Marijuana is increasingly utilized for the treatment of multiple medical problems, including back pain, in the United States. Although there is strong preclinical evidence supporting the promise of cannabinoids in the treatment of back pain, there is a paucity of clinical data supporting their use in clinical practice. Opioids are an important medication for the treatment of acute and chronic back pain, but utilization of opioid-based regimens have likely contributed to the growing opioid epidemic. The significant risk of morbidity, mortality, and dependence secondary to opioid medications have increased the interest in nonopioid medications, including cannabinoid-based pain regimens, in treating back pain. This review will provide an overview on the pharmacology, drug delivery methods, clinical evidence, and safety considerations critical to understanding the potential role of cannabinoids in the treatment of back pain.
Cannabinoids are naturally occurring compounds found in the Cannabis sativa plant. Of over 450 different compounds present in the plant, only around 60 are termed cannabinoids.
The most known among these compounds is the delta-9-tetrahydrocannabinol (Δ9-THC), which is the main psychoactive ingredient in cannabis.
Cannabidiol (CBD) is another important component, which makes up about 40% of the plant resin extract and it’s a part of many products that you can find on the market today. Including our only Delta 8 Store where you can find all the products available on the market.
Cannabinoids are the group of chemical compounds found in the cannabis plant that have physical and mental affects when they interact with cannabinoid receptors in your cells.
Cannabinol (CBN) is a mildly psychoactive cannabinoid found only in trace amounts in Cannabis, and is mostly found in aged Cannabis. Pharmacologically relevant quantities are formed as a metabolite of tetrahydrocannabinol (THC).
The cannabinoids are separated into the following groups:
- Cannabigerols (CBG)
- Cannabichromenes (CBC)
- Cannabidiol (CBD)
- Tetrahydrocannabinol (THC)
- Cannabinol (CBN)
- Cannabinodiol (CBDL)
- Other cannabinoids including cannabicyclol (CBL), cannabielsoin (CBE) and cannabitriol (CBT)
EFFECTS OF CANNABINOIDS
Cannabinoids exert their effects by interacting with specific cannabinoid receptors present on the surface of cells.
These receptors are found in different parts of the central nervous system and the two main types of cannabinoid receptors in the body are CB1 and CB2.
In 1992, a naturally occurring substance in the brain that binds to CB1 was discovered, called anandamide. This cannabinoid-like chemical and others that were later discovered are referred to as endocannabinoids.
The effects of cannabinoids depends on the brain area involved. Effects on the limbic system may alter the memory, cognition and psychomotor performance; effects on the mesolimbic pathway may affect the reward and pleasure responses and pain perception may also be altered.
DIFFERENCES BETWEEN CANNABINOIDS
The main way in which the cannabinoids are differentiated is based on their degree of psychoactivity.
For example, CBG, CBC and CBD are not known to be psycholgically active agents whereas THC, CBN and CBDL along with some other cannabinoids are known to have varying degrees of psychoactivity.
The most abundant of the cannabinoids is CBD, which is thought to have anti-anxiety effects, possibly counteracting the psychoactive effects of THC.
When THC is exposed to the air, it becomes oxidized and forms CBN which also interacts with THC to lessen its impact.
This is why cannabis that has been left out unused will has less potent effects when smoked, due to the increased CBN to THC ratio.
The Human Endocannabinoid System
The endocannabinoid system is a nerve signaling system throughout the human body that helps maintain physiological, emotional and cognitive stability. They’re similar to cannabinoids, but they’re produced by your body. Once in your body, THC interacts with your ECS by binding to receptors, just like endocannabinoids. It’s powerful partly because it can bind to both CB1 and CB2 receptors. This allows it to have a range of effects on your body and mind. For example, THC may help to reduce pain and stimulate your appetite.
Experts are currently looking into ways to produce synthetic THC cannabinoids that interact with the ECS in only beneficial ways.
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