Human beings produce their own cannabinoids (endocannabinoids) according to need and are not stored in the body. Like endorphins, the human body produces endocannabinoids in response to activities such as physical exercise (the high of runners might be due to endocannabinoids, not endorphins!).
Cannabis contains more than 400 chemical components 80 of which contain cannabinoid components and 200 non-cannabinoids components. For medical purposes, cannabinoid substances such as THC (Delta-9-tertrahydrocannabinol), CBD (cannabidiol) and non-cannabinoid substances such as terpenoids and flavonoids are relevant.
Medicinal cannabis must be distinguished from recreational cannabis which is used to achieve a psychotomimetic state of ‘high’. Cannabis strains used for recreational purposes contain a higher THC and lower CBD ratio than cannabis for medicinal use. Usually two cannabis plants are used: cannabis sativa which has a higher THC concentration and cannabis indica which has a higher CBD concentrate. The flavonoids are known for their antioxidant and anti-inflammatory effects. The terpenoids are resins (oil) with a strong odour.
Cannabis, a very easy plant to grow, has been used for centuries for its medicinal properties. The oldest known document about cannabis use originates from the Chinese emperor Shen Nung in 2727 B.C. It suggested that cannabis has a neuron-protective effect. The Egyptians used cannabis to treat glaucoma and as an anti-inflammatory agent (inflammation of the eyes, fever). Cannabis was even used in obstetrics (mixed with honey) and the mixture was applied in the vagina to “cool” the uterus. In the Old Testament, there is also an account of God instructing Moses to make a holy anointing olive oil-based “Kaneh Bosm.”
It is also important that we inform the patient about the possible interactions of cannabis oil with certain regular medications such as Coumarin (this blood thinner interacts with cannabis oil, leading to an increase of the INR and a greater risk of bleeding!). There are different types of cannabis oil available, such as CBD and THC oils with different concentrations which makes it difficult for patients to make a choice.
Introduction and Objectives
To examine the prevalence of cannabis use among men with CP/CPPS, to estimate the dose size and frequency of cannabis use, and to describe the patient reported indications for its use in this population.
Login to Access Video or Poster Abstract: 1083
Date & Time: May 21, 2012 01:00 PM
Session Title: Infections/Inflammation of the Genitourinary Tract: Prostate & Genitalia
Sources of Funding: Valeant Canada Inc.
Parallel online and clinic questionnaire surveys were conducted to assess cannabis use among men with CP/CPPS. As a check on study generalizability, comparisons between the online data (n=365) and clinic data (n=60) showed no clinically meaningful differences in the outcome variables of quality of life (QoL), suicidal ideation, pain and urinary symptoms were evident between these groups.
Forty nine percent of this sample reported cannabis use (n=206). Of those reporting cannabis use, 29% (n=59) indicated use for pain relief (pain users) and 71% (n=147) for recreation. The pain users (mean age=38.26±13.78), were younger than recreational users (42.37±12.18) and individuals who reported never using cannabis (45.29±13.73)(p=.001). More pain users reported cannabis was of pain reduction benefit in comparison to recreational users (Chisq=3.83, p=.05). No differences were found between recreational and pain users in degree of side effects (Chisq=4.43, p=.22), reasons for stopping (Chisq=4.84, p=.18), or use frequency (Chisq=5.48, p=.07). There were no differences in dose smoked between the pain and recreational users (Chisq=5.80, p=.12), but a difference was found in dose eaten between these two groups with 20% of pain users reporting consuming more than 1 gram per dose versus only 7% of recreational users reporting consuming this dosage. (Chisq=12.51,p=.002). Pain users reported more pain (F=4.04, p=.05), poorer CP/CPPS QoL/impact (F=8.61, p=.004), and more suicidal thoughts (F=6.59, p=.01) than recreational users.
Cannabis use is prevalent in men reporting CP/CPPS (49%), but not necessarily used for CP/CPPS symptoms (used for pain in only 29% users). It is important that physicians planning a therapeutic strategy for patients with CP/CPPS know the relevance of this data and question their patients on their use (and effect/impact on symptoms) of marijuana/cannabis. Although this study cannot qualify the benefit or hazard of cannabis use, this is the first study to document the prevalence and patterns of cannabis use in a CP/CPPS population.