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Cannabis as a potential pain control in sickle cell disease (SCD)

Cannabis as a potential pain control modality in sickle cell disease (SCD)

Sickle cell disease (SCD) poses unique challenges for pain management, driven by both complex biological factors and societal issues. The reliance on opioids has led to concerns about adverse effects and stigmatisation. As cannabis gains legal status in the United States, Europe and other regions, patients with SCD are increasingly turning to this alternative for pain control. This article explores the risks and benefits associated with cannabis use in managing SCD-related pain.

The opioid dilemma

For a long time, the main option for treating pain related to SCD has been opioids. Nonetheless, the seek for substitute methods is growing due to their link with negative consequences, intolerance, and stigmatisation. It is critical to look into alternative pain management options in light of recent findings showing inappropriate dose and increased stigmatisation of SCD patients obtaining opioids.

Cannabis is becoming legal in more places for both medical and recreational use, and people with sickle cell disease are looking at this possibility. Currently, recreational cannabis use is legal in 20 states, involving 45.7% of the population. Howeverm medical cannabis use is lawful in 37 states, comprising 72% of the US population. Researchers now have the chance to examine the possible benefits and drawbacks of cannabis use in the setting of sickle cell disease.

Exploring the benefits of cannabis treatment

Numerous research points to cannabis’s possible advantages in reducing pain related to sickle cell disease. Nonetheless, careful evaluation of the advantages and disadvantages of cannabis use is necessary before accepting it as a suitable substitute. Studies linking previous cannabis use to bone avascular necrosis illustrate the complex biology of sickle cell disease (SCD), which researchers must traverse.

Regarding cannabis’s effect on sickle cell disease patients’ use of healthcare, there is conflicting data. Research on hospitalizations and ER visits seem to be declining, but research on hospitalizations for vaso-occlusive crises—especially those involving inhalation or smoking—show an increase. To completely understand the impact of cannabis on pain crises and associated side events, prospective and randomised controlled trials are essential.

Up to 50% of SCD patients go through transfusion due to pain crises, making it essential to evaluate how cannabis use may influence healthcare visits. Given potential hazards, including alloimmunization, transfusion for pain crises is not advised in the absence of other grounds.

Concerns regarding cannabis’s possible immunomodulatory properties and its effect on SCD biology are raised. During vaso-occlusive crises, cannabis’s anti-inflammatory qualities can reduce inflammatory reactions. Further research is needed to fully understand the intricate interactions between cannabis, SCD biology, and pain pathways.

Overcoming stigmas

While opioid dependence remains a health emergency, stigmatisation surrounding cannabis use persists. Outdated opinions hinder access for SCD patients seeking alternative pain management. By exploring alternative administration routes and dispelling unfounded myths, cannabis could offer a novel intervention for SCD-related pain.

In the evolving landscape of pain management for SCD, cannabis emerges as a potential frontier. However, advocating for or against its use requires a nuanced understanding of the risks and benefits. Thorough research is essential, considering the unique biology of SCD and the potential impact of cannabis on health. As recreational marijuana use continues to rise, it is imperative to unravel the impact of these substances on outcomes in patients with SCD.


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