吸入大麻已显示可减轻慢性疼痛，但是其麻醉作用目前存在临床局限性。几项研究支持流行的观点，即CBD（大麻二酚）可以降低THC（反式-Δ⁹-四氢大麻酚）的主观效果，但其他多项研究表明，CBD实际上可以增强THC的中毒作用。这些差异取决于两种大麻素的比例和浓度。我们假设大多数具有THC和CBD的医用大麻产品具有与休闲产品类似的能够产生严重急性中毒的比率。这项研究随后旨在表征可从药店获得的大麻产品的比例和浓度类别，并评估标记为娱乐的产品的可能效果与标记为医疗的产品是否可能不同，以确定其对慢性疼痛的潜在效用。我们从九个州（CA，CO，ME，MA，MA，NH，NM，RI，VT，WA）的653个药房在线提供的大麻产品中收集了THC和CBD含量。总共记录了8,505种草药大麻产品，其中6,293种提供了有关CBD含量的信息。含有CBD的产品（> 0％）的72.8％分为四类具有临床意义的类别：CBD可以增强THC效果（THC：CBD比率≥1：1），CBD对THC效果无显着影响（比率约为1：2） ，CBD可能没有作用或对THC的影响具有保护作用（比率1：> 2 <6），或者CBD对THC的作用具有保护作用（比率≤1：6）。根据我们的假设，具有CBD的大多数医疗和休闲产品均列在首位（例如66.7％的医疗产品和67.7％的CO休闲产品），其中CBD可能会增强THC效果；可能提供CBD缓解THC效应的产品类别最少（例如，6.7％的医疗产品和9.2％的CO休闲娱乐产品）。因此，寻求具有CBD含量以治疗慢性疼痛的医用大麻的患者存在放大THC急性影响的巨大风险。麻醉科-维克森林医学院基金。因此，寻求具有CBD含量以治疗慢性疼痛的医用大麻的患者存在放大THC急性影响的巨大风险。麻醉科-维克森林医学院基金。因此，寻求具有CBD含量以治疗慢性疼痛的医用大麻的患者存在放大THC急性影响的巨大风险。麻醉科-维克森林医学院基金。
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CBD and THC: Does the market reflect therapeutic dosing?
Inhaled cannabis has been shown to reduce chronic pain, however its intoxicating effects present a clinical limitation. Several studies support the popular notion that CBD (cannabidiol) can reduce THC (trans-Δ⁹-tetrahydrocannabinol) subjective effects, yet multiple other studies demonstrate that CBD can actually enhance THC's intoxicating effects. These discrepancies are dependent upon the two cannabinoids’ ratios and concentrations. We hypothesize that the majority of medical cannabis products with THC and CBD will have ratios capable of producing significant acute intoxication, similar to recreational products. This study subsequently aims to characterize cannabis products available from dispensaries within ratio and concentration categories, and evaluate whether the probable effects of products labeled as recreational differ from those labeled as medical to determine their potential utility for chronic pain. We collected THC and CBD content from cannabis products offered by 653 dispensaries online from nine states (CA, CO, ME, MA, NH, NM, RI, VT, WA). A total of 8,505 herbal cannabis products were recorded, with 6,293 offering information on CBD content. The 72.8% of products containing CBD (>0%) fall into four clinically meaningful categories: CBD can enhance THC effects (THC:CBD ratios ≥ 1:1), CBD has no significant effect on THC effects (ratios ∼1:2), CBD can either have no effect or is protective against THC effects (ratios 1: >2<6), or CBD is protective against THC effects (ratios ≤ 1:6). In line with our hypothesis, the majority of both medical and recreational products with CBD fall into the foremost listed category (e.g., 66.7% medical, and 67.7% recreational in CO), with CBD likely potentiating THC effects; and products likely to provide CBD mitigation of THC effects make up the smallest category (e.g., 6.7% medical, and 9.2% recreational in CO). Patients seeking medical cannabis with CBD content for chronic pain are therefore at substantial risk of amplifying THC acute effects. Department of Anesthesiology - Wake Forest School of Medicine Funds.
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