Keywords
hospices
narcotic painkillers
non-narcotic painkillers
PTSD
How to Cite
Abstract
One of the ways to solve the problem of pain relief for palliative patients in Ukraine is to expand the arsenal of painkillers through the use of medical cannabis. In many palliative diseases, cannabis is able to alleviate other symptoms that accompany patients with incurable diseases at the end of their lives: nausea, lack of appetite, seizures, anxiety, depression. The procedure for the legalization of medical cannabis in Ukraine is coming to an end, which is a timely decision of the legislators and the government. Before the full-scale medical cannabis war, 2.3 million patients were needed. Since its inception, this need has increased to 5.5–6 million. The Ukrainian agricultural market and the pharmaceutical industry will eventually be able not only to provide the country with the necessary amount of plant raw materials for the production of medicines and other cannabis products, but also to earn profits from exports, providing part of the growing demand for cannabis in Europe in other countries of the world. But this will require good conditions for investors and a consistent state policy in the adoption of by-laws and the practical implementation of already adopted laws. The medical effects of herbal cannabis and preparations containing it depend on the content of the narcotic TetraHydroCannabiol (THC) and the non-narcotic CanaBiDiol (CBD). Consumer preferences for recreational cannabis are gradually flooding the market with high-THC, low-CBD herbal cannabis, which increases the risk of faster addiction, the frequency and severity of cannabis side effects such as psychotic disorders and cardiovascular crises. Ukraine needs to be prepared for the increase in the use of illicit recreational cannabis along with the increase in the use of medical cannabis, including among children and adolescents, and to counter these phenomena. But even despite these risks, significant positive medical and social consequences can be expected from the legalization of medical cannabis for palliative patients and war victims with post-traumatic stress disorders.
Keywords: chronic pain, hospices, narcotic painkillers, non-narcotic painkillers, PTSD.
Archived: https://doi.org/10.5281/zenodo.12690535
References
Holovanova IA, Shevchenko AS. Determination of the main needs of palliative patients and ways of their provision in the healthcare system of Ukraine. Experimental and Clinical Medicine. 2021;90(3):88-94. DOI: 10.35339/ekm.2021.90.3.hos.
Lekhan VM. Retrospective analysis of the construction of the national system of hospice and palliative care in Great Britain. Inter Collegas. 2024;11(1):5p. In press. DOI: 10.35339/ic.11.1.lvm.
Nesterenko VG. On the procedure for providing palliative and hospice care in Ukraine. Medicine Today and Tomorrow. 2021;90(2):57-62. DOI: 10.35339/msz.2021.90.2.nes. [In Ukrainian].
United Nations Office on Drugs and Crime. World Drug Report, 2015. Vienna: UNODC; 2015. 162 p. Available at: https://www.unodc.org/documents/wdr2015/World_Drug_Report_2015.pdf
Draft Law on Regulation of the Circulation of Cannabis Plants for Medical, Industrial Purposes, Scientific and Scientific-Technical Activities to Create Conditions for Expanding Patients' Access to Necessary Treatment of Oncological Diseases and Post-Traumatic Stress Disorders Acquired as a Result of War. Verkhovna Rada (Parliament) of Ukraine. Bills. Available at: https://itd.rada.gov.ua/billInfo/Bills/Card/39783 [Accessed 20 Mar 2024]. [In Ukrainian].
Marchuk S. Prospects of the medical cannabis market for entrepreneurs. Legal Company "Main Business Partner", 13 Nov 2023 [Internet]. Available at: http://surl.li/nbwlgs [accessed 20 Mar 2024]. [In Ukrainian].
Murillo-Rodríguez E (ed.). The Endocannabinoid System. USA: Academic Press (Elsevier); 2017. DOI: 10.1016/B978-0-12-809666-6.01001-7.
de Melo Reis RA, Isaac AR, Freitas HR, de Almeida MM, Schuck PF, Ferreira GC, et al. Quality of Life and a Surveillant Endocannabinoid System. Front Neurosci. 2021;15:747229. DOI: 10.3389/fnins.2021.747229. PMID: 34776851.
Di Forti M, Marconi A, Carra E, Fraietta S, Trotta A, Bonomo M, et al. Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. Lancet Psychiatry. 2015;2(3):233-8. DOI: 10.1016/S2215-0366(14)00117-5. PMID: 26359901.
Cascini F, Aiello C, Di Tanna G. Increasing delta-9-tetrahydrocannabinol (Δ-9-THC) content in herbal cannabis over time: systematic review and meta-analysis. Curr Drug Abuse Rev. 2012;5(1):32-40. DOI: 10.2174/1874473711205010032. PMID: 22150622.
Jansen AM (ref.). The economics of cannabis cultivation in Europe. Phenomenon of "import substitution". Proceedings of the 2nd European Conference on Drug Trafficking and Law Enforcement (Paris, 26–27 Sep 2002). Available at: www.cedro-uva.org/lib/jansen.economics.html
Rigter S, Niesink R. THC-concentraties in wiet, nederwiet en hasj in Nederlandsecoffeeshop, 2013–2014 [THC concentrations in weed, Dutch weed and hashish in Dutch’s coffee shop]. Utrecht: Netherlands Institute of Mental Health and Addiction (Trimbos Institut); 2014. [In Dutch].
Knight G, Hansen S, Connor M, Poulsen H, McGovern C, Stacey J. The results of an experimental indoor hydroponic Cannabis growing study, using the 'Screen of Green' (ScrOG) method-Yield, tetrahydrocannabinol (THC) and DNA analysis. Forensic Sci Int. 2010;202(1-3):36-44. DOI: 10.1016/j.forsciint.2010.04.022. PMID: 20462712.
Mehmedic Z, Chandra S, Slade D, Denham H, Foster S, Patel AS, et al. Potency trends of Δ9-THC and other cannabinoids in confiscated cannabis preparations from 1993 to 2008. J Forensic Sci. 2010;55(5):1209-17. DOI: 10.1111/j.1556-4029.2010.01441.x. PMID: 20487147.
The impact of war on mental health is enormous (Victor Lyashko). Ministry of Health of Ukraine, 7 Jun 2022 [Internet]. Available at: http://surl.li/cmhhyk [accessed 20 Mar 2024]. [In Ukrainian].
Wang L, Hong PJ, May C, Rehman Y, Oparin Y, Hong CJ, et al. Medical cannabis or cannabinoids for chronic non-cancer and cancer related pain: a systematic review and meta-analysis of randomised clinical trials. BMJ;374:n1034. DOI: 10.1136/bmj.n1034. PMID: 34497047.
Nesterenko VG. The need for palliative and hospice care in Ukraine in 2018–2020. Medicine Today and Tomorrow. 2021;90(3):43-52. DOI: 10.35339/msz.2021.90.3.nes. [In Ukrainian].
Bulyha K, Bulyha O. The use of information technologies for analysis of epidemiological situation. Digital Platform: Information Technologies in Sociocultural Sphere. 2020;3(2):161-9. DOI: 10.31866/2617-796x.3.2.2020.220590. [In Ukrainian].
Holovanova IA, Shevchenko AS. The issue of patient-oriented organization of palliative and hospice care in Ukraine. Experimental and Clinical Medicine. 2021;90(2):21-7. DOI: 10.35339/ekm.2021.90.2.hos.
Holovanova IA, Shevchenko AS. Evaluation of packaged funding programs for palliative and hospice care by the National Health Service of Ukraine. Experimental and Clinical Medicine. 2021;90(4):45-52. DOI: 10.35339/ekm.2021.90.4.hos.
Grinspoon P. Medical marijuana. Harvard Health Blog, 10 Apr 2020 [Internet]. Available at: https://www.health.harvard.edu/blog/medical-marijuana-2018011513085 [accessed 20 Mar 2024].
Dugas EN, Sylvestre MP, Ewusi-Boisvert E, Chaiton M, Montreuil A, O'Loughlin J. Early Risk Factors for Daily Cannabis Use in Young Adults. Can J Psychiatry. 2019;64(5):329-37. DOI: 10.1177/0706743718804541. PMID: 30373372.
Hill S, Shanahan L, Costello EJ, Copeland W. Predicting Persistent, Limited, and Delayed Problematic Cannabis Use in Early Adulthood: Findings From a Longitudinal Study. J Am Acad Child Adolesc Psychiatry. 2017;56(11):966-74.e4. DOI: 10.1016/j.jaac.2017.08.012. PMID: 29096779.
Jones EL, Rozenman M. Social Evaluation in Emerging Adults: Associations with Interpretation Bias and Perceived Social Support. Child Psychiatry Hum Dev. 2024 Feb 8. DOI: 10.1007/s10578-023-01663-1. PMID: 38329648.
Orhurhu V, Urits I, Olusunmade M, Olayinka A, Salisu Orhurhu M, Uwandu C, et al. Cannabis Use in Hospitalized Patients with Chronic Pain. Adv Ther. 2020;37(8):3571-83. DOI: 10.1007/s12325-020-01416-9. PMID: 32632850.
Nutt DJ, King LA, Phillips LD; Independent Scientific Committee on Drugs. Drug harms in the UK: a multicriteria decision analysis. Lancet. 2010;376(9752):1558-65. DOI: 10.1016/S0140-6736(10)61462-6. PMID: 21036393.
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