An observational study of the effects of edible cannabis and its constituent cannabinoids on pain, inflammation, and cognition

慢性疼痛影响着7600万美国人，是使用医用大麻最常见的原因。 大麻素及其成分大麻素，包括9-δ-四氢大麻酚（THC），被认为是 参与减轻疼痛和相关炎症。然而，THC也与有害的 认知副作用大麻素的协同作用被认为对疼痛产生不同的影响 和炎症，以及对认知功能的影响。例如，大麻二酚（CBD） 是另一种主要大麻素，可与THC协同作用于多靶点镇痛剂和镇静剂 approach.此外，CBD不具有精神活性，被认为可以减轻 四氢大麻酚的认知副作用尽管关于其影响的数据有限，但有大量广泛的 使用大麻产品可用于疼痛治疗整个美国药房。这些大麻 产品含有一系列大麻素的效力和比例，这可能对它们的效果有很大的影响， 慢性疼痛患者，包括认知副作用。我们提出了一项观察性研究， 血液中大麻素水平对慢性下背部疼痛缓解、炎症和认知功能障碍的影响 在短期（2周）机制研究中选择使用食用大麻的疼痛患者 采用以患者为导向的方法和移动的药理学实验室，解决了许多后勤问题， 大麻研究我们的总体假设是，我们对自我报告和客观报告的观察 测量大麻可食用产品对选择使用这些产品的疼痛患者的影响， 产品将根据血液中THC与CBD的比例而变化。此外，我们假设， 观察到的认知影响将因血液中的THC/CBD比率而异。为此，我们将测量 疼痛，炎症和认知障碍与血液中THC和CBD水平的相关性 疼痛患者希望使用食用大麻来治疗他们的疼痛。这种方法在生态上是有效和及时的 考虑到各种大麻素效力和比例的大麻可食用物被患者广泛地医学使用 在我们州和整个美国，迄今为止还没有对这些产品进行过研究。血液 THC和CBD的水平将在暴露期之前，期间和之后进行测量（当参与者 观察性研究摄入他们购买并选择摄入产品），以确定是否 与疼痛、炎症和认知功能障碍有关。这项研究的结果将提供 向公众和卫生专业人员提供关于自我导向大麻影响的关键和及时的数据 使用，包括各种大麻素的协会，对疼痛和相关过程。

Chronic pain effects 76 million Americans and is the most commonly cited reason for use of medical marijuana. Marijuana and its constituent cannabinoids, including 9-delta-tetrahydrocannabinol (THC), are thought to be involved in reducing pain and associated inflammation. However, THC also is associated with harmful cognitive side effects. Synergistic interactions of cannabinoids are believed to produce different effects on pain and inflammation, as well as on cognitive function as compared to THC alone. For example, cannabidiol (CBD) is another primary cannabinoid that may work synergistically with THC in a multi-target analgesic and antiinflammatory approach. In addition, CBD does not have psychoactive properties and is thought to attenuate the negative cognitive side effects of THC. Despite limited data on their effects, there is a vast array of widely used marijuana products available for pain treatment across dispensaries throughout the US. These marijuana products contain a range cannabinoid potencies and ratios, which may have a large impact on their effects in chronic pain patients, including cognitive side effects. We propose an observational study to examine the effects of cannabinoid levels in blood on pain relief, inflammation, and cognitive dysfunction in chronic low back pain patients who choose to use edible cannabis in the context of a short-term (2 weeks) mechanistic study using a patient-oriented approach and a mobile pharmacology lab that solves many of the logistical problems with marijuana research. Our global hypothesis is that our observations of self-report and objective measures of the effects of marijuana edible products by pain patients who choose to use these products will vary as a function of the ratio of THC to CBD in their blood. Further, we hypothesize that cognitive impacts observed will differ by the THC/CBD ratio in blood. To that end, we will measure the association of pain, inflammation, and cognitive impairment with the levels of THC and CBD in the blood of pain patients who wish to use edible cannabis to treat their pain. This approach is ecologically valid and timely given that marijuana edibles of various cannabinoid potencies and ratios are widely used medically by patients in our state and across the US, yet absolutely no research has been done on these products to date. Blood levels of THC and CBD will be measured before, during, and after the exposure period (when participants in the observational study ingest a product they have purchased and choose to ingest) to determine whether there are associations with pain, inflammation, and cognitive dysfunction. Results from this study will provide critical and timely data to the public and health professionals regarding the effects of self-directed marijuana use, including the associations of various cannabinoids, on pain and related processes.