Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort.
Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort.
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DOI：
10.1186/s10194-018-0862-2
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发表时间：
2018-05-24
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影响因子：
--
通讯作者：
Hogue O
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文献类型：
--
作者：
Baron EP;Lucas P;Eades J;Hogue O
药用大麻登记处通常报告疼痛是最常见的使用原因。这将是临床上有用的，以确定模式的大麻治疗偏头痛和头痛，相比关节炎和慢性疼痛，并分析首选的大麻品种，生化特征，处方药替代大麻。通过对患有头痛，关节炎和慢性疼痛的药用大麻患者进行电子调查，记录了大麻使用的人口统计学和模式，包括方法，频率，数量，首选菌株，大麻素和萜烯概况以及处方替代。通过ID Migraine™问卷评估了头痛患者使用大麻治疗偏头痛的情况，这是一种用于预测偏头痛概率的有效筛选。在2032名患者中，有21种疾病是用大麻治疗的。疼痛综合征占总体的42.4%（n = 861）;慢性疼痛29.4%（n = 598;）、关节炎9.3%（n = 188）和头痛3.7%（n = 75;）。在所有21种疾病中，头痛是24.9%（n = 505）大麻治疗的症状。对这些患者进行ID Migraine™问卷调查，68%（n = 343）给出3个“是”回答，20%（n = 102）给出2个“是”回答（偏头痛的概率分别为97%和93%）。因此，88%（n = 445）的头痛患者正在用大麻治疗可能的偏头痛。杂交菌株在所有疼痛亚型中是最优选的，其中“OG Shark”是ID Migraine™和头痛组中最优选的菌株。许多疼痛患者用大麻（41.2-59.5%）代替处方药，最常见的是阿片类药物/阿片类药物（40.5-72.8%）。头痛患者的处方替代包括阿片类药物/阿片类药物（43.4%）、抗抑郁/抗焦虑药物（39%）、NSAID（21%）、曲坦类药物（8.1%）、抗惊厥药物（7.7%）、肌肉松弛剂（7%）、麦角类药物（0.4%）。慢性疼痛是使用大麻的最常见原因，与大多数登记处一致。大多数使用大麻治疗的头痛患者对偏头痛呈阳性。在ID Migraine™、头痛和大多数疼痛组中优选杂交菌株，其中“OG Shark”是高THC（Δ9-四氢大麻酚）/THCA（四氢大麻酚酸）、低CBD（大麻二酚）/CBDA（大麻二酚酸）的菌株，具有主要萜烯β-香叶烯和β-月桂烯，在头痛和ID Migraine™组中最优选。这可能反映了THC的强效镇痛、抗炎和止吐特性，以及β-香芹烯和β-月桂烯的抗炎和镇痛特性。阿片类药物/阿片类药物最常被大麻替代。前瞻性研究是必要的，但结果可能提供早期洞察优化杂交大麻菌株，协同生化概况，剂量和使用模式在头痛，偏头痛和慢性疼痛综合征的治疗。
Medicinal cannabis registries typically report pain as the most common reason for use. It would be clinically useful to identify patterns of cannabis treatment in migraine and headache, as compared to arthritis and chronic pain, and to analyze preferred cannabis strains, biochemical profiles, and prescription medication substitutions with cannabis. Via electronic survey in medicinal cannabis patients with headache, arthritis, and chronic pain, demographics and patterns of cannabis use including methods, frequency, quantity, preferred strains, cannabinoid and terpene profiles, and prescription substitutions were recorded. Cannabis use for migraine among headache patients was assessed via the ID Migraine™ questionnaire, a validated screen used to predict the probability of migraine. Of 2032 patients, 21 illnesses were treated with cannabis. Pain syndromes accounted for 42.4% (n = 861) overall; chronic pain 29.4% (n = 598;), arthritis 9.3% (n = 188), and headache 3.7% (n = 75;). Across all 21 illnesses, headache was a symptom treated with cannabis in 24.9% (n = 505). These patients were given the ID Migraine™ questionnaire, with 68% (n = 343) giving 3 “Yes” responses, 20% (n = 102) giving 2 “Yes” responses (97% and 93% probability of migraine, respectively). Therefore, 88% (n = 445) of headache patients were treating probable migraine with cannabis. Hybrid strains were most preferred across all pain subtypes, with “OG Shark” the most preferred strain in the ID Migraine™ and headache groups. Many pain patients substituted prescription medications with cannabis (41.2–59.5%), most commonly opiates/opioids (40.5–72.8%). Prescription substitution in headache patients included opiates/opioids (43.4%), anti-depressant/anti-anxiety (39%), NSAIDs (21%), triptans (8.1%), anti-convulsants (7.7%), muscle relaxers (7%), ergots (0.4%). Chronic pain was the most common reason for cannabis use, consistent with most registries. The majority of headache patients treating with cannabis were positive for migraine. Hybrid strains were preferred in ID Migraine™, headache, and most pain groups, with “OG Shark”, a high THC (Δ9-tetrahydrocannabinol)/THCA (tetrahydrocannabinolic acid), low CBD (cannabidiol)/CBDA (cannabidiolic acid), strain with predominant terpenes β-caryophyllene and β-myrcene, most preferred in the headache and ID Migraine™ groups. This could reflect the potent analgesic, anti-inflammatory, and anti-emetic properties of THC, with anti-inflammatory and analgesic properties of β-caryophyllene and β-myrcene. Opiates/opioids were most commonly substituted with cannabis. Prospective studies are needed, but results may provide early insight into optimizing crossbred cannabis strains, synergistic biochemical profiles, dosing, and patterns of use in the treatment of headache, migraine, and chronic pain syndromes.
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影响因子：
8.8
作者：
Ahmedzai, S;Carlyle, D L;Calder, I T;Moran, F
通讯作者：
Moran, F
DOI：
10.1124/jpet.103.059808
发表时间：
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影响因子：
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作者：
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3.1
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