuring 100 to 250 μm...
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Written Exposure Therapy for PTSD Integrated with Cognitive Behavioral Coping Skills for Cannabis Use Disorder After Recent Sexual Assault: A Case Series

Abstract Background/Objectives: The co-occurrence of posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) symptoms is common following sexual assault, particularly among emerging adult women. CUD is associated with more severe PTSD symptoms and other mental health comorbidities including depression, suicidality, and emotion dysregulation. Addressing these issues concurrently soon after sexual assault could help decrease the risk for downstream negative health outcomes. Integrated trauma-focused interventions for PTSD and co-occurring substance use disorders have been shown to decrease PTSD severity and substance use. Yet, existing protocols are lengthy and have rarely been applied following recent trauma exposure or specifically to address CUD symptoms. Methods: This case...
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Pre-trauma insomnia and posttraumatic alcohol and cannabis use in the AURORA observational cohort study of trauma survivors

Please use this link to access this publication. Abstract Background and aims Insomnia symptoms are a potential risk factor for alcohol and cannabis use, particularly in trauma-exposed populations. The initial weeks and months after trauma are a period of risk for problematic substance use, however prior research has not examined whether insomnia symptoms predict alcohol or cannabis use after trauma. Design Using a large-scale, multi-site, prospective study of trauma survivors presenting to emergency departments (EDs), the current study tested direct and indirect associations between pre-trauma insomnia symptoms, two-week posttraumatic stress disorder (PTSD) symptoms, and eight-week post-trauma heavy alcohol and cannabis use and binge drinking. Setting Participants were recruited from 23 EDs in the United States and followed up using remote...
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Cannabis or Cannabinoids for the Management of Chronic Noncancer Pain: Best Practice Advice From the American College of Physicians

Please use this link to access this publication. Abstract Description: The American College of Physicians’ Population Health and Medical Science Committee (PHMSC) developed this best practice advice to inform clinicians about what is currently known about the benefits and harms of cannabis or cannabinoids in the management of chronic noncancer pain and to provide advice for clinicians counseling patients seeking this therapy. Methods: The PHMSC considers areas where evidence is uncertain or emerging or practice does not follow the evidence to provide clinical advice based on a review and assessment of scientific work, including systematic reviews and individual studies. Sources of evidence included a...
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Medical cannabis and ‘Total Pain’ in a cancer population

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From Risk to Remedy?: Importance of Cannabinoid Specificity When Considering Cannabis Associated Cardiovascular Risk

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Exploring the Practice of Dual Vaping: Health Risks and Behavioral Patterns in Nicotine and Cannabis E-Cigarette Users

Abstract Background: E-cigarettes, initially designed for nicotine consumption, are now increasingly being used to smoke cannabis, resulting in a growing trend known as “dual vaping”. This term describes individuals, referred to as “dual users”, who use e-cigarettes for both substances. This study aims to review and analyze existing research on dual vaping, with a focus on the associated health risks and behavioral patterns. Methods: A narrative review of the literature was conducted using PubMed. Studies focusing on individuals who use electronic cigarettes for vaping tobacco and cannabis, either chronically or episodically, were examined. Relevant articles were identified and thematically synthesized to provide a comprehensive...
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