Most clinical trials with medical cannabis have involved neuropathic pain, Eisenberg noted, and experts don’t agree on whether there’s enough evidence to support cannabis as pain treatment.
About 10% of medicinal cannabis users experience adverse events that include psychotomimetic effects, anxiety and psychosis, cognitive dysmotivational syndrome, or addiction, Eisenberg said.
More recently, a simulator study in the Netherlands demonstrated that when healthy young occasional users vaped cannabis with 13.75 mg of tetrahydrocannabinol , they had problems driving, including lane weaving, swerving, and overcorrecting.
Traditionally, cannabinoids are not viewed as life-threatening compounds, but changes in blood pressure and heart rate soon after consuming marijuana have been recorded, Eisenberg said.
“What’s worrisome is that these events occur in young patients who are otherwise healthy; they don’t have cardiovascular risk factors,” he noted.
Smoking 1 g of cannabis a day — the equivalent of two cigarettes — could expose a patient to up to 200 mg of THC a day.
In a small study in Israel, a metered dose inhaler that exposed neuropathic pain patients to precise doses of low-dose THC showed a significant reduction in pain intensity that remained stable for 150 minutes.
Some patients benefit from medical cannabis in ways they have not benefited from any other pain interventions, Eisenberg noted.
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