Cannabinoid analgesia as a potential new therapeutic option in the treatment of chronic pain

It has been estimated that chronic pain affects 86 millionAmericans and costs about $90 billion annually in re-duced employment, medication expenses, and medical care.1 Just over one-half of patients who report chronic pain feel that their pain is under control.2 There is a need for additional treatment options for these people, as many suffer from intractable pain that is not relieved by current treatment modalities. Many other people are unable to tol-erate current treatment options, such as opioids and non-steroidal antiinflammatory drugs (NSAIDs). This is a re-view of recent information regarding an approach to pain management using novel pharmacologic targets and mech-anisms. Cannabis-based medicines have recently been studied for a variety of uses including treatment of the pain and spasticity associated with multiple sclerosis, control of nausea and vomiting, appetite stimulation, and analgesia.3-6 Interest in cannabinoid agonists has increased since the isolation of specific cannabinoid receptors and endogenous ligands for these receptors. Cannabis has had a long histo-ry of use both recreationally and medicinally, but has faced increasing opposition as a medicinal agent.7 Drug develop-ment has recently focused on synthetic cannabinoid ago-nists that have more favorable adverse effect profiles than cannabis.