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Pain can appear as a symptom, but it can also have its own disease value - especially in the case of chronic pain. One then speaks of a pain syndrome.
Repeated pain leads to more intense and longer pain sensations, since the pain threshold is lowered. In the case of chronic pain that is not or not sufficiently treated, a pain memory develops. Consequently, sleep disorders can occur and physical and mental resilience is significantly reduced. As a result, the ability to perform at work is reduced and it is not uncommon that permanent incapacity to work and depressions develop. In these cases, pain treatment with medication alone is often not enough to restore the quality of life of those affected.
Cannabinoid treatment is considered a useful supplement or alternative to classic medication for chronic pain if this has not shown sufficient effect or is accompanied by severe side effects. The great advantage of medical cannabis is the often low level of side effects and the usually rapid effectiveness, which can provide rapid relief in the case of chronic pain. In patients with chronic pain, there is a significant improvement in pain perception, which in turn is associated with an improvement in mood and quality of life. In addition, opioid treatment can be significantly reduced and therefore also the costs for patients.
[1] Cahill, S. P., Lunn, S. E., Diaz, P., Page, J. E. Evaluation of patient reported safety and efficacy of cannabis from a survey of medical cannabis patients in Canada. Frontiers in Public Health 9:626853
[2] MacCallum, C. A., Eadie, L., Barr, A. M., Boivin, M., Lu, S. Practical strategies using medical cannabis to reduce harms associated with long term opioid use in chronic pain. Fron Pharmacol 2021, 12:633168
[3] Takakuwa, K. M. & Sulak, D. A. Survey on the effect that medical cannabis has on prescription opioid medication usage fort he treatment of chronic pain at three medical cannabis practice sites. Cureus 2020, 12(12):e11848
[4] Bachhuber, M., Arnsten, J. H., Wurm, G. Use of cannabis to relieve pain and promote sleep by customers at an adult use dispensary. J Psychoactive Drugs 2019, 51(5):400-404
[5] Gruber, S. A., Smith, R. T., Dahlgren, M. K., Lambros, A. M., Sagar, K. A. No pain, all gain? Interim analyses from a longitudinal, observational study examining the impact of medical cannabis treatment on chronic pain and related symptoms. Exp Clin Psychopharmacol 2021, 29(2):147-156
[6] Piper, B. J., DeKeuster, R. M., Beals, M. L., Cobb, C. M., Burchman, C. A., Perkinson, L., Lynn, S. T., Nichols, S. D., Abess, A. T. Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep. J Psychopharmacol 2017, 31(5):569-575
[7] Bellnier, T., Brown, G. W., Ortega, T. R. Preliminary evaluation of the efficacy, safety, and costs associated with the treatment of chronic pain with medical cannabis. Ment Health Clin 2018, 8(3):110-115
[8] Wilsey, B., Marcotte, T., Deutsch, R., Gouaux, B., Sakai, S., & Donaghe, H. (2013). Low-dose vaporized cannabis significantly improves neuropathic pain. The Journal of Pain, 14(2), 136-148
Depression is the most common mental illness. Medicinal cannabis can be used to treat chronic, treatment-resistant depression and stabilize your emotions during a depressive episode.
Cannabinoids have both anxiolytic and antidepressant effects. Medicinal cannabis is therefore well suited for the treatment of depression. Studies have shown that both THC and CBD can significantly increase functional behavior in stressful situations. Apart from that, a significantly faster onset of action of cannabinoids compared to traditional antidepressants is another attractive factor for treatment.
Unlike antidepressants, cannabinoid treatment is often associated with only minor side effects and is often used as a complement to psychotreatment used or if antidepressants are ineffective or burden the patient too much.
[1] De Mello Schier, A.R., De Oliveira Ribeiro, N.P., Coutinho, D.S., Machado, S., Arias-Carrión, O., Crippa, J.A., Silva, A.C. (2014). Antidepressant-like and anxiolytic-like effects of cannabidiol: A chemical compound of Cannabis & sativa. CNS Neurological Disorders-Drug Targets, 13(6), 953-960
[2] Sales, A. J., Fogaça, M. V., Sartim, A. G., Pereira, V. S., Wegener, G., Guimarães, F. S., & Joca, S. R. (2019). Cannabidiol induces rapid and sustained antidepressant-like effects through increased BDNF signaling and synaptogenesis in the prefrontal cortex. Molecular Neurobiology, 56(2), 1070-1081
[3] Poleszak, E., Wośko, S., Sławińska, K., Szopa, A., Wróbel, A., & Serefko, A. (2018). Cannabinoids in depressive disorders. Life Sciences, 213, 18-24
Sleep disorders are subjectively perceived or objectively observed deviations from normal sleep and can be organic or non-organic. If treatment attempts fail or drugs lead to severe side effects, cannabinoid treatment can be a useful addition to non-drug measures.
In patients with chronic sleep disorders, there is a significant improvement in sleep as part of cannabis treatment. Cannabinoids have an impact on the sleep-wake cycle, sleep quality and sleep length. Cannabidiol in particular is beneficial for a number of sleeping disorders.
Medical cannabis can not only help you fall asleep faster, but also enable you to stay asleep for longer. It can also reduce stress and have a calming effect during the day. Since sleep disorders often occur as an accompanying symptom of a main disease such as chronic pain, cannabinoid treatment often alleviates both symptoms.
[1] Cahill, S. P., Lunn, S. E., Diaz, P., Page, J. E. Evaluation of patient reported safety and efficacy of cannabis from a survey of medical cannabis patients in Canada. Frontiers in Public Health 9:626853
[2] Bachhuber, M., Arnsten, J. H., Wurm, G. Use of cannabis to relieve pain and promote sleep by customers at an adult use dispensary. J Psychoactive Drugs 2019, 51(5):400-404
[3] Walsh, J. H., Maddison, K. J., Rankin, T., Murray, K., McArdle, N., Ree, M. J., Hillman, D. R., Eastwood, P. R. Treating insomnia symptoms with medicinal cannabis: a randomized, crossover trial of the efficacy of a cannabinoid medicine compared with placebo. Sleep
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[4] Babson, K. A., Sottile, J., & Morabito, D. (2017). Cannabis, cannabinoids, and sleep: a review of the literature. Current Psychiatry Reports, 19(23), 1-12
[5] Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in anxiety and sleep: a large case series. The Permanente Journal, 23, 18-41
[6] Piper, B. J., DeKeuster, R. M., Beals, M. L., Cobb, C. M., Burchman, C. A., Perkinson, L., Lynn, S. T., Nichols, S. D., Abess, A. T. Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep. J Psychopharmacol 2017, 31(5):569-575
[7] Kuhathasan, N., Minuzzi, L., MacKillop, J., & Frey, B. N. (2022). An investigation of cannabis use for insomnia in depression and anxiety in a naturalistic sample. BMC psychiatry, 22(1), 303. https://doi.org/10.1186/s12888-022-03948-6
Migraines are one of the most common types of primary headaches. Typical are strong one-sided headaches with or without accompanying symptoms ("aura"). The exact cause is still unclear. When drug treatment is unsuccessful, medical cannabis treatment may be indicated. Inhaling cannabis can reduce the frequency and intensity of migraine attacks in many cases. At the same time, non-drug treatment approaches should be implemented.
[1] Cuttler, C., Spradlin, A., Cleveland, M. J., Craft, R. M. Short- and long-term effects of cannabis on headache and migraine. J Pain 2020, 21(5- 6):722-730.
[2] Mechtler, L. L., Gengo, F. M., & Bargnes, V. H. (2021). Cannabis and Migraine: It's Complicated. Current pain and headache reports, 25(3), 16.
[3] Baron E. P. (2018). Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science. Headache, 58(7), 1139–1186
[4] Stith, Sarah S et al. “Alleviative effects of Cannabis flower on migraine and headache.” Journal of integrative medicine vol. 18,5 (2020): 416-424.
[5] Pini, L. A., Guerzoni, S., Cainazzo, M. M., Ferrari, A., Sarchielli, P., Tiraferri, I., Zappaterra, M. (2012). Nabilone for the treatment of medication overuse headache: results of a preliminary double-blind, active-controlled, randomized trial. The Journal of Headache and Pain, 13(8), 677-684.
ADHD – or Attention Deficit Hyperactivity Disorder – refers to a behavioral disorder that can occur in children, adolescents and adults and is associated with difficulty concentrating, motor hyperactivity and increased excitability. Although ADHD has long been considered a typical childhood disease, the disorder is also common among adults. Depending on the age and character of the patient, symptoms can vary in severity.
In the past, medicinal cannabis was able to lead to a significant improvement in concentration, attention and performance in patients with ADHD, thereby reducing the impairment and improving the lifestyle of those affected.
[1] Hupli, A. M. M. Medical cannabis for adult attention deficit hyperactivity disorder: Sociological patient case report of cannabinoid therapeutics in Finland. Med Cannabis Cannabinoids 2018, 1:112-118
[2] Cooper, R. E., Williams, E., Seegobin, S., Tye, C., Kuntsi, J., Asherson, P. Cannabinoids in attention-deficit/hyperactivity disorder: A randomised-controlled trial. Eur Neuropsychopharmacol 2017, 27(8), 795-808
[3] Strohbeck-Kühner, P., Skopp, G., Mattern, R. Cannabis verbessert Symptome der ADHS. Cannabinoids 2008, 3(1):1-4 (deutschsprachige Fassung)
[4] Hergenrather, J., Aviram, J., Vysotski, Y., Campisi-Pinto, S., Lewitus, G. M., Meiri, D. Cannabinoid and terpenoid doses are associated with adult ADHD status of medical cannabis patients. Rambam Maimonides Med J 2020, 11(1):e0001
Epilepsy is a cerebral disease with excessive activation of one or more areas of the brain. Causes can be damage or inflammation of the brain. The result is epileptic seizures.
In patients with treatment-resistant epilepsy, the combination of THC and CBD has been shown to be a safe and effective medication to reduce seizures and significantly improve quality of life. Treatment with medicinal cannabis oil (CBD-rich) also shows a reduction in the frequency and intensity of seizures.
[1] Tzadok, M., Uliel-Siboni, S., Linder, I., Kramer, U., Epstein, O., Menascu, S., Ben-Zeev, B. (2016). CBD-enriched medical cannabis for intractable pediatric epilepsy: the current Israeli experience. Seizure, 35, 41-44
[2] McCoy, B., Wang, L., Zak, M., Al‐Mehmadi, S., Kabir, N., Alhadid, K., Snead III, O. C. A prospective open‐label trial of a CBD/THC cannabis oil in dravet syndrome. Ann Clin Transl Neurol 2018, 5(9), 1077-1088.
[3] Erridge, S., Salazar, O., Kawka, M., Holvey, C., Coomber, R., Usmani, A., Sodergren, M. H. (2021). An initial analysis of the UK Medical Cannabis Registry: Outcomes analysis of first 129 patients. Neuropsychopharmacology Reports, 41(3), 362-370.
[4] Scheffer, I. E., Halford, J. J., Miller, I., Nabbout, R., Sanchez‐Carpintero, R., Shiloh‐ Malawsky, Y., Devinsky, O. (2021). Add‐on cannabidiol in patients with Dravet syndrome: Results of a long‐term open‐label extension trial. Epilepsia. 62(10), 2505-2517
In Germany, medical treatment with cannabis may be carried out since March 2017 if there is a corresponding indication. Cannabis buds, extracts and the synthetically produced ingredient THC can be prescribed. Medical cananbis is obtained in pure quality from the pharmacy.
Basically, cannabis is not a first-line treatment. A prescription is only considered if conventional medicines were not promising or if there were significant side effects. In addition, the patient's disease must significantly limit the quality of life.