The DOI matches its Crossref record, with a small difference in title or year; 156 of the 156 references it cites were found in a registry or an index; none of the 103 sources its claims cite is checked for support yet.
The analgesic potential of cannabinoids.
Open accessAbstract
Historically and anecdotally cannabinoids have been used as analgesic agents. In recent years, there has been an escalating interest in developing cannabis-derived medications to treat severe pain. This review provides an overview of the history of cannabis use in medicine, cannabinoid signaling pathways, and current data from preclinical as well as clinical studies on using cannabinoids as potential analgesic agents. Clinical and experimental studies show that cannabis-derived compounds act as antiemetic, appetite modulating, and analgesic agents. However, the efficacy of individual products is variable and dependent upon the route of administration. As opioids are the only therapy for severe pain, analgesic ability of cannabinoids may provide a much-needed alternative to opioids. Moreover, cannabinoids act synergistically with opioids and act as opioid sparing agents, allowing lower doses and fewer side effects from chronic opioid therapy. Thus, rational use of cannabis-based medications deserves serious consideration to alleviate the suffering of patients due to severe pain.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This narrative review concludes that cannabinoids show antinociceptive efficacy in preclinical models and may serve as adjuncts or opioid-sparing agents, but human data remain emerging and product/route dependent. It reports mixed clinical results across neuropathic, cancer, MS, HIV, and acute/postoperative pain, and notes no analgesic studies in sickle cell disease.
Key findings
- Preclinical animal studies report cannabinoid antinociception in neuropathic, inflammatory, and cancer pain models, with both CB-1 and CB-2 receptors implicated; CB-1 receptor activation is described as critical to antinociceptive activity.
- Opioid synergy: in rats, high-dose morphine, high-dose THC, or a low-dose combination produced equivalent antinociception and the combination circumvented tolerance; clinically, 30 mg morphine plus 20 mg Δ9-THC showed slightly additive analgesia for electric stimulation, while Δ9-THC alone was hyperalgesic, and no synergism was found with piritramide in post-prostatectomy pain.
- Clinical results are mixed: a 667-patient MS trial found subjective improvement in spasticity and pain with oral Δ9-THC or Cannador® but no objective Ashworth-scale improvement; Sativex® (Δ9-THC 27 mg/mL, CBD 25 mg/mL, 100 μL/spray) reduced mean pain intensity and sleep disturbance in MS; in severe neuropathic pain, dihydrocodeine (max 240 mg) gave clinically significant relief to more patients than nabilone (max 2 mg), and no subject responded to both.
- In HIV, cannabis users reported improvement in appetite (97%), muscle pain (94%), nausea (93%), anxiety (93%), nerve pain (90%), depression (86%), and paraesthesia (85%), but 47% reported memory deterioration; in sickle cell disease, 31 of 84 questionnaire respondents reported cannabis use, and 52% of users said they used it to reduce or prevent acute or chronic pain, though no analgesic studies were found.
Methods
- Narrative review synthesizing historical, preclinical animal, and clinical human literature on cannabinoids for analgesia, plus sections on anti-emetic/appetite effects, HIV/AIDS, multiple sclerosis, sickle cell disease, and side effects.
- Data include animal models of neuropathic, inflammatory, and cancer pain and clinical trials in MS, HIV neuropathy, chronic pain, cancer, postoperative pain, fibromyalgia, and rheumatoid arthritis; no systematic search strategy, inclusion criteria, or meta-analysis is described.
Limitations
- Stated: human data are still emerging; most opioid-cannabinoid synergy studies were in healthy subjects and need further study in specific disease models; no studies evaluating cannabinoids as analgesics in sickle cell disease were found.
- Stated/evident: efficacy is variable and dependent on route of administration, and different cannabis-derived drugs differ in effectiveness across conditions.
- Evident: as a narrative review, it lacks a systematic search and quantitative synthesis, and side-effect data often come from marijuana users rather than controlled therapeutic use.
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Claims the paper makes
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In the paper
“We did not find any studies evaluating cannabinoids as analgesic agents in sickle cell disease (SCD).”
§ The Analgesic Potential of Cannabinoids > Can Cannabinoids be useful in Sickle cell disease?
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“However, in some patients, they are associated with rather unpleasant side effects, including sedation, loss of appetite, initial nausea, persistent constipation [5] and respiratory depression [6].”
§ The Analgesic Potential of Cannabinoids > Introduction
What the sources say
- Not checked yetcites [5] Brown RT Zuelsdorff M Fleming M Adverse effects and cognitive function among primary care patients taking opioids for chronic nonmalignant pain J Opioid Manag 2006 2 3 137 146 17319447
- Not checked yetcites [6] Davis MP Lasheen W Gamier P Practical guide to opioids and their complications in managing cancer pain. What oncologists need to know Oncology (Williston Park) 2007 21 10 1229 38 discussion 1238 17926800
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“CB-1 receptor activation suppresses the nociceptive sensitization by influencing the release of neurotransmitters including acetylcholine, norepinephrine, gamma-amino butyric acid (GABA), glycine, dopamine, serotonin and cholecystokinin (CCK) from the presynaptic terminal”
§ The Analgesic Potential of Cannabinoids > Cannabinoid receptors and signaling pathways
What the sources say
- Not checked yetcites [11] Kano M Ohno-Shosaku T Hashimotodani Y Endocannabinoid-mediated control of synaptic transmission Physiol Rev 2009 89 1 309 380 19126760
- Not checked yetcites [13] Guzman M Sanchez C Galve-Roperh I Control of the cell survival/death decision by cannabinoids J Mol Med 2001 78 11 613 625 11269508
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Moreover, issues such as tolerance, dependence and opioid induced hyperalgesia remain a major deterrent in opioid use [7].”
§ The Analgesic Potential of Cannabinoids > Introduction
What the sources say
- Not checked yetcites [7] Chang G Chen L Mao J Opioid tolerance and hyperalgesia Med Clin North Am 2007 91 2 199 211 17321281
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesNone of the sources cited for this claim have been checked yet.
In the paper
“Binding of cannabinoids to CB-1 receptors is critical to their antinociceptive activity.”
§ The Analgesic Potential of Cannabinoids > Cannabinoid receptors and signaling pathways
What the sources say
- Not checked yetcites [11] Kano M Ohno-Shosaku T Hashimotodani Y Endocannabinoid-mediated control of synaptic transmission Physiol Rev 2009 89 1 309 380 19126760
- Not checked yetcites [13] Guzman M Sanchez C Galve-Roperh I Control of the cell survival/death decision by cannabinoids J Mol Med 2001 78 11 613 625 11269508
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“Both CB1 and CB2 receptors are involved in the mediation of inflammatory pain [46].”
§ The Analgesic Potential of Cannabinoids > Cannabinoids for analgesia – animal studies > b) Inflammatory pain
What the sources say
- Not checked yetcites [46] Clayton N Marshall FH Bountra C CB1 and CB2 cannabinoid receptors are implicated in inflammatory pain Pain 2002 96 3 253 260 11972997
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These studies demonstrate that cannabinoids can be potentially used as analgesics in treating neuropathic pain accompanying diverse pathologies.”
§ The Analgesic Potential of Cannabinoids > Cannabinoids for analgesia – animal studies > a) Neuropathic pain
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIn the paper
“In a subanalysis of data from a multicountry randomized clinical trial studying self-care symptom management in HIV patients, anxiety was found to be lower in marijuana users than nonusers.”
§ The Analgesic Potential of Cannabinoids > Cannabinoids in HIV/AIDS
What the sources say
- Not checked yetcites [93] Corless IB Lindgren T Holzemer W Marijuana effectiveness as an HIV self-care strategy Clin Nurs Res 2009 18 2 172 193 19377043
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Oral dronabinol achieved a modest reduction in pain intensity in MS and related conditions [100].”
§ The Analgesic Potential of Cannabinoids > Cannabinoids In Multiple sclerosis
What the sources say
- Not checked yetcites [100] Svendsen KB Jensen TS FW Bach FW Does the cannabinoid dronabinol reduce central pain in multiple sclerosis? Randomised double blind placebo controlled crossover trial BMJ 2004 329 7460 253 15258006 PMC498019
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Smoked marijuana appears to have a beneficial role in reducing neuropathic pain in HIV, and the studies discussing this are detailed below.”
§ The Analgesic Potential of Cannabinoids > Cannabinoids in HIV/AIDS
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
- Probably not a substantial claim. 14
- It may state two separate claims as one. 57
In the paper
“Marijuana use is followed by a disruption of short-term memory, cognitive impairment, a sense of slowing of time, mood alterations, enhanced body awareness, reduced ability to focus, incoordination, and sleepiness [9].”
§ The Analgesic Potential of Cannabinoids > Routes of cannabinoid use
What the sources say
- Not checked yetcites [9] Svizenska I Dubovy P Sulcova A Cannabinoid receptors 1 and 2 (CB1 and CB2), their distribution, ligands and functional involvement in nervous system structures–a short review Pharmacol Biochem Behav 2008 90 4 501 511 18584858
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“CB-2 receptor activation also inhibits adenylyl cyclase, but does not influence ion conductance [15].”
§ The Analgesic Potential of Cannabinoids > Cannabinoid receptors and signaling pathways
What the sources say
- Not checked yetcites [15] Howlett AC Breivogel CS Childers SR Cannabinoid physiology and pharmacology: 30 years of progress Neuropharmacology 2004 47 Suppl 1 345 358 15464149
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Importantly, this variability in cell signaling induced by cannabinoids in neuronal and non-neuronal cells suggests that the effect of cannabinoids will need to be examined for both their anti-nociceptive activity and the peripheral effect for individual pathological condition.”
§ The Analgesic Potential of Cannabinoids > Cannabinoid receptors and signaling pathways
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Clinical and experimental studies show that cannabis-derived compounds act as anti-emetic, appetite modulating and analgesic agents.”
§ The Analgesic Potential of Cannabinoids > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Smoking results in rapid absorption and onset of psychoactive effects, and is the preferred mode of recreational use.”
§ The Analgesic Potential of Cannabinoids > Routes of cannabinoid use
What the sources say
- Not checked yetcites [9] Svizenska I Dubovy P Sulcova A Cannabinoid receptors 1 and 2 (CB1 and CB2), their distribution, ligands and functional involvement in nervous system structures–a short review Pharmacol Biochem Behav 2008 90 4 501 511 18584858
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Cannabinoids mainly act via 2 different receptors: (i) the cannabinoid-1 (CB-1) receptor, predominantly expressed on the neurons; and (ii) the cannabinoid-2 (CB-2) receptor, predominantly expressed on cells of the immune system [9].”
§ The Analgesic Potential of Cannabinoids > Cannabinoid receptors and signaling pathways
What the sources say
- Not checked yetcites [9] Svizenska I Dubovy P Sulcova A Cannabinoid receptors 1 and 2 (CB1 and CB2), their distribution, ligands and functional involvement in nervous system structures–a short review Pharmacol Biochem Behav 2008 90 4 501 511 18584858
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“When Δ9-THC enters the bloodstream, it is metabolized to 11-hydroxy Δ9-THC, which is absorbed into the adipose tissue, where it stays for 30 minutes before being released back into circulation and reaching the brain. [2].”
§ The Analgesic Potential of Cannabinoids > Routes of cannabinoid use
What the sources say
- Not checked yetcites [2] Booth M Cannabis: A History Thomas Dunne Books 1 2004
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, it appears that the cannabinoid signaling is cell-specific and may also be dependent upon specific agonists used.”
§ The Analgesic Potential of Cannabinoids > Cannabinoid receptors and signaling pathways
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“In view of these side- effects and the decrease in analgesic efficacy over time [8], there is a need to explore alternative or adjunct medications to opioids in management of severe pain”
§ The Analgesic Potential of Cannabinoids > Introduction
What the sources say
- Not checked yetcites [8] Ballantyne JC Shin NS Efficacy of opioids for chronic pain: a review of the evidence Clin J Pain 2008 24 6 469 478 18574357
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
- Rests on an assumption: Opioids are the only analgesics for treating severe pain.
None of the sources cited for this claim have been checked yet.
In the paper
“Cannabinoids modulate both the cell proliferation as well as cell survival pathways, albeit sometimes effects may be opposite depending on the cell type”
§ The Analgesic Potential of Cannabinoids > Cannabinoid receptors and signaling pathways
What the sources say
- Not checked yetcites [18] Ozaita A Puighermanal E Maldonado R Regulation of PI3K/Akt/GSK-3 pathway by cannabinoids in the brain J Neurochem 2007 102 4 1105 1114 17484726
- Not checked yetcites [19] Molina-Holgado F Pinteaux E Heenan L Neuroprotective effects of the synthetic cannabinoid HU-210 in primary cortical neurons are mediated by phosphatidylinositol 3-kinase/AKT signaling Mol Cell Neurosci 2005 28 1 189 194 15607953
- Not checked yetcites [20] Lee YM Uhm KO Lee ES AM251 suppresses the viability of HepG2 cells through the AMPK (AMP-activated protein kinase)-JNK (c-Jun N-terminal kinase)-ATF3 (activating transcription factor 3) pathway Biochem Biophys Res Commun 2008 370 4 641 645 18406347
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the efficacy of individual products is variable and dependent upon the route of administration.”
§ The Analgesic Potential of Cannabinoids > Abstract
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear? Based: unclearIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover, cannabinoids act synergistically with opioids and act as opioid sparing agents, allowing lower doses and fewer side effects from chronic opioid therapy.”
§ The Analgesic Potential of Cannabinoids > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes? Based: unclearIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, cannabinoids appear to be effective in treating pain in MS, and would need to be further evaluated for their optimum use in MS.”
§ The Analgesic Potential of Cannabinoids > Cannabinoids In Multiple sclerosis
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Pretreatment with HU-210 also increased the antinociceptive effect of morphine injected into the periaqueductal gray and prevented the development of tolerance [53].”
§ The Analgesic Potential of Cannabinoids > Synergism with opioids > a) Experimental studies
What the sources say
- Not checked yetcites [53] Wilson AR Maher L MM Morgan MM Repeated cannabinoid injections into the rat periaqueductal gray enhance subsequent morphine antinociception Neuropharmacology 2008 55 7 1219 1225 18723035 PMC2743428
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Since, inflammatory pain is a hallmark of several chronic diseases including sickle cell disease and cancer, cannabinoids appear to be a promising therapy to treat severe pain in these diseases.”
§ The Analgesic Potential of Cannabinoids > Cannabinoids for analgesia – animal studies > b) Inflammatory pain
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Studies using smoked cannabis in HIV associated sensory neuropathy and other types of neuropathic pain have found that it offers clinically significant analgesia to a large number of subjects [112], [114, 115] but often with associated neurocognitive and psychoactive effects, especially at higher doses [115].”
§ The Analgesic Potential of Cannabinoids > Clinical studies with cannabinoids in pain
What the sources say
- Not checked yetcites [112] Ellis RJ Toperoff W Vaida F Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial Neuropsychopharmacology 2009 34 3 672 680 18688212 PMC3066045
- Not checked yetcites [114] Abrams DI Jay CA Shade SB Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial Neurology 2007 68 7 515 521 17296917
- Not checked yetcites [115] Wilsey B Marcotte T Tsodikov A A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain J Pain 2008 9 6 506 521 18403272 PMC4968043
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Δ9-THC (both by itself and in combination with morphine) has been shown to provide better anti-nociception in diabetic mice than in non-diabetic arthritic mice, and this has been correlated to the lower endogenous opioid levels in diabetic mice [63].”
§ The Analgesic Potential of Cannabinoids > Synergism with opioids > a) Experimental studies
What the sources say
- Not checked yetcites [63] Williams J Haller VL Stevens DL Decreased basal endogenous opioid levels in diabetic rodents: effects on morphine and delta-9-tetrahydrocannabinoid-induced antinociception Eur J Pharmacol 2008 584 1 78 86 18313663
Strength:boosted· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Conversely, cannabinoid withdrawal symptoms were decreased in double μ and κ opioid receptor knockout mice [66], suggesting a relationship between opioid and cannabinoid receptor activities.”
§ The Analgesic Potential of Cannabinoids > Synergism with opioids > a) Experimental studies
What the sources say
- Not checked yetcites [66] Castane A Robledo P Matifas A Cannabinoid withdrawal syndrome is reduced in double mu and delta opioid receptor knockout mice Eur J Neurosci 2003 17 1 155 159 12534979
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Many HIV infected patients smoke marijuana for a variety of reasons, including symptom relief and reducing symptom frequency; the users report improvement in appetite (97%), muscle pain (94%), nausea (93%), anxiety (93%), nerve pain (90%), depression (86%), and paraesthesia (85%).”
§ The Analgesic Potential of Cannabinoids > Cannabinoids in HIV/AIDS
What the sources say
- Not checked yetcites [92] Woolridge E Barton S Samuel J Cannabis use in HIV for pain and other medical symptoms J Pain Symptom Manage 2005 29 4 358 367 15857739
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“A 2 yr open label study as a follow up of this trial using Sativex® in 63 MS patients showed it to be effective in decreasing pain, however less than half of the subjects completed the trial [99].”
§ The Analgesic Potential of Cannabinoids > Cannabinoids In Multiple sclerosis
What the sources say
- Not checked yetcites [99] Rog DJ Nurmikko TJ Young CA Oromucosal delta9-tetrahydrocannabinol/cannabidiol for neuropathic pain associated with multiple sclerosis: an uncontrolled, open-label, 2-year extension trial Clin Ther 2007 29 9 2068 2079 18035205
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“A recent systematic review concluded that nabilone is superior to placebo, domperidone and prochlorperazine in the management of CINV, but not superior to metoclopramide and chlorpromazine [88].”
§ The Analgesic Potential of Cannabinoids > Cannabinoid as an Anti-emetic and Appetite stimulant
What the sources say
- Not checked yetcites [88] Davis MP Oral nabilone capsules in the treatment of chemotherapy-induced nausea and vomiting and pain Expert Opin Investig Drugs 2008 17 1 85 95 18095921
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Both CB-1 and CB-2 receptors appear to be involved in pain modulation, and selective agonists may be useful when the specific role of each receptor is fully characterized in each type of pain.”
§ The Analgesic Potential of Cannabinoids > Cannabinoids for analgesia – animal studies > c) Cancer pain
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“While many studies have shown dronabinol to improve mood, appetite and to decrease nausea in patients with AIDS or advanced cancer [90], a recent study comparing cannabis extracts (CE), Δ9-THC and placebo in patients with cancer related anorexia cachexia syndrome found no significant advantage of CE or Δ9-THC over placebo with regard to appetite, quality of life or toxicity [91].”
§ The Analgesic Potential of Cannabinoids > Cannabinoid as an Anti-emetic and Appetite stimulant
What the sources say
- Not checked yetcites [90] Kogan NM Mechoulam R Cannabinoids in health and disease Dialogues Clin Neurosci 2007 9 4 413 430 18286801 PMC3202504
- Not checked yetcites [91] Strasser F Luftner D Possinger K Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group J Clin Oncol 2006 24 21 3394 3400 16849753
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“However, ultra-low dose naltrexone has also been shown to enhance the anti-nociceptive action of WIN 55,212-2, while high dose naltrexone does not [60].”
§ The Analgesic Potential of Cannabinoids > Synergism with opioids > a) Experimental studies
What the sources say
- Not checked yetcites [60] Paquette J Olmstead MC Ultra-low dose naltrexone enhances cannabinoid-induced antinociception Behav Pharmacol 2005 16 8 597 603 16286810
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Also, CB1 receptor knockout mice appear to have lesser opioid addiction and withdrawal [65], suggesting a role for cannabinoid receptors in opioid signaling pathways.”
§ The Analgesic Potential of Cannabinoids > Synergism with opioids > a) Experimental studies
What the sources say
- Not checked yetcites [65] Ledent C Valverde O Cossu G Unresponsiveness to cannabinoids and reduced addictive effects of opiates in CB1 receptor knockout mice Science 1999 283 5400 401 404 9888857
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Marijuana offered slightly better overall relief then the prescription/OTC medications for a number of symptoms (including anxiety, depression, nausea, vomiting, diarrhea, neuropathy).”
§ The Analgesic Potential of Cannabinoids > Cannabinoids in HIV/AIDS
What the sources say
- Not checked yetcites [93] Corless IB Lindgren T Holzemer W Marijuana effectiveness as an HIV self-care strategy Clin Nurs Res 2009 18 2 172 193 19377043
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These studies suggest that different cannabinoids may offer pain relief in cancer by both systemic and peripheral routes, primarily via CB-1 receptors, and the route of administration may be tailored to the specific need.”
§ The Analgesic Potential of Cannabinoids > Cannabinoids for analgesia – animal studies > c) Cancer pain
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“It was found to decrease mean pain intensity and reduce sleep disturbance in MS [98].”
§ The Analgesic Potential of Cannabinoids > Cannabinoids In Multiple sclerosis
What the sources say
- Not checked yetcites [98] Rog DJ Nurmikko TJ Friede T Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis Neurology 2005 65 6 812 819 16186518
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The preclinical studies described above provide a rationale for further evaluation of cannabinoid receptor agonists in different types of pain.”
§ The Analgesic Potential of Cannabinoids > Cannabinoids for analgesia – animal studies > c) Cancer pain
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, in other conditions, the addition of a cannabinoid may confer no additional benefit, so the optimal therapy for pain management in specific conditions remains an area for future research.”
§ The Analgesic Potential of Cannabinoids > Synergism with opioids > b) Clinical studies
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Opioids and cannabinoids both provide antinociception through G-protein coupled mechanisms, and many studies have explored synergistic interactions between them.”
§ The Analgesic Potential of Cannabinoids > Synergism with opioids > a) Experimental studies
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Cannabinoids have a role in relieving pain, spasticity, tremor, nocturia and improving general well being in MS (Table 5).”
§ The Analgesic Potential of Cannabinoids > Cannabinoids In Multiple sclerosis
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A randomized controlled trial with 667 MS patients using oral Δ9-THC or a cannabis extract Cannador®; found subjective improvement in subjects’ self-reported sense of spasticity and pain, but no objective improvement in spasticity [95] by the Ashworth scale, [96].”
§ The Analgesic Potential of Cannabinoids > Cannabinoids In Multiple sclerosis
What the sources say
- Not checked yetcites [95] Zajicek J Fox P Sanders H Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial Lancet 2003 362 9395 1517 1526 14615106
- Not checked yetcites [96] Herndon RM Handbook of Neurological rating scales Demos Medical Publishing 2 2006
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Especially in cases of pain attributable wholly or partly to inflammation, it may be worthwhile to explore a local route of administering the cannabinoid and thus avoid systemic side effects.”
§ The Analgesic Potential of Cannabinoids > Cannabinoids for analgesia – animal studies > c) Cancer pain
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
In the paper
“Sativex® is an oromucosal spray containing Δ9-THC (27 mg/mL) and cannabidiol (CBD)(25 mg/mL), with a dosage of 100 μL/spray [97].”
§ The Analgesic Potential of Cannabinoids > Cannabinoids In Multiple sclerosis
What the sources say
- Not checked yetcites [97] Russo EB Guy GW PJ Robson PJ Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine Chem Biodivers 2007 4 8 1729 1743 17712817
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, adjunct use of cannabinoids may permit the use of lower doses of opioids than otherwise required, thus acting as an opioid sparing agent in similar situations.”
§ The Analgesic Potential of Cannabinoids > Synergism with opioids > b) Clinical studies
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Marijuana users reported better overall medication effectiveness than non-users, however it is unclear whether it is attributable to the euphoric effect of marijuana or a real synergism with the medications [93].”
§ The Analgesic Potential of Cannabinoids > Cannabinoids in HIV/AIDS
What the sources say
- Not checked yetcites [93] Corless IB Lindgren T Holzemer W Marijuana effectiveness as an HIV self-care strategy Clin Nurs Res 2009 18 2 172 193 19377043
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“CB-2 receptor activation by AM1241 causes the release of β-endorphin from keratinocytes, and the antinociceptive effect of AM1241 in rats is blocked by antagonism of the μ opiod receptor and by antiserum to β-endorphin [64].”
§ The Analgesic Potential of Cannabinoids > Synergism with opioids > a) Experimental studies
What the sources say
- Not checked yetcites [64] Ibrahim MM Porreca F Lai J CB2 cannabinoid receptor activation produces antinociception by stimulating peripheral release of endogenous opioids Proc Natl Acad Sci USA 2005 102 8 3093 3098 15705714 PMC549497
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“A case-control study showed no increase in risk of head and neck cancer with cannabis use [130].”
§ The Analgesic Potential of Cannabinoids > Side effects of cannabinoids
What the sources say
- Not checked yetcites [130] Aldington S Harwood M Cox B Cannabis use and cancer of the head and neck: case-control study Otolaryngol Head Neck Surg 2008 138 3 374 380 18312888 PMC2277494
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Studies regarding the use of cannabinoids for post-operative analgesia suggest that while cannabis extract Cannador® might potentially be beneficial [108], Δ9-THC offers no benefit and may actually provoke hyperalgesia [84], [109].”
§ The Analgesic Potential of Cannabinoids > Clinical studies with cannabinoids in pain
What the sources say
- Not checked yetcites [108] Holdcroft A Maze M Dore C A multicenter dose-escalation study of the analgesic and adverse effects of an oral cannabis extract (Cannador) for postoperative pain management Anesthesiology 2006 104 5 1040 1046 16645457
- Not checked yetcites [84] Beaulieu P Effects of nabilone, a synthetic cannabinoid, on postoperative pain Can J Anaesth 2006 53 8 769 775 16873343
- Not checked yetcites [109] Buggy DJ Toogood L Maric S Lack of analgesic efficacy of oral delta-9-tetrahydrocannabinol in postoperative pain Pain 2003 106 1–2 169 172 14581124
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Interestingly, studies in healthy human volunteers using oral cannabis extracts in acute pain models do not show any analgesic effect, but rather suggest a hyperalgesic action [85].”
§ The Analgesic Potential of Cannabinoids > Clinical studies with cannabinoids in pain
What the sources say
- Not checked yetcites [85] Kraft B Frickey NA Kaufmann RM Lack of analgesia by oral standardized cannabis extract on acute inflammatory pain and hyperalgesia in volunteers Anesthesiology 2008 109 1 101 110 18580179
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Some studies show higher lung cancer rates in marijuana smokers [131], [132], while some do not find any such association [133].”
§ The Analgesic Potential of Cannabinoids > Side effects of cannabinoids
What the sources say
- Not checked yetcites [131] Aldington S Harwood M Cox B Cannabis use and risk of lung cancer: a case-control study Eur Respir J 2008 31 2 280 286 18238947 PMC2516340
- Not checked yetcites [132] Voirin N Berthiller J Benhaim-Luzon V Risk of lung cancer and past use of cannabis in Tunisia J Thorac Oncol 2006 1 6 577 579 17409920
- Not checked yetcites [133] Hashibe M Morgenstern H Cui Y Marijuana use and the risk of lung and upper aerodigestive tract cancers: results of a population-based case-control study Cancer Epidemiol Biomarkers Prev 2006 15 10 1829 1834 17035389
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“A systematic review in 2001 of all randomized controlled trials done with cannabinoids in various types of pain concluded that in cancer pain, cannabinoids were of the same efficacy of codeine, while being associated with dose limiting CNS depressant effects [119].”
§ The Analgesic Potential of Cannabinoids > Clinical studies with cannabinoids in pain
What the sources say
- Not checked yetcites [119] Campbell FA Tramer MR Carroll D Are cannabinoids an effective and safe treatment option in the management of pain? A qualitative systematic review BMJ 2001 323 7303 13 16 11440935 PMC34324
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Sativex® and a THC predominant cannabis extract GW-2000-02 both offered significant analgesia in subjects with neuropathic pain from brachial plexus avulsion [113].”
§ The Analgesic Potential of Cannabinoids > Clinical studies with cannabinoids in pain
What the sources say
- Not checked yetcites [113] Berman JS Symonds C Birch R Efficacy of two cannabis based medicinal extracts for relief of central neuropathic pain from brachial plexus avulsion: results of a randomised controlled trial Pain 2004 112 3 299 306 15561385
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Pain in SCD is a result of vascular occlusion, tissue infarction and inflammation [121], and is widely prevalent and often undertreated [122].”
§ The Analgesic Potential of Cannabinoids > Can Cannabinoids be useful in Sickle cell disease?
What the sources say
- Not checked yetcites [121] Ballas SK Pain management of sickle cell disease Hematol Oncol Clin North Am 2005 19 5 785 802 16214644
- Not checked yetcites [122] Smith WR Penberthy LT Bovbjerg VE Daily assessment of pain in adults with sickle cell disease Ann Intern Med 2008 148 2 94 101 18195334
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“While cannabis use was not found to vary with the severity of the disease, 52% of the users said they used it to reduce or prevent acute or chronic pain; other reasons were to improve sleep, mood or to aid relaxation [120].”
§ The Analgesic Potential of Cannabinoids > Can Cannabinoids be useful in Sickle cell disease?
What the sources say
- Not checked yetcites [120] Howard J Anie KA Holdcroft A Cannabis use in sickle cell disease: a questionnaire study Br J Haematol 2005 131 1 123 128 16173972
Strength:plain· not yet calibratedn = 84Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Marijuana smoke has been shown to be mutagenic [135, 136], while THC by itself is not mutagenic [137, 138].”
§ The Analgesic Potential of Cannabinoids > Side effects of cannabinoids
What the sources say
- Not checked yetcites [135] Wehner FC van Rensburg SJ Thiel PG Mutagenicity of marijuana and Transkei tobacco smoke condensates in the Salmonella/microsome assay Mutat Res 1980 77 2 135 142 6990238
- Not checked yetcites [136] Busch FW Seid DA Wei ET Mutagenic activity of marihuana smoke condensates Cancer Lett 1979 6 6 319 324 378366
- Not checked yetcites [137] Van Went GF Mutagenicity testing of 3 hallucinogens: LSD, psilocybin and delta 9-THC, using the micronucleus test Experientia 1978 34 3 324 325 631257
- Not checked yetcites [138] Zimmerman AM Stich H San R Nonmutagenic action of cannabinoids in vitro Pharmacology 1978 16 6 333 343 353830
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“CB-2 receptor activation and CB-1 receptor inhibition has beneficial effects in cerebral ischemia [128], [129].”
§ The Analgesic Potential of Cannabinoids > Can Cannabinoids be useful in Sickle cell disease?
What the sources say
- Not checked yetcites [128] Hillard CJ Role of cannabinoids and endocannabinoids in cerebral ischemia Curr Pharm Des 2008 14 23 2347 2361 18781985 PMC2581413
- Not checked yetcites [129] Zhang M Martin BR Adler MW Modulation of cannabinoid receptor activation as a neuroprotective strategy for EAE and stroke J Neuroimmune Pharmacol 2009 4 2 249 259 19255856 PMC2855650
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“As an adjuvant drug added to opioids, it also improved pain control and the quality of sleep in patients with chronic non-cancer pain [107].”
§ The Analgesic Potential of Cannabinoids > Clinical studies with cannabinoids in pain
What the sources say
- Not checked yetcites [107] Narang S Gibson D Wasan AD Efficacy of dronabinol as an adjuvant treatment for chronic pain patients on opioid therapy J Pain 2008 9 3 254 264 18088560
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“CB-2 receptor activation by JWH-133 has been found to protect from cardiac ischemia reperfusion injury [126], [127] and may help in SCD as well.”
§ The Analgesic Potential of Cannabinoids > Can Cannabinoids be useful in Sickle cell disease?
What the sources say
- Not checked yetcites [126] Montecucco F Lenglet S Braunersreuther V CB(2) cannabinoid receptor activation is cardioprotective in a mouse model of ischemia/reperfusion J Mol Cell Cardiol 2009 46 5 612 620 19162037
- Not checked yetcites [127] Defer N Wan J Souktani R The cannabinoid receptor type 2 promotes cardiac myocyte and fibroblast survival and protects against ischemia/reperfusion-induced cardiomyopathy FASEB J 2009 23 7 2120 2130 19246487
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“However, a study comparing escalating daily doses of nabilone (maximum 2 mg) and dihydrocodeine (maximum 240mg) in patients with severe neuropathic pain found dihydrocodeine to offer clinically significant pain relief to more patients than nabilone; interestingly, no subject responded to both agents [117].”
§ The Analgesic Potential of Cannabinoids > Clinical studies with cannabinoids in pain
What the sources say
- Not checked yetcites [117] Frank B Serpell MG Hughes J Comparison of analgesic effects and patient tolerability of nabilone and dihydrocodeine for chronic neuropathic pain: randomised, crossover, double blind study BMJ 2008 336 7637 199 201 18182416 PMC2213874
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“A recent review of the clinical trials conducted with Sativex® and other cannabis extracts in various types of pain observed a benefit in a range of conditions, including MS, cancer, irritative urinary symptoms, neuropathy, peripheral nerve injury and spinal cord injury. The only condition where benefit was not noted was post-herpetic neuralgia [97].”
§ The Analgesic Potential of Cannabinoids > Clinical studies with cannabinoids in pain
What the sources say
- Not checked yetcites [97] Russo EB Guy GW PJ Robson PJ Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine Chem Biodivers 2007 4 8 1729 1743 17712817
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cannabinoids could possibly be used as adjunct agents along with opioids to decrease opioid dose and achieve better pain control.”
§ The Analgesic Potential of Cannabinoids > Can Cannabinoids be useful in Sickle cell disease?
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Cannabinoids, endocannabinoids and non-cannabinoid derivatives of the cannabis plant have also been found to have anti-inflammatory properties [124], which may be helpful in SCD.”
§ The Analgesic Potential of Cannabinoids > Can Cannabinoids be useful in Sickle cell disease?
What the sources say
- Not checked yetcites [124] Burstein SH Zurier RB Cannabinoids, endocannabinoids, and related analogs in inflammation AAPS J 2009 11 1 109 119 19199042 PMC2664885
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cannabinoids are commonly used to control nausea and vomiting in other settings, and could be potentially beneficial in this scenario as well.”
§ The Analgesic Potential of Cannabinoids > Can Cannabinoids be useful in Sickle cell disease?
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: Cannabinoids are commonly used to control nausea and vomiting in other settings.
In the paper
“Sativex® was found to offer significant pain relief, as well as improvement in sleep and allodynia in neuropathic pain of various etiologies [116].”
§ The Analgesic Potential of Cannabinoids > Clinical studies with cannabinoids in pain
What the sources say
- Not checked yetcites [116] Nurmikko TJ Serpell MG Hoggart B Sativex successfully treats neuropathic pain characterised by allodynia: a randomised, double-blind, placebo-controlled clinical trial Pain 2007 133 1–3 210 220 17997224
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Δ9-THC has analgesic and other beneficial effects in fibromyalgia and rheumatoid arthritis as well [110], [111].”
§ The Analgesic Potential of Cannabinoids > Clinical studies with cannabinoids in pain
What the sources say
- Not checked yetcites [110] Skrabek RQ Galimova L Ethans K Nabilone for the treatment of pain in fibromyalgia J Pain 2008 9 2 164 173 17974490
- Not checked yetcites [111] Blake DR Robson P Ho M Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis Rheumatology (Oxford) 2006 45 1 50 52 16282192
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It appears that past conflicting epidemiological data regarding association of marijuana smoking and cancer may not necessarily apply to Δ9–THC and other cannabis derivatives during therapeutic use via a non-inhalational route; however, caution may still be exercised while awaiting conclusive data.”
§ The Analgesic Potential of Cannabinoids > Side effects of cannabinoids
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“In contrast, THC was found to increase apoptosis and improve survival in murine cancer models and in human lymphoma and leukemia [141].”
§ The Analgesic Potential of Cannabinoids > Side effects of cannabinoids
What the sources say
- Not checked yetcites [141] McKallip RJ Lombard C Fisher M Targeting CB2 cannabinoid receptors as a novel therapy to treat malignant lymphoblastic disease Blood 2002 100 2 627 634 12091357
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Moreover, the cannabinoid HU-331 is anti-angiogenic in vivo and vitro, suggestive of an inhibitory effect on cancer progression [142].”
§ The Analgesic Potential of Cannabinoids > Side effects of cannabinoids
What the sources say
- Not checked yetcites [142] Kogan NM Blazquez C Alvarez L A cannabinoid quinone inhibits angiogenesis by targeting vascular endothelial cells Mol Pharmacol 2006 70 1 51 59 16571653
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“It appears that cannabinoids may have two opposite effects on cancer: tumor regression via promotion of apoptosis, and tumor promotion via suppression of immunogenicity [13].”
§ The Analgesic Potential of Cannabinoids > Side effects of cannabinoids
What the sources say
- Not checked yetcites [13] Guzman M Sanchez C Galve-Roperh I Control of the cell survival/death decision by cannabinoids J Mol Med 2001 78 11 613 625 11269508
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The legalization of medical marijuana would also enable more clinical trials in humans, and development of cannabis-derived drugs for multiple disease processes, in addition to treating severe pain.”
§ The Analgesic Potential of Cannabinoids > Conclusion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- Rests on an assumption: Legal barriers are a principal obstacle to conducting clinical trials of medical marijuana.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The legalization of medical marijuana would also enable more clinical trials in humans, and development of cannabis-derived drugs for multiple disease processes, in addition to treating severe pain.”
§ The Analgesic Potential of Cannabinoids > Conclusion
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
- Rests on an assumption: Legal barriers are a principal obstacle to conducting clinical trials of medical marijuana.
In the paper
“WIN-55,212-2 and other cannabinoid agonists have been suggested as potential therapeutic options in prostate cancer [144].”
§ The Analgesic Potential of Cannabinoids > Side effects of cannabinoids
What the sources say
- Not checked yetcites [144] Sarfaraz S Afaq F Adhami VM Cannabinoid receptor as a novel target for the treatment of prostate cancer Cancer Res 2005 65 5 1635 1641 15753356
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
Opioids are the only analgesics for treating severe pain.
“Currently, opioids are the only analgesics for treating severe pain.”
The paper relies on this without support.
Cannabinoids are commonly used to control nausea and vomiting in other settings.
“Cannabinoids are commonly used to control nausea and vomiting in other settings, and could be potentially beneficial in this scenario as well.”
The paper relies on this without support.
Findings from animal and preclinical studies of cannabinoids will translate into therapeutic effects in humans.
“Currently there is intriguing evidence from animal studies showing efficacy of cannabinoids as antinociceptive agents, however data from human studies is still emerging.”
The paper relies on this without support.
Legal barriers are a principal obstacle to conducting clinical trials of medical marijuana.
“The legalization of medical marijuana would also enable more clinical trials in humans”
The paper relies on this without support.
Low doses of cannabinoids are incapable of inducing hyperalgesia or other side effects.
“especially in low doses incapable of inducing hyperalgesia or other side effects”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“and supports a growing body of previous work in numerous contexts demonstrating the considerable potential of the endocannabinoid system as a target for the development of new therapies to alleviate pain [14,17].”
From Endocannabinoid involvement in endometriosis. (2010) · cites this paper as [14]
In the citing paper
“Although mechanisms by which the endocannabinoid system and exogenous cannabinoid agents act to influence pain are under intense study [14,17], little is known in the specific context of endometriosis-associated pain.”
From Endocannabinoid involvement in endometriosis. (2010) · cites this paper as [14]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rimonabant is assigned conflicting receptor targets
MinorThe text calls rimonabant a CB-2 antagonist, while its cited reference calls it a CB1 receptor antagonist.
“However, CB-2 antagonist rimonabant induces G1/S arrest and inhibits cell proliferation in breast cancer cells, though apoptosis or necrosis is not observed [27].”
“27. Sarnataro D Pisanti S Santoro A The cannabinoid CB1 receptor antagonist rimonabant (SR141716) inhibits human breast cancer cell proliferation through a lipid raft-mediated mechanism”
Diabetic neuropathy study changes mice to rats
MinorThe text describes the animals in the cited WIN-55212-2 study as diabetic rats, but the reference identifies them as diabetic mice.
“Mechanical allodynia developing in diabetic rats also responds to WIN-55212-2 administration [40]”
“40. Dogrul A Gul H Yildiz O Cannabinoids blocks tactile allodynia in diabetic mice without attenuation of its antinociceptive effect”
Opioid knockout pair differs from cited reference
MinorThe text says the knockout mice lacked μ and κ opioid receptors; the cited reference says they lacked μ and delta receptors.
“Conversely, cannabinoid withdrawal symptoms were decreased in double μ and κ opioid receptor knockout mice [66]”
“66. Castane A Robledo P Matifas A Cannabinoid withdrawal syndrome is reduced in double mu and delta opioid receptor knockout mice”
Adjuvant pain study names different cannabinoid drug
MinorFollowing a sentence about nabilone, the text says it improved pain control as an opioid adjuvant and cites reference 107. That reference identifies the adjuvant drug as dronabinol.
“In cancer patients, nabilone provided multi-symptom relief, including pain relief, as compared to patients who did not receive nabilone [106]. As an adjuvant drug added to opioids, it also improved pain control and the quality of sleep in patients with chronic non-cancer pain [107].”
“107. Narang S Gibson D Wasan AD Efficacy of dronabinol as an adjuvant treatment for chronic pain patients on opioid therapy”
Inflammatory-pain study changes rats to mice
MinorThe text attributes the systemic-treatment finding to mouse hindpaws, whereas the cited study identifies its inflammatory-pain model as a rat model.
“Inflammatory pain and swelling in mouse hindpaw were relieved by systemic administration of both non-selective HU-210 and CB-2 selective JWH-133 [31]”
“31. Elmes SJ Winyard LA Medhurst SJ Activation of CB1 and CB2 receptors attenuates the induction and maintenance of inflammatory pain in the rat”
Citations
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Endocannabinoid-Mediated Control of Synaptic Transmission
Kano, M., Ohno‐Shosaku, T., Hashimotodani, Y., Uchigashima, M., & Watanabe, M. (2009) · Physiological Reviews · doi:10.1152/physrev.00019.2008 · Cited by 1,595
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Cannabinoid CB2 receptors: immunohistochemical localization in rat brain
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Opioids and the control of respiration
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Development and preliminary validation of a pain measure specific to neuropathic pain
Galer, B. S., & Jensen, M. (1997) · Neurology · doi:10.1212/wnl.48.2.332 · Cited by 778
Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis
Rog, D. J., Nurmikko, T. J., Friede, T., & Young, C. A. (2005) · Neurology · doi:10.1212/01.wnl.0000176753.45410.8b · Cited by 679
The Numeric Rating Scale for Clinical Pain Measurement: A Ratio Measure?
Hartrick, C. T., Kovan, J. P., & Shapiro, S. (2003) · Pain Practice · doi:10.1111/j.1530-7085.2003.03034.x · Cited by 677
Daily Assessment of Pain in Adults with Sickle Cell Disease
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Marijuana Effectiveness as an HIV Self-Care Strategy
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- [12]Demuth DG Molleman A Cannabinoid signalling Life Sci 2006 78 6 549 563 16109430
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Crane, N. A., Schuster, R. M., Fusar‐Poli, P., & González, R. (2012) · Neuropsychology Review · doi:10.1007/s11065-012-9222-1 · Cited by 330
Blurred Boundaries: The Therapeutics and Politics of Medical Marijuana
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Abrams, D., & Guzmán, M. (2015) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt.108 · Cited by 217
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Self-citationSubstitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep
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Metadata
- Authors
- Elikottil, M., Gupta, M., & Gupta, P.
- Venue
- Journal of Opioid Management
- Publisher
- Weston Medical Publishing
- Published
- 2018-01-29
- Volume
- 5
- Issue
- 6
- Pages
- 341-357
- ISSN
- 1551-7489 (ISSN-L)
- PMC
- PMC3728280
- OpenAlex
- W175893313
- Semantic Scholar
- 71bb33feff23eaab6ccf3997854dfefa6ee79e04
- Cited by
- 141
- References
- 153
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 7 · 2023: 10 · 2022: 16 · 2021: 16 · 2020: 13 · 2019: 14 · 2018: 11
- FWCI
- 8.71
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Opioid Management (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL-68802, R01HL068802)
- National Cancer Institute (R01CA109582, CA109582)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Keywords
- cannabinoids, analgesia, opioid sparing, opioid synergy, chronic pain, antiemetic effect, route of administration
- MeSH terms
- Analgesics, Analgesics, Opioid, Animals, Antiemetics, Cannabinoids, Chronic Disease, Drug Therapy, Combination, Humans, Pain, Pain Measurement, Severity of Illness Index, Signal Transduction, Treatment Outcome, Appetite Stimulants, Receptors, Cannabinoid
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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