Cannabis, also known as marijuana, has historically generated endless controversies, mainly due to its recreational use and the psychoactive effects it entails. However, it is increasingly common to recognize its potential in the field of medicine, especially in neurorehabilitation. But what is cannabis and how can it benefit those who require it in the field of neurorehabilitation? Let’s see.
What is Cannabis?
Cannabis is a plant from which more than 100 chemical compounds called cannabinoids are extracted. The two best known are delta-9-tetrahydrocannabinol (THC), responsible for its psychoactive effects, and cannabidiol (CBD), a non-psychoactive compound that has aroused interest in the scientific community for its medicinal properties (Pertwee, 2015).
Cannabis and Neurorehabilitation: a Scientific Approach
Neurorehabilitation is a clinical process aimed at minimizing and compensating for cognitive, motor, and emotional functions affected by neurological diseases. The endocannabinoid system, a signaling system in our body that interacts with cannabinoids, has been shown to play a crucial role in modulating these functions (Lu & Mackie, 2016).
In fact, a growing amount of scientific research supports the use of cannabis in neurorehabilitation. In particular, CBD has been highlighted for its neuroprotective and anti-inflammatory potential, suggesting that it may be beneficial in the treatment of neurodegenerative diseases (Fernández-Ruiz et al., 2013). In addition, CBD has been observed to improve the quality of life of people with multiple sclerosis by relieving muscle spasms and fatigue (Pellati et al., 2018).
A study in the Journal of Neurology, Neurosurgery, and Psychiatry (Wade et al., 2003) showed that medicinal cannabis could relieve the symptoms of spasticity in patients with multiple sclerosis. In addition, THC has been shown to help reduce neuropathic pain, another common symptom in these conditions (Jensen et al., 2015).
Approved Medications
El cannabis ha sido ampliamente estudiado en neurología gracias a sus compuestos activos, como el THC y el CBD, que interactúan con el sistema endocannabinoide. Este sistema regula funciones como el estado de ánimo, el dolor, el apetito y la memoria.
Areas of Application:
Epilepsia: El CBD ha demostrado reducir convulsiones en epilepsias graves como el síndrome de Lennox-Gastaut y el síndrome de Dravet. En 2018, la FDA aprobó Epidiolex, un fármaco a base de CBD. Puede causar efectos secundarios como fatiga y alteraciones hepáticas.
Esclerosis múltiple: El spray oral Sativex, aprobado por la FDA, combina THC y CBD y ayuda a aliviar el dolor y los espasmos musculares. Puede provocar somnolencia, mareos y fatiga.
Parkinson y Alzheimer: Estudios preliminares indican posibles efectos neuroprotectores del cannabis, ayudando a controlar síntomas como rigidez, temblores, agitación o agresividad. Aún se requieren más investigaciones para confirmar su eficacia.
Dolor neuropático: El cannabis puede aliviar dolores crónicos resistentes, incluyendo el neuropático. Nabilona(Cesamet y Canemes) se prescribe para náuseas por quimioterapia, pero también se usa para dolor difícil de tratar.
Estos tratamientos están autorizados en varios países, como Estados Unidos, Canadá, España, Reino Unido, Francia, Alemania, Italia, Austria y Polonia.
Side Effects of Cannabis Use
Despite the growing evidence of the potential benefits of cannabis in neurorehabilitation, there are also concerns about its side effects and the lack of standardization in dosage and administration. It is important to emphasize that any medicinal use of cannabis must be supervised by a doctor.
Side effects vary depending on the frequency of use, the amount consumed, the form of consumption (e.g., smoking, vaporizing, or ingesting), and the individual characteristics of the person. Immediate effects can produce:
- Alterations in short-term memory and difficulties learning.
- Problems with coordination and perception, which can interfere with motor skills and driving.
- Psychedelic effects, such as hallucinations and paranoia.
- Anxiety or panic.
- Increased heart rate.
En Cuanto a Los Efectos a Largo Plazo:
- Cognitive problems: Regular and long-term cannabis use can affect cognitive functions, especially if use begins during adolescence, when the brain is still developing. These problems may include difficulties with memory, attention, and academic or work performance.
- Mental health: There is evidence that cannabis use may be associated with an increased risk of developing mental health disorders, such as schizophrenia, depression, and anxiety, especially in people with a genetic predisposition.
- Dependence: Although not common, some people may develop a cannabis use disorder, which is characterized by the inability to stop using the drug despite its negative consequences.
- Respiratory problems: Like tobacco, smoking cannabis can lead to lung diseases such as bronchitis and an increased risk of lung infections.
- Cardiovascular problems: Cannabis use increases heart rate and may increase the risk of heart disease in susceptible people.
It is essential that more research be carried out in this field. Current studies tend to be small-scale, and many of the claims about the medicinal benefits of cannabis come from studies in animals or in vitro tests. We need more large-scale research in humans to fully understand the benefits and risks of using cannabis in neurorehabilitation. A deeper analysis will allow us to determine how to effectively use these substances for the benefit of patients, while avoiding possible adverse effects.
Legislative Advances and Their Impact
En la última década, varios países han modificado sus leyes para permitir el uso medicinal del cannabis bajo supervisión médica.
Este cambio legal ha impulsado la investigación científica sobre los efectos terapéuticos del cannabis, especialmente en el área de la neurorrehabilitación.
En Canadá, donde el cannabis es legal para uso recreativo y medicinal, se realizan múltiples ensayos clínicos en enfermedades neurológicas (Kahan et al., 2014).
Las reformas legislativas han facilitado el acceso a estudios controlados que analizan el potencial terapéutico del cannabis en pacientes con daño neurológico.
Gracias a estos avances, se profundiza en la comprensión de cómo el cannabis puede beneficiar la recuperación neurológica en distintos contextos clínicos.
Conclusion
El cannabis es una planta milenaria con una composición química compleja y un creciente interés en el campo de la neurorrehabilitación.
Diversos estudios sugieren que puede ser útil en el tratamiento de enfermedades neurológicas, aunque aún quedan retos por resolver.
Entre los desafíos destacan la estandarización de dosis y la reducción de efectos adversos asociados a su uso.
Las investigaciones actuales indican que el cannabis podría convertirse en un aliado terapéutico relevante para mejorar la calidad de vida en pacientes neurológicos.
Es fundamental que los pacientes consulten a un médico antes de iniciar cualquier tratamiento con cannabis, incluso si es de origen natural.
Con más estudios a gran escala, el cannabis medicinal podría ocupar un papel más importante en la neurorrehabilitación del futuro.
Antes estigmatizado, el cannabis está ganando reconocimiento en la medicina por sus posibles beneficios neurológicos y terapéuticos.
La ciencia sigue revelando cómo los compuestos del cannabis pueden influir positivamente en el bienestar de personas con daño neurológico.
