An observational study of the effects of edible cannabis and its constituent cannabinoids on pain, inflammation, and cognition

食用大麻及其成分大麻素对疼痛、炎症和认知影响的观察性研究

• 批准号: 10238870
• 负责人: L. Cinnamon Bidwell
• 金额: $ 65.4万
• 依托单位: UNIVERSITY OF COLORADO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10238870
• 关键词: Affect; American; Analgesics; Anti-Inflammatory Agents; Attenuated; Blood; Cannabidiol; Cannabinoids; Cannabis; Chronic low back pain; Cognition; Cognitive; Colorado; Consumption; Data; Diabetes Mellitus; Dose; Europe; Health Professional; Heart Diseases; IL8 gene; Impaired cognition; Individual; Inflammation; Inflammatory; Ingestion; Interleukin-6; Legal; Logistics; Malignant Neoplasms; Marijuana; Measures; Mediating; Medical; Medical Marijuana; Observational Study; Oral; Outcome; Pain; Pain interference; Pain management; Participant; Patient Self-Report; Patients; Pharmacologic Substance; Pharmacology; Policies; Process; Property; Public Health; Reporting; Research; Role; Route; Sativex; Self-Direction; Smoke; TNF gene; Testing; Tetrahydrocannabinol; Time; United States National Center for Health Statistics; Work; base; chronic pain; chronic pain patient; cognitive function; cognitive process; cytokine; design; inflammatory marker; marijuana legalization; marijuana use; marijuana user; pain patient; pain reduction; pain relief; patient oriented; patient population; selective attention; side effect; Affect; American; Analgesics; Anti-Inflammatory Agents; Attenuated; Blood; Cannabidiol; Cannabinoids; Cannabis; Chronic low back pain; Cognition; Cognitive; Colorado; Consumption; Data; Diabetes Mellitus; Dose; Europe; Health Professional; Heart Diseases; IL8 gene; Impaired cognition; Individual; Inflammation; Inflammatory; Ingestion; Interleukin-6; Legal; Logistics; Malignant Neoplasms; Marijuana; Measures; Mediating; Medical; Medical Marijuana; Observational Study; Oral; Outcome; Pain; Pain interference; Pain management; Participant; Patient Self-Report; Patients; Pharmacologic Substance; Pharmacology; Policies; Process; Property; Public Health; Reporting; Research; Role; Route; Sativex; Self-Direction; Smoke; TNF gene; Testing; Tetrahydrocannabinol; Time; United States National Center for Health Statistics; Work; base; chronic pain; chronic pain patient; cognitive function; cognitive process; cytokine; design; inflammatory marker; marijuana legalization; marijuana use; marijuana user; pain patient; pain reduction; pain relief; patient oriented; patient population; selective attention; side effect

Chronic pain effects 76 million Americans and is the most commonly cited reason for use of medical marijuana. Marijuana and its constituent cannabinoids, including 9-delta-tetrahydrocannabinol (THC), are thought to be involved in reducing pain and associated inflammation. However, THC also is associated with harmful cognitive side effects. Synergistic interactions of cannabinoids are believed to produce different effects on pain and inflammation, as well as on cognitive function as compared to THC alone. For example, cannabidiol (CBD) is another primary cannabinoid that may work synergistically with THC in a multi-target analgesic and antiinflammatory approach. In addition, CBD does not have psychoactive properties and is thought to attenuate the negative cognitive side effects of THC. Despite limited data on their effects, there is a vast array of widely used marijuana products available for pain treatment across dispensaries throughout the US. These marijuana products contain a range cannabinoid potencies and ratios, which may have a large impact on their effects in chronic pain patients, including cognitive side effects. We propose an observational study to examine the effects of cannabinoid levels in blood on pain relief, inflammation, and cognitive dysfunction in chronic low back pain patients who choose to use edible cannabis in the context of a short-term (2 weeks) mechanistic study using a patient-oriented approach and a mobile pharmacology lab that solves many of the logistical problems with marijuana research. Our global hypothesis is that our observations of self-report and objective measures of the effects of marijuana edible products by pain patients who choose to use these products will vary as a function of the ratio of THC to CBD in their blood. Further, we hypothesize that cognitive impacts observed will differ by the THC/CBD ratio in blood. To that end, we will measure the association of pain, inflammation, and cognitive impairment with the levels of THC and CBD in the blood of pain patients who wish to use edible cannabis to treat their pain. This approach is ecologically valid and timely given that marijuana edibles of various cannabinoid potencies and ratios are widely used medically by patients in our state and across the US, yet absolutely no research has been done on these products to date. Blood levels of THC and CBD will be measured before, during, and after the exposure period (when participants in the observational study ingest a product they have purchased and choose to ingest) to determine whether there are associations with pain, inflammation, and cognitive dysfunction. Results from this study will provide critical and timely data to the public and health professionals regarding the effects of self-directed marijuana use, including the associations of various cannabinoids, on pain and related processes.

慢性疼痛影响7600万美国人，是使用医用大麻的最常见原因。 大麻及其成分大麻素，包括9-二甲基氢糖（THC），被认为是 参与减轻疼痛和相关的炎症。但是，THC也与有害有关 认知副作用。据信大麻素的协同相互作用会对疼痛产生不同的影响 与单独的THC相比，与炎症以及认知功能有关。例如，大麻二醇（CBD） 是另一种主要的大麻素，可以在多靶性镇痛和抗炎中与THC协同作用 方法。此外，CBD没有精神活性，被认为可以减弱 THC的负认知副作用。尽管对其效果的数据有限，但仍有大量 使用的大麻产品可用于整个美国药房的疼痛治疗。这些大麻 产品包含大麻素的效力和比率，这可能会对它们的影响产生很大的影响 慢性疼痛患者，包括认知副作用。我们提出了一项观察性研究，以检查 大麻素水平在血液中的影响对慢性下背部缓解疼痛，炎症和认知功能障碍的影响 在短期（2周）机械研究的背景下，选择使用可食用大麻的疼痛患者 使用以患者为导向的方法和解决许多后勤问题的移动药理学实验室 与大麻研究。我们的全球假设是我们对自我报告和客观的观察 选择使用这些大麻的患者大麻食品的影响 产品将随血液中THC与CBD比率的函数而变化。此外，我们假设 观察到的认知影响将因血液中THC/CBD比而有所不同。为此，我们将衡量 疼痛，炎症和认知障碍与血液中THC和CBD的水平的关联 希望使用可食用大麻治疗疼痛的疼痛患者。这种方法在生态上有效和及时 鉴于各种大麻素势力和比率的大麻食物被患者广泛使用 在我们的州和整个美国，迄今为止对这些产品的研究绝对没有进行。血 在暴露期之前，期间和之后，将测量THC和CBD的水平（当参与者参加 观察性研究摄入他们购买的产品并选择摄入的产品），以确定是否是否 有疼痛，炎症和认知功能障碍的关联。这项研究的结果将提供 对公共和卫生专业人员的关键和及时数据，涉及自我指导的大麻的影响 使用，包括各种大麻素的关联，在疼痛和相关过程上。