Adverse effects of cannabinoid use: what is the safety paradigm?
Efeitos adversos do uso dos canabinoides: qual o paradigma de segurança?
João Batista Santos Garcia; José Osvaldo Barbosa Neto
Abstract
BACKGROUND AND OBJECTIVES: Interest in the use of marijuana (Cannabis sativa) for medicinal purposes has increased exponentially in recent decades, and the plant and its derivatives are becoming more frequently found in prescriptions for patients with chronic pain. All prescription drugs and illicit substances have adverse effects, even those from plants, fruits, and flowers, as has been well established with the use of tobacco, alcohol, and opium. Marijuana is no exception. The purpose of this study was to review and synthesize the evidence related to the adverse effects promoted by plant-derived cannabinoids, and the implications for the safety of using these substances in pain patients.
CONTENTS: A narrative review was conducted based on articles published in scientific journals indexed in Pubmed and Scielo between the years 2000 and 2022.
CONCLUSION: The evidence is still contradictory and weak on many aspects of adverse effects and clearly there is a need for further research and advances towards a more detailed elucidation of these effects for both non-medical and medical cannabis use. Screening and monitoring of such use, identifying situations of vulnerability to mental illness and dependence, with careful surveillance for adverse effects, is critical.
Keywords
Resumo
JUSTIFICATIVA E OBJETIVOS: O interesse na utilização da maconha (Cannabis sativa) com fins medicinais aumentou de forma exponencial nas últimas décadas e a planta e seus derivados vêm se tornando mais frequentemente encontrados nas prescrições médicas de pacientes com dor crônica. Todos os fármacos prescritos e substâncias ilícitas têm efeitos adversos, mesmo aquelas provenientes de plantas, frutas e flores, como já ficou bem estabelecido com o uso do tabaco, álcool e ópio. A maconha não é exceção. O objetivo deste estudo foi revisar e sintetizar as evidências relacionadas aos efeitos adversos promovidos pelos canabinoides derivados da planta, e às implicações sobre a segurança do uso destas substâncias em pacientes com dor.
CONTEÚDO: Foi realizada uma revisão narrativa baseada em artigos publicados em revistas científicas indexadas no Pubmed e Scielo, entre os anos de 2000 e 2022.
CONCLUSÃO: As evidências ainda são contraditórias e frágeis em relação a muitos aspectos dos efeitos adversos e claramente há a necessidade de mais pesquisas e avanços para uma elucidação mais detalhada destes efeitos tanto para o uso não medicinal quanto médico de cannabis. É fundamental uma triagem e monitoramento desse uso, identificando situações de vulnerabilidade a doenças mentais e dependência, com cuidadosa vigilância de efeitos adversos.
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Referências
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Submetido em:
15/09/2022
Aceito em:
10/02/2023
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