Cannabis and Cannabinoids in Pain Relief

Cannabis is a term that describes products derived from the Indian hemp, Cannabis sativa. It has its origins probably in India but now grows all over the world. The chemical compounds responsible for intoxication and medicinal effects are found mainly in a sticky golden resin exuded from the flowers of the female plants and surrounding leaves. Cannabis sativa contains a wide range of different chemicals including a family of compounds called “cannabinoids”. Of the cannabinoids delta-9 tetrahydrocannabinol (THC) is probably the main compound responsible for the psychotropic activities. Cannabis has been used as a medicine for thousands of years and is mentioned in a Chinese herbal dating back to 2700 BC. There are records of ’its medicinal use in Egyptian papyri of the sixteenth century BC. Much later, the plant is mentioned in Assyrian texts and in Greek and Roman sources as a medicinal agent. Early Experiences in the 19th Century Cannabis Tincture was used in the nineteenth century as an analgesic, as well as numerous other conditions and was considered milder and less dangerous than opium. W.B.O’Shaughnessy was the first of the western physicians to take an interest in cannabis as a medicine on account Read more […]

Nabilone — Clinical Experience at the James Paget Hospital

The dose per capsule is 1 mg but we found that this could be excessive for some patients. Therefore, some were started at 0.25 mg by opening the capsule and dividing the resultant powder into four. The initial time for nabilone use has been at night to reduce the potential discomfort of any side effects. Once the patient’s confidence has been developed, the dosage has been increased where appropriate. Those patients who have benefited from nabilone have been through a period of discontinuation to help evaluate the benefits of this drug. The age range of the 43 patients who have used nabilone is from 25–82 years with 75% between the ages of 30 and 50. More women than men were treated, mainly reflecting a large sex difference in the group with multiple sclerosis. The diagnoses of the patients were categorised into 6 groups as the most convenient method of presenting the information from such an heterogeneous group. No attempt has been made to do anything more than describe the effects of using nabilone on each individual patient and thereby evaluate whether it might be of value in pain control. Multiple Sclerosis Multiple Sclerosis is characterised by widespread and varied damage to the central nervous Read more […]

Pharmacology of Poppy Alkaloids: Major Opium Alkaloids

 The latex obtained by the incision of unripe seed capsules of Papaver somniferum and which is known as opium is the source of several pharmacologically important alkaloids. Dioskorides, in about AD 77, referred to both the latex (opos) and the total plant extract (mekonion) and to the use of oral and inhaled (pipe smoked) opium to induce a state of euphoria and sedation. Since before the Christian era the therapeutic properties of opium were evident, with the first written reference to poppy juice by Theophrastus in the third century BC. Powdered opium contains more than 40 alkaloids which constitute about 25% by weight of the opium and are responsible for its pharmacological activity. In 1803 the German pharmacist Sertiirner achieved the isolation of morphine as one of the active ingredients of opium. Morphine, codeine, thebaine, papaverine, narcotine and narceine are the most important bases, with many of the remaining (minor) alkaloids occurring only in traces. Morphine Morphine has long occupied an eminent position on the list of useful drugs. As a pure alkaloid, it has been employed for over a century and a half and, as the most important constituent of opium, it has contributed to the comfort of the human Read more […]

The Medicinal Uses of Thyme

The uses of thyme, Thymus vulgaris and other Thymus species are well known, and extensive parts of the world get benefit from this plant group in medicinal and non-medicinal respects. Following the development of the medicinal uses of thyme we can see that thyme has changed from a traditional herb to a serious drug in rational phytotherapy. This is due to many pharmacological in vitro experiments carried out during the last decades, and even a few clinical tests. The studies have revealed well defined pharmacological activities of both, the essential oils and the plant extracts, the antibacterial and spasmolytical properties being the most important ones. The use of thyme in modern phytotherapy is based on this knowledge, whereas the traditional use of thyme describes only empirical results and often debatable observations. Therefore it seems necessary to present here the data available on the pharmacodynamics of thyme and thyme preparations in order to substantiate the use of thyme in modern medicine. The non-medicinal use of thyme is no less important, because thyme (mainly Thymus vulgaris) is used in the food and aroma industries. It serves as a preservative for foods and is a culinary ingredient widely used as Read more […]

The Therapeutic Potential For Cannabis

«Cannabis Use and Abuse by Man: An Historical Perspective» of this site provides a fascinating, historical account of the use of cannabis across many cultures and centuries. Suffice it to say here that any natural substance with over 5000 years of medical history will have attached to it a heritage of hearsay and legend through which one must sift to identify areas of true therapeutic potential for us in the late twentieth century and beyond. A summary of conditions for which cannabis has been used, ranging through various shades of rationality, appears in Table Medicinal and quasi-medicinal uses for cannabis and its derivatives: Indications for which only anecdote or reports of traditional use exist: aphrodisiac muscular spasm in rabies / tetanus Huntingdon’s chorea jaundice toothache earache tumour growth cough hysteria insanity menstrual cramps rheumatism movement disorders gut spasm pyrexia inflammed tonsils migraine headache increasing uterine  contractions in childbirth urinary retention/ bladder spasm parasite infection fatigue allergy fever herpetic pain hypertension joint inflammation diarrhoea malaria forgetfulness Indications Read more […]

Specific Medicinal Uses of Cannabis

The historical and contemporary, medicinal uses of cannabis have been reviewed on several occasions. Perhaps the earliest published report to contain at least some objectivity on the subject was that of O’Shaughnessy (1842), an Irish surgeon, working in India, who described the analgesic, anticonvulsant and muscle relaxant properties of the drug. This report triggered the appearance of over 100 publications on the medicinal use of cannabis in American and European medical journals over the next 60 years. One such use was to treat nausea and vomiting; but it was not until the advent of potent cancer chemotherapeutic drugs that the antiemetic properties of cannabis became more widely investigated and then employed. One can argue that the available clinical evidence of efficacy is stronger here than for any other application and that proponents of its use are most likely to be successful in arguing that cannabis should be re-scheduled (to permit its use as a medicine) because it has a “currently accepted medical use”. Specific Medicinal Uses of Cannabis: Use as an Antiemetic Specific Medicinal Uses of Cannabis: Glaucoma Specific Medicinal Uses of Cannabis: Multiple Sclerosis Spastic Conditions A discussion Read more […]

Specific Medicinal Uses of Cannabis: Use as an Antiemetic

Many agents used in cancer chemotherapy produce severe nausea and vomiting in most patients. Symptoms can last for hours or days and have a major impact on patient nutrition and electrolyte status, body weight and physical and mental resilience to both the disease and its treatment. The current choice of available anti-emetics is limited and most are only partially effective, which may lead patients to refuse therapy all together, or for clinicians to use chemotherapeutic regimens which are less than optimum. For these reasons, the search for more effective antiemetics continues. Cannabis In the late 1960s and early 1970s, patients receiving various cancer chemotherapy regimes (including mustine, vincristine, prednisone and procarbazine) noted that smoking cannabis from illicit sources, before and during chemotherapy, reduced the incidence of nausea and vomiting to a variable degree. Only since the isolation of THC have formal clinical trials on the safety and efficacy of cannabis derivatives been conducted. As far as crude cannabis is concerned, we have only anecdotal evidence that inhaling its smoke is effective in a variable percentage of patients who vomit, despite supposedly adequate doses of standard antiemetics. There Read more […]

Catha edulis (Khat)

Distribution, Botany, and Morphology Khat, Catha edulis (Vahl) Forssk. ex Endl. (Celasteraceae), is an evergreen shrub or tall tree that may reach up to 25 m in height if not pruned. Extensive pruning makes it a small shrub, as it is usually described. Its life span may extend for 40 years. The plant is indigenous to East Africa and southern Arabia, but may have originated in the Harar district of Ethiopia, according to earlier reports. Its habitat extends from northern Ethiopia to the mountainous regions of East Africa and Yemen, all the way to south Africa, between latitudes 18 °N and 30 °S. It is cultivated mostly on hillsides and mountain slopes at altitudes of 1500-2000 m above sea level. Besides Ethiopia and Yemen, the khat plant is now grown in Djibouti, Somalia, Kenya, Tanzania, Uganda, and Madagascar. However, the use of the plant is by no means restricted to the natives of these countries, but extends to other Asian countries and immigrant communities in several Western countries. The fact that the khat plant is not allowed to produce seeds and is mainly propagated by cuttings, and that only fresh leaves are used, may have confined its cultivation to the regions of origin and neighboring areas. In these Read more […]

Ginseng (Panax Ginseng)

Medical Uses Ginseng is used as an adaptogenic (for stress), an anti-fatigue agent, an anti-stress agent, and a tonic. Historical Uses Ginseng has been used medicinally in Asia for more than 5000 years. It is known as the ruler of tonic herbs. It is also known as “root of man.” Growth This perennial plant is indigenous to China and is cultivated in many countries. Ginseng: Part Used • Root Major Chemical Compounds • Triterpenoid saponins, especially ginsenosides. Ginseng: Clinical Uses Ginseng is approved by the German Commission E and the World Health Organization for use as an adaptogenic (for stress), an anti-fatigue agent, an anti-stress agent, and a tonic. In Germany, ginseng may be labeled as an aid to convalescence and a tonic to treat fatigue, reduced work capacity, and poor concentration. Mechanism of Action Triterpenoid saponins are believed to help the body build vitality, resist stress, and overcome disease. Ginseng inhibits platelet aggregation by inhibiting thromboxane A2 production. Ginsenosides may act on the pituitary gland, not the adrenal glands. The pituitary secretes corticosteroids indirectly through the release of adrenocorticotrophic hormone and also stimulates nerve fibers Read more […]

Low-Dose Herbs For Depression

Historically, several potentially toxic herbs have been used for depression. It is unlikely that modern practitioners will find much use for them as they are only indicated for the most serious cases of depression, where the better studied, more reliable synthetic drugs are more appropriate. Nevertheless, we briefly discuss these herbs, one of which still has a potential place in the treatment of people with depression. Papaver somniferum (opium) is highly recommended by the late Dr. Weiss as the safest and most effective botanical for therapy-resistant, severe depression. Mu opioid receptor agonists like morphine induce euphoria. However, it is clear from Weiss’s description that opium is only palliative, and he says that symptoms will return unless the opium is used long term. Weiss states that opium is best for endogenous depression, particularly in perimenopausal women and in elderly patients with atherosclerosis causing cerebrovascular insufficiency. He recommends extremely small doses of whole plant extracts (5 doses of tincture three times per day titrated slowly up to 20 drops three times per day), which in his experience are not addictive. Perhaps even more controversial is his suggestion that the patient Read more […]