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Experts warn cannabis is not a panacea for chronic pain
Cannabis Law in force since March 2017
In March of this year, the law "Cannabis as medicine" came into force. This regulates the use of cannabis-based medicines as a therapeutic alternative. Seriously ill patients may in certain cases receive cannabis at the box office if, for example, they suffer from chronic pain, multiple sclerosis or loss of appetite due to AIDS or cancer. The prerequisite for such a prescription is that, according to the attending physician, a positive effect on the course of the disease is to be expected.
Since March, doctors can prescribe medical cannabis in justified individual cases. From an expert's point of view, however, there is hardly any evidence that this has an effect on chronic pain. (Image: Africa Studio / fotolia.com) Experts advise against self-therapy
Six months after the new law came into effect, however, the Deutsche Schmerzgesellschaft e.V. and the German Migraine and Headache Society e. V. (DMKG) pointed out that a positive effect of cannabis drugs was only proven in a fraction of the diseases with chronic pain. As the German Pain Society e.V. explains in a recent press release, the experts strongly advise against self-therapy with cannabis flowers. Since the dosages would be inaccurate, it could lead to unwanted adverse health effects.
"There is insufficient evidence that cannabis-based drugs are effective in the treatment of cancer pain, rheumatic and gastrointestinal pain or loss of appetite for cancer and AIDS," said the medical director of the Department of Psychosomatics at Saarbrücken Hospital, Professor Winfried Häuser, according to the release.
Efficacy detected only in neuropathic pain
After evaluating eleven systematic reviews from a total of 750 identified studies on this topic, Haus and his colleagues came to this conclusion, all published between January 2009 and January 2017. The paper published in Deutsches Ärzteblatt shows that the benefits of cannabis-based drugs, such as cannabis-based drugs. Dronabinol, nabilone, or THC / CBD spray for tumor pain, rheumatic and gastrointestinal pain could not be sufficiently empirically demonstrated. Likewise, according to the scientific evaluation, no positive effect on loss of appetite due to cancer and AIDS diseases can be proven.
An exception is therefore only the so-called nerve pain, which are caused by damage or diseases of the nervous system. "A sufficient quantity of evidence exists only for neuropathic pain," adds Häuser.
Expert warns of cannabis in headache
"Cannabis as a painkiller has been in vogue since the amendment in March," said DMKG President. Stefanie Förderreuther. As a result of the intensive media coverage of the "cannabis on prescription" for chronic pain patients sometimes even in headaches vehemently demand a prescription from their doctor, says Förderreuther. But even in this area, the study would not be enough to recommend a regular treatment with drugs based on cannabis.
"We need studies that prove that one or several cannabinoids are not only effective, but also safe in the treatment of defined headache syndromes. Unlike all substances approved for headache treatment, there is a lack of appropriate data, "emphasizes the senior physician of the Neurological Clinic of the Ludwig-Maximilians-Universität. The expert warned therefore above all against a hasty prescription of a cannabis remedy for headaches and migraines.
Impact effects unexplored
As the German painkiller e.V. informs, the female cannabis plant Cannabis sativa contains about 500 different components, of which about 100 are cannabinoids. Although the medical effect of two cannabinoids (tetrahydrocannbinol and cannabidiol) in the relief of pain and inflammation is proven for individual cases and in some clinical studies - the effects on the human body are largely unexplored, according to the experts.
"First of all, there must be methodologically well-prepared randomized, placebo-controlled trials for every clinical picture, which demonstrate the desired effect of pain relief and record the type, severity and frequency of side effects such as confusion or psychosis," emphasizes Förderreuther.
14 varieties of cannabis flowers available
Furthermore, it is important to distinguish different forms of drugs based on cannabis. Among the 14 cannabis blooms ("medicinal hemp") available on prescription at present, the concentration of the contained tetrahydrocannabinol (THC) is between 1 and 22 percent and that of cannabidiol (CBD) between 0.05 and 9 percent. Here, it would be more difficult to add that there are no dosage specifications for individual indications, the expert warns.
Warning of self-therapy
Despite all the criticisms and warnings the German Pain Society e.V nevertheless welcome the new law. The amendment now regulates the reimbursement of cannabis-containing prescription and finished medicinal products. It is important, however, that these "not as an isolated therapy, but in combination with physiotherapeutic and
pain psychotherapeutic procedures are used, "claim houses and Förderreuther. In contrast, the experts generally reject self-therapy due to unpredictable side effects due to inaccurate dosages. (No)