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CC BY-NC-ND 4.0 · Pharmacopsychiatry 2024; 57(03): 152-159
DOI: 10.1055/a-2231-6630
Review

Overview: Chronic Pain and Cannabis-Based Medicines

Matthias Karst
1   Anesthesiology, Pain Clinic, Hannover Medical School, Hannover, Germany
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Abstract

Chronic pain is primarily conceptualized as a disease in its own right when it is associated with emotional distress and functional impairment. Pathophysiologically, dysfunction of the cortico-mesolimbic connectome is of major importance, with overlapping signals in the nociceptive and stress systems. The endocannabinoid system plays an important role in the central processing of nociceptive signals and regulates the central stress response. Clinically, there is moderate evidence that cannabis-based medicines (CBM) can contribute to a significant reduction in pain, especially the associated pain affect, and improvement in physical function and sleep quality in a proportion of patients with chronic pain. The analgesic effect appears to be largely independent of the cause of pain. In this context, CBM preferentially regulates stress-associated pain processing.

Key words

cannabis-based medicines - chronic pain - chronic stress - central sensitization - nociplastic pain


Publication History

Received: 14 September 2023
Received: 03 December 2023

Accepted: 07 December 2023

Article published online:
10 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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