A Review of Scientific Evidence for THC:CBD Oromucosal Spray (Nabiximols) in the Management of Chronic Pain

The 20% prevalence of chronic pain in the general population is a major health concern given the often profound associated impairment of daily activities, employment status, and health-related quality of life in sufferers. Resource utilization associated with chronic pain represents an enormous burd...

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Bibliographic Details
Published in:Journal of pain research 2020-02, Vol.13, p.399-410
Main Author: Uberall, Michael A
Format: Article
Language:English
Subjects:
Analgesia
Analysis
Anti-inflammatory agents
Biological products
Cancer
Cancer pain
Cannabidiol
Cannabinoids
Chronic pain
Clinical trials
Death
Health aspects
Marijuana
Medical marijuana
Nabilone
nabiximols
neuropathic pain
Opioids
Pain management
Palliative care
Patient care
Phenols (Class of compounds)
Public health
Review
Steroidal anti-inflammatory agents
thc:cbd oromucosal spray
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Summary:The 20% prevalence of chronic pain in the general population is a major health concern given the often profound associated impairment of daily activities, employment status, and health-related quality of life in sufferers. Resource utilization associated with chronic pain represents an enormous burden for healthcare systems. Although analgesia based on the World Health Organization's pain ladder continues to be the mainstay of chronic pain management, aside from chronic cancer pain or end-of-life care, prolonged use of non-steroidal anti-inflammatory drugs or opioids to manage chronic pain is rarely sustainable. As the endocannabinoid system is known to control pain at peripheral, spinal, and supraspinal levels, interest in medical use of cannabis is growing. A proprietary blend of cannabis plant extracts containing delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) as the principal cannabinoids is formulated as an oromucosal spray (USAN name: nabiximols) and standardized to ensure quality, consistency and stability. This review examines evidence for THC:CBD oromucosal spray (nabiximols) in the management of chronic pain conditions. Cumulative evidence from clinical trials and an exploratory analysis of the German Pain e-Registry suggests that add-on THC:CBD oromucosal spray (nabiximols) may have a role in managing chronic neuropathic pain, although further precise clinical trials are required to draw definitive conclusions.
ISSN:1178-7090
1178-7090
DOI:10.2147/JPR.S240011