Endogenous Cannabinoid Receptors and Medical Cannabis
Sahar Swidan, Matthew Bennett in Advanced Therapeutics in Pain Medicine, 2020
Well-documented as a botanical medicine for over 5000 years, the discovery of endogenous cannabinoid receptors and evidence-based reports indicating the efficacy of medical cannabis for treating pain have renewed consideration of its therapeutic use. The chapter emphasizes how appreciating the biologic context of how and why endogenous cannabinoid receptors function will allow healthcare providers to better interpret pre-clinical trials and limited evidence-based data. Examination of the cannabis plant’s biochemistry and mechanisms of action has revealed so-called endocannabinoid receptors and their natural ligands, comprising a previously unknown ubiquitous receptor system responsible for maintaining physiological balances that are essential to sustain animal life. In consideration of opioids and balanced risk reduction strategies, this chapter summarizes evidence-based safety and efficacy profiles that suggest therapeutic balances of phytocannabinoid and terpenoid compounds. The conclusion discusses a bioethical rationale for compassionate access to cannabis when used for the treatment of pain as well as public health concerns from contaminants to dependence.
Drugs of Abuse
T.M. Craft, P.M. Upton in Key Topics In Anaesthesia, 2021
The incidence of drug abuse is increasing in the United Kingdom (UK) and world wide, but the pattern of abuse differs between countries. In general, abuse of cannabis and amfetamines tends to occur amongst young adults. Occasional drug use may not affect general health. Chronic abuse can result in deterioration in diet and social conditions, leading to cachexia, anaemia, liver function abnormalities and lung pathology in all abusers. Amfetamine use in the UK has risen greatly with the popularity of ecstasy among young adults. Amfetamines cause sympathetic stimulation by cate-cholamine release from adrenergic nerve terminals. Anaesthetic management of acute abuse may require short acting beta blockade to reduce the risk of arrhythmia and the hypertensive responses of laryngoscopy and surgery. The myocardium is sensitised to catecholamines therefore halothane should be avoided. Cannabis modulates neuronal activity via cannabinoid receptors, with effects on calcium and potassium transport.
The Relaxation System Theoretical Construct
Len Wisneski in The Scientific Basis of Integrative Health, 2017
The autonomic nervous system, the neural or electrical control center for stress and relaxation, has a sympathetic portion that responds to stress and a parasympathetic portion that is concerned with homeostasis or relaxation. The term “relaxation response” was coined in the late 1960s to refer to the general stress-reducing phenomenon resulting from meditation and similar practices. The research needs to be performed, but it is strong belief that eventually a pattern of hormonal action and interaction will be established for a relaxation response. Undoubtedly, the most dramatic finding is that the endogenous cannabinoid ligands have the ability to influence the relaxation system in a retrograde manner and modulate both inhibition and excitation. Giving the mind and the body more time to practice relaxation, such as periods of meditation, promotes the endogenous learning of how to instigate a cascade of relaxation rather than stress hormones.
The Changing Face of Synthetic Cannabinoids in Texas
Published in Journal of Psychoactive Drugs, 2018
This article describes the characteristics of individuals who used synthetic cannabinoids and the changes in the user population over time. Data sources include treatment admissions with a primary problem with synthetic cannabinoids reported to the Texas treatment dataset, synthetic cannabinoid exposures reported to the Texas Poison Center Network, and items identified in the National Forensic Laboratory Information System in 2009–2016. Statistically significant trends were identified for race/ethnicity, gender, age, education level, employment status, homelessness, criminal justice problems, use of other substances, lag time between first use and time to treatment, exposure site, chronicity, reason for exposure, and the most common types of cannabinoids. Comparisons were made between the years and the variables in the datasets. Findings suggest that the characteristics of synthetic cannabinoid users and the varieties of these drugs in Texas have changed over time. Data to link individual cases with the changing results of toxicological analysis are needed, as well as targeted prevention and treatment efforts for an aging population who may be at risk of homelessness and also have co-morbid substance use and psychiatric problems.
Glial endocannabinoid system in pain modulation
Published in International Journal of Neuroscience, 2019
Pain is affecting the human for centuries and there still is no satisfactory strategy for patients suffering pain particularly chronic pain although intensive studies about its mechanism have been performed in order to improve the treatment of pain. Cannabinoid is a group of chemicals extracted from plants and has a long history in treating pain through the endogenous cannabinoid receptor in the body; however, its application in pain treatment is limited due to its inverse effects. Recent studies have indicated that glial cells play critical role in mediating pain processing through multiple pathway, including excitatory and inhibitory neurotransmission in different levels of the nervous system. Furthermore, the glial cells are found to express cannabinoid receptors. This review summarized the recent studies about the cannabinoid system in glial cells, which may provide some insight for the studying of pain.
Synthetic Cannabinoids and Acute Kidney Injury
Published in Baylor University Medical Center Proceedings, 2015
Weeraporn Srisung, Faisal Jamal, Sharma Prabhakar
Synthetic cannabinoids (SCB) are a family of chemicals that bind to cannabinoid receptors and cause psychoactive effects. Over the past few years, they have been increasingly used for recreational purposes, especially by young adults, and have been reported to have many adverse effects. Acute kidney injury (AKI) has been recently reported; the pathophysiology of SCB-induced AKI is unknown. We report three cases of AKI in the setting of SCB use. The peak serum creatinine levels ranged from 3.0 to 5.7 mg/dL; one patient required hemodialysis. SCB can induce AKI.
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