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Pain

Pain (the sensory and emotional response associated with tissue damage) impairs quality of life. Therapeutic options for patients living with pain are limited and consist predominantly of opioids and anti-inflammatory drugs. Over the past years it has become clear that the continued use of opioids has resulted in a crisis in Europe and the USA with many patients now dependent on these drugs. This fact, together with the large number of patients who do not react to any current pain medication, makes it essential that more effective and safer pain medications are developed.

In the US alone, the number of individuals suffering from chronic pain is close to 100m, with two thirds of patients feeling that current medication does not meet their needs. More people suffer from chronic pain than cancer, heart disease and diabetes combined. Patients use cannabis to treat multiple forms of pain, with cannabis shown to address neuropathic (burning or lancinating), mechanical (dullness or aching) and inflammatory (acute or sharp) pain components or sensations. 

Cannabinoid receptors are expressed in the peripheral and central nervous systems, as well as on immune cells, all of which are ideally suited for the modulation of pain processing. Pre-clinical data, in vivo animal model studies and a small number of clinical trials in acute, neuropathic, chronic and cancer pain models suggest that CB1 and CB2 receptors play an important role in pain processing and that modulation of the endocannabinoid system can alleviate pain. However, clinical trials have also shown that a thorough understanding of the interplay of various cannabinoids (e.g. THC vs. CBD) and their specificity for different pain conditions, is essential to develop targeted pain medications that can help patients.