Medicinal cannabis: is current use clinically justified?

IF 1.5 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Russ J Scott, Ian A Scott
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引用次数: 0

Abstract

Cannabis products are increasingly perceived and advertised as natural and safe treatments for a variety of conditions, including chronic non-cancer pain (CNCP). The number of prescriptions for medicinal cannabis (MC) currently averages >80 000 per month for >1 million Australians. Although over 800 different cannabis products are available to prescribe in Australia, only two are registered on the Australian Register of Therapeutic Goods and approved by the Therapeutic Goods Administration for specific clinical indications. Using treatment for CNCP as an example, evidence of efficacy across nine systematic reviews was inconsistent and/or of low quality and, with the exception of neuropathic pain, was unable to identify patient phenotypes in whom a specific type and dosing of cannabis product can reliably provide sustained symptomatic relief. Professional bodies do not endorse unregulated or first-line use of cannabis for CNCP. Harm from cannabis is under-reported but adverse effects include impaired cognitive function, dizziness, sedation, confusion, psychosis and arrhythmias, potentially more so in older patients. Healthcare professionals must inform patients of the significant limitations of current evidence of efficacy and safety for cannabis use in CNCP and other conditions and resist media and industry pressures for greater access to and prescribing of MC.

药用大麻:目前的临床使用是否合理?
大麻产品越来越被认为是各种疾病的天然和安全治疗方法,包括慢性非癌性疼痛(CNCP)。药用大麻(MC)的处方数量目前平均每月为100万澳大利亚人开80万澳元。尽管在澳大利亚有800多种不同的大麻产品可供处方,但只有两种在澳大利亚治疗用品登记册上注册,并由治疗用品管理局批准用于特定临床适应症。以CNCP治疗为例,9项系统评价的疗效证据不一致和/或质量较低,除神经性疼痛外,无法确定特定类型和剂量的大麻产品能够可靠地提供持续症状缓解的患者表型。专业机构不支持不受管制或一线使用大麻的CNCP。大麻的危害未得到充分报道,但其不良影响包括认知功能受损、头晕、镇静、精神错乱、精神失常和心律失常,老年患者的情况可能更为严重。医疗保健专业人员必须告知患者,在CNCP和其他情况下使用大麻的有效性和安全性的现有证据存在重大局限性,并抵制媒体和行业要求更多地获得和开出MC处方的压力。
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来源期刊
Internal Medicine Journal
Internal Medicine Journal 医学-医学:内科
CiteScore
3.50
自引率
4.80%
发文量
600
审稿时长
3-6 weeks
期刊介绍: The Internal Medicine Journal is the official journal of the Adult Medicine Division of The Royal Australasian College of Physicians (RACP). Its purpose is to publish high-quality internationally competitive peer-reviewed original medical research, both laboratory and clinical, relating to the study and research of human disease. Papers will be considered from all areas of medical practice and science. The Journal also has a major role in continuing medical education and publishes review articles relevant to physician education.
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