Oral ulcers, gynecologic pain & spinal disorders

Oral ulcers, gynecologic pain & spinal disorders
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In his 1978 song “Bush Doctor,” Peter Tosh espoused the health benefits of marijuana by citing two ailments that may strike some listeners as odd: glaucoma and asthma. But Tosh had his facts straight. Glaucoma was actually one of the first indications for which the U.S. government provided canisters of marijuana cigarettes to a handful of patients beginning in the late 1970s. And experiments around the same time also showed that marijuana smoke can dilate and open up the airways – unlike tobacco smoke, which has the opposite effect.

Were he still alive today, Tosh would likely feel both vindicated and amazed by the incredible range of ailments whose treatment with cannabis and CBD has been scientifically supported in recent years. Many more are currently being investigated – and still others are being probed, at the very least, for endocannabinoid system involvement.

As for Tosh, his 1976 anthem “Legalize It” also sang pot’s praises as a treatment for the flu, tuberculosis, and a mysterious (though rhyming) condition called “numara thrombosis.” We may never get to the bottom of what he meant by that one, but here are three more recent papers in field-specific medical journals on obscure or unexpected therapeutic applications of cannabis and cannabinoids.

CBD for oral ulcers

Researchers in China wanted to know whether treating oral ulcers might be among the many potential uses of CBD. To find out, they tested a CBD-infused oral spray at three different concentrations (0, 1, and 10 mg/mL) on tongue ulcers in mice over the course of three days. Their results, published this month in the Journal of Dental Research,1 indicate that not only did the CBD-treated mice generally recover faster than the control animals, but the high-dose CBD group tended to fare better than the low-dose group.

The researchers also investigated the mechanisms behind this effect. They determined it to be largely attributable to immune response and inflammatory pathways mediated by direct activation of PPARy nuclear receptors, a main target of CBD, and, to a lesser extent, partial activation of CB1 receptors. This work was funded in part by a China-based pharmaceutical company.

PEA for gynecologic pain

Cannabinoids are well known for their ability to combat pain and inflammation. So researchers in the Department of Gynecology and Obstetrics at Johns Hopkins School of Medicine (with a practicing OB/GYN as senior author) conducted a systematic review of existing studies on the use of cannabis for gynecologic pain conditions. These include chronic pelvic pain, reported to affect one in four women worldwide;2 dysmenorrhea; vulvodynia; endometriosis; interstitial cystitis (bladder pain syndrome); and gynecologic malignancy.

Most women reported that cannabis improved pain from numerous gynecologic conditions.

Sixteen studies met inclusion criteria for the review, which was published this month in the journal Obstetrics and Gynecology3 and covered in the February episode of the journal’s podcast. Two randomized controlled trials and six prospective cohort studies evaluated the efficacy of medications containing either palmitoylethanolamide (PEA, an endocannabinoid-like compound) or an inhibitor of fatty acid amide hydrolase (FAAH, an enzyme that degrades PEA and endocannabinoids), while eight cross-sectional studies evaluated cannabis use.

“Survey data showed that most women reported that cannabis improved pain from numerous gynecologic conditions,” the authors write. “Cohort studies and an RCT using PEA-combination medications reported pain reduction.” While promising, these findings come with many of the usual caveats: “Interpretation of the studies is limited due to varying cannabis formulations, delivery methods, and dosages that preclude a definitive statement about cannabis for gynecologic pain relief.”

Cannabis for spinal disorders

Also published in Feb. 2022, a new paper in the journal Current Reviews in Musculoskeletal Medicine4 summarizes recent research surrounding the use of cannabis and cannabinoids in four “spinal disorder” contexts: chronic low back pain; spinal cord injury; before and after surgery; and general orthopedic procedures. The narrative review identifies key studies and papers in each of these areas and provides an overview of their findings relative to various factors, including pain, spasticity, surgery recovery, and opioid use.

The long and the short of it: evidence for cannabis use in spinal disorders is still limited and of generally low quality but contains some promising nuggets.

“This is an interesting and burgeoning area of musculoskeletal research, as patients with spine disorders can be severely afflicted with chronic pain without many effective pain treatment options,” senior author and Northwestern University orthopedic surgeon Srikanth Divi said in an email to Project CBD.

“Before we can recommend it routinely for patients that undergo surgery, we need to know its biological effects on spine fusions and long-term complications. This would require robust prospective studies. For now, for patients that state they get good relief from CBD or THC products that are not operative candidates, I think it may be an effective alternative treatment.”

Nate Seltenrich, an independent science journalist based in the San Francisco Bay Area, covers a wide range of subjects including environmental health, neuroscience, and pharmacology.

Copyright, Project CBD. May not be reprinted without permission.



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