Peripherally Restricted Cannabinoids for the Treatment of Pain.
The use of cannabinoids for the treatment of chronic diseases has increased in the United States, with 23 states having legalized the use of marijuana. Although currently available cannabinoid compounds have shown effectiveness in relieving symptoms associated with numerous diseases, the use of cannabis or cannabinoids is still controversial mostly due to their psychotropic effects (e.g., euphoria, laughter) or central nervous system (CNS)-related undesired effects (e.g., tolerance, dependence). A potential strategy to use cannabinoids for medical conditions without inducing psychotropic or CNS-related undesired effects is to avoid their actions in the CNS. This approach could be beneficial for conditions with prominent peripheral pathophysiologic mechanisms (e.g., painful diabetic neuropathy, chemotherapy-induced neuropathy). In this article, we discuss the scientific evidence to target the peripheral cannabinoid system as an alternative to cannabis use for medical purposes, and we review the available literature to determine the pros and cons of potential strategies that can be used to this end.
Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, South Carolina.
E Alfonso
EA
Romero-Sandoval
Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, South Carolina.
Scott
S
Asbill
Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, South Carolina.
Candler A
CA
Paige
Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, South Carolina.
Kiara
K
Byrd-Glover
D000279:Administration, Cutaneous; D000700:Analgesics / Q000627:therapeutic use; D001812:Blood-Brain Barrier / Q000378:metabolism; D002186:Cannabinoids / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D002908:Chronic Disease; D003929:Diabetic Neuropathies / Q000188:drug therapy; D006801:Humans; D064086:Medical Marijuana / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D051474:Neuralgia, Postherpetic / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy*; D043882:Receptors, Cannabinoid / Q000378:metabolism; D014481:United States
D000700:Analgesics; D002186:Cannabinoids; D064086:Medical Marijuana; D043882:Receptors, Cannabinoid
cannabinoids; chronic pain; inflammatory pain; marijuana; neuropathic pain; psychotropic effects