Medicinal cannabis products for the treatment of acute pain

doi:10.12998/wjcc.v11.i12.2670

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World Journal of Clinical Cases

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World J Clin Cases. Apr 26, 2023; 11(12): 2670-2676
Published online Apr 26, 2023. doi: 10.12998/wjcc.v11.i12.2670

Medicinal cannabis products for the treatment of acute pain

Marco Fiore, Aniello Alfieri, Sveva Di Franco, Stephen Petrou, Giovanni Damiani, Maria Caterina Pace

Marco Fiore, Aniello Alfieri, Sveva Di Franco, Maria Caterina Pace, Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy

Stephen Petrou, Department of Emergency Medicine, University of California San Francisco, San Francisco, CA 94143, United States

Giovanni Damiani, Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan 20122, Italy

Author contributions: This review was mainly written by Fiore M, Alfieri A and Di Franco S; Alfieri A and Di Franco S collected the data; Pace MC supervised the writing of the paper; Petrou S and Damiani G critically revised the paper; Petrou S provided to revise the English language of the manuscript; and all authors approved the final version to be published.

Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.

Corresponding author: Marco Fiore, MD, Doctor, Department of Women, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Piazza Miraglia 2, Naples 80138, Italy. marco.fiore@unicampania.it

Received: January 29, 2023
Peer-review started: January 29, 2023
First decision: February 17, 2023
Revised: March 10, 2023
Accepted: March 27, 2023
Article in press: March 27, 2023
Published online: April 26, 2023
Processing time: 86 Days and 1.2 Hours

Abstract

For thousands of years, medicinal cannabis has been used for pain treatment, but its use for pain management is still controversial. Meta-analysis of the literature has shown contrasting results on the addition of cannabinoids to opioids compared with placebo/other active agents to reduce pain. Clinical studies are mainly focused on medicinal cannabis use in chronic pain management, for which the analgesic effect has been proven in many studies. This review focuses on the potential use of medical cannabis for acute pain management in preclinical studies, studies on healthy subjects and the few pioneering studies in the clinical setting.

Keywords: Cannabis; Cannabinoids; Endocannabinoid system; 2-arachidonoylglycerol; Anandamide; Analgesia; Acute pain

Core Tip: Medicinal cannabis use for pain management is still controversial. Meta-analysis of the literature has shown contrasting results on the addition of cannabinoids to opioids to in reducing pain. Clinical studies are mainly focused on medicinal cannabis use in chronic pain management, for which the analgesic effect has been proven in many studies. This present review focuses on the potential application of medical cannabis for acute pain, exploring the physiopathology of the endocannabinoid system, preclinical studies, studies on healthy subjects and the few pioneering studies in the clinical setting.