Characterization of the problem of the therapeutic use of Cannabis Oil in Córdoba, Argentina
DOI:
https://doi.org/10.31053/1853.0605.v79.n2.30922Keywords:
dronabinol, cannabidiol, cannabinoids (therapeutic use)Abstract
The therapeutic use of “cannabis” oil is a social problem that puts legal, health, scientific and cultural aspects under stress. The difficulty in access generates an emptiness than is exploited by illegal market, to which patients and relatives resort to improve their health and quality of life. These oils, with unknown chemical composition, are used without a therapeutic follow-up. An interdisciplinary team from the UNC got involved in this problem with the aim of proving elements for its characterization in our environment. Methodology: Observational-descriptive and cross-sectional study (approved by CIEIS-HNC-UNC): interviews with patients/caregivers of legal age who were using “cannabis” oil (2019). Experimental study: analysis of oil samples obtained from interviewees to determine their cannabinoids content (THC and CBD), by means of HPLC technique. Results: thirty-seven interviews were conducted, and 48 samples were analysed. The 73% were adults and older adults. The 79% started using the oil on the recommendation of relatives/friends or on their self-initiative, mainly due to the lack of effectiveness of other therapies (54%) and searching for alternatives (33%). The 84% perceived it effective (moderate to highly effective), and 78% did not report adverse events. Main uses: refractory epilepsy 27% and arthritis/arthrosis 24%. Fifteen percent of the samples did not show any quantifiable content of CBD nor THC, and 67% had only THC. The quantifiable contents of cannabinoids were very low. Conclusions: an approach to therapeutic use of “cannabis” oil in Córdoba and its quality were obtained. Discrepancy between the perceived effectiveness and the low content of cannabinoids detected was observed.
Downloads
References
Estupefacientes. Ley N° 17.818. Buenos Aires: Poder Ejecutivo nacional; 1961. [acceso 2020 septiembre 23]. Disponible en: http://servicios.infoleg.gob.ar/infolegInternet/anexos/20000-24999/20883/texact.htm
Callado LF. Cuestiones de Interés en torno a los usos terapéuticos del Cannabis [en línea]. Departamento de Farmacología (UPV/EHU) y Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); 2012. Disponible en: http://www.ararteko.net/RecursosWeb/DOCUMENTOS/1/0_2561_1.pdf
Ben Amar M. Cannabinoids in medicine: A review of their therapeutic potential. J Ethnopharmacol. 2006 Apr 21;105(1-2):1-25. doi: 10.1016/j.jep.2006.02.001.
Lorenzo P, Leza JC. Utilidad terapéutica del Cannabis y derivados. 2000; 12: 149-68. Disponible en: https://www.adicciones.es/index.php/adicciones/article/view/678
Administración Nacional de Medicamentos, Alimentos y Tecnología Médica. Usos terapéuticos de los cannabinoides. Informe ultrarrápido de evaluación de tecnología sanitaria [en línea]. Buenos Aires: Administración Nacional de Medicamentos, Alimentos y Tecnología Médica, Ministerio de Salud; 2016 junio 8. Disponible en: http://www.anmat.gov.ar/ets/ETS_Cannabinoides.pdf
Epistemonikos Foundation [en línea]. Selección FRISBEEs sobre uso médico de cannabis y cannabinoides; Disponible en: https://es.epistemonikos.cl/2018/02/14/seleccion-frisbees-sobre-uso-medico-de-cannabis-y-cannabinoides/
Bertotto ME. Uso terapéutico de Cannabis en Argentina y su marco regulatorio. Informe CIME 2018 [en línea]. Centro de información de Medicamientos. Facultad de Ciencias Químicas. Universidad Nacional de Córdoba. 2018 marzo. Disponible en: http://cime.fcq.unc.edu.ar/wp-content/uploads/sites/15/2018/04/Cannabis-Informe-CIME-v.final_.pdf
Investigación médica y científica del uso Medicinal de la Planta de Cannabis y sus derivados. Ley 27350. Buenos Aires: Senado y Cámara de Diputados de la Nación Argentina; 2017. [acceso 2020 septiembre 23]. Disponible en: http://servicios.infoleg.gob.ar/infolegInternet/anexos/270000-274999/273801/norma.htm
Investigación médica y científica del uso Medicinal de la Planta de Cannabis y sus derivados. (reglamentación) Decreto 738/2017. Buenos Aires: Poder Ejecutivo Nacional, República Argentina; 2017. [acceso 2020 septiembre 23]. Disponible en: http://servicios.infoleg.gob.ar/infolegInternet/anexos/275000-279999/279831/norma.htm
Programa Nacional para el estudio y la investigación del uso medicinal de la planta de Cannabis, sus derivados y tratamientos no convencionales. Resolución 1537-E/2017. Buenos Aires. Ministerio de Salud, República Argentina; 2017. [acceso 2020 septiembre 23]. Disponible en: http://servicios.infoleg.gob.ar/infolegInternet/anexos/275000-279999/279883/norma.htm
Wershoven N, Kennedy AG, MacLean CD. Use and Reported Helpfulness of Cannabinoids Among Primary Care Patients in Vermont. J Prim Care Community Health. 2020 Jan-Dec;11:2150132720946954. doi: 10.1177/2150132720946954.
Hussain SA, Zhou R, Jacobson C, Weng J, Cheng E, Lay J, Hung P, Lerner JT, Sankar R. Perceived efficacy of cannabidiol-enriched cannabis extracts for treatment of pediatric epilepsy: A potential role for infantile spasms and Lennox-Gastaut syndrome. Epilepsy Behav. 2015 Jun;47:138-41. doi: 10.1016/j.yebeh.2015.04.009.
International Association for Cannabinoid Medicines. Boletín de la IACM Canabioid medicines. IACM. [acceso 2021 mayo 03] Disponible en: http://www.cannabis-med.org/spanish/bulletin/ww_es_db_cannabis_search.php
Canabis Medicinal Argentina; 2021 [acceso 2021 abril 19]. Disponible en: https://www.cannabismedicinal.com.ar/
Mamá cultiva Argentina. 2019 [acceso 2021 abril 19]. Disponible en: https://www.mamacultivaargentina.org/
Sarma ND, Waye A, ElSohly MA, Brown PN, Elzinga S, Johnson HE, Marles RJ, Melanson JE, Russo E, Deyton L, Hudalla C, Vrdoljak GA, Wurzer JH, Khan IA, Kim NC, Giancaspro GI. Cannabis Inflorescence for Medical Purposes: USP Considerations for Quality Attributes. J Nat Prod. 2020 Apr 24;83(4):1334-1351. doi: 10.1021/acs.jnatprod.9b01200.
ElSohly MA, Radwan MM, Gul W, Chandra S, Galal A. Phytochemistry of Cannabis sativa L. Prog Chem Org Nat Prod. 2017;103:1-36. doi: 10.1007/978-3-319-45541-9_1.
Romano LL, Hazekamp A. Cannabis Oil: chemical evaluation of an upcoming cannabis-based medicine. Cannabinoids. 2013; 1:1-11 [acceso 2020 octubre 1]. Disponible en: https://www.researchgate.net/publication/297707359_Cannabis_oil_Chemical_evaluation_of_an_upcoming_cannabis-_based_medicine
Reddy DS, Golub VM. The Pharmacological Basis of Cannabis Therapy for Epilepsy. J Pharmacol Exp Ther. 2016 Apr;357(1):45-55. doi: 10.1124/jpet.115.230151.
U.S. Food & Drug Administration. Highlights of prescribing information: Epidiolex®; 2018. [acceso: 2020 septiembre 23]. Disponible en: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/210365lbl.pdf
Turna J, Simpson W, Patterson B, Lucas P, Van Ameringen M. Cannabis use behaviors and prevalence of anxiety and depressive symptoms in a cohort of Canadian medicinal cannabis users. J Psychiatr Res. 2019 Apr;111:134-139. doi: 10.1016/j.jpsychires.2019.01.024.
Devinsky O, Patel AD, Cross JH, Villanueva V, Wirrell EC, Privitera M, Greenwood SM, Roberts C, Checketts D, VanLandingham KE, Zuberi SM; GWPCARE3 Study Group. Effect of Cannabidiol on Drop Seizures in the Lennox-Gastaut Syndrome. N Engl J Med. 2018 May 17;378(20):1888-1897. doi: 10.1056/NEJMoa1714631.
Privitera M, Bhathal H, Wong M, Cross JH, Wirrell E, Marsh ED, Mazurkiewicz-Beldzinska M, Villanueva V, Checketts D, Knappertz V, VanLandingham K. Time to onset of cannabidiol (CBD) treatment effect in Lennox-Gastaut syndrome: Analysis from two randomized controlled trials. Epilepsia. 2021 May;62(5):1130-1140. doi: 10.1111/epi.16878.
Ali S, Parker APJ. Medicinal use of cannabis-based products: a practical guide for paediatricians. Paediatr Child Health. 2019; 30 (2):79-83. doi: 10.1016/j.paed.2019.11.009.
Administración Nacional de Medicamentos Alimentos y Tecnología Médica. Informe ultrarrápido de evaluación de tecnología sanitaira: Cannabinoides y epilepsia. Buenos Aires: ANMAT: Ministerio de Salud; 2017. [acceso 2020 septiembre 23]. Disponible en: http://www.anmat.gov.ar/ets/Cannabinoides_y_epilepsia.pdf
Tzadok M, Uliel-Siboni S, Linder I, Kramer U, Epstein O, Menascu S, Nissenkorn A, Yosef OB, Hyman E, Granot D, Dor M, Lerman-Sagie T, Ben-Zeev B. CBD-enriched medical cannabis for intractable pediatric epilepsy: The current Israeli experience. Seizure. 2016 Feb;35:41-4. doi: 10.1016/j.seizure.2016.01.004.
Englund A, Freeman TP, Murray RM, McGuire P. Can we make cannabis safer? Lancet Psychiatry. 2017 Aug;4(8):643-648. doi: 10.1016/S2215-0366(17)30075-5.
White CM. A Review of Human Studies Assessing Cannabidiol's (CBD) Therapeutic Actions and Potential. J Clin Pharmacol. 2019 Jul;59(7):923-934. doi: 10.1002/jcph.1387.
VanDolah HJ, Bauer BA, Mauck KF. Clinicians' Guide to Cannabidiol and Hemp Oils. Mayo Clin Proc. 2019 Sep;94(9):1840-51. doi: 10.1016/j.mayocp.2019.01.003.
Administración Nacional de Medicamentos, Alimentos y Tecnología Médica. Disposición DI-2020-8920-APN-ANMAT#MS, EX-2020-67988515-APN-DFYGR#ANMAT. Buenos Aires: Administración Nacional de Medicamentos, Alimentos y Tecnología Médica, Ministerio de Salud; 2020 diciembre 3.
Bazzoni C. Advierten una gran circulación de aceites de cannabis fraudulentos. La Capital. 2019 mayo 05 [acceso 2022 marzo 31]. Disponible en: https://www.lacapital.com.ar/la-ciudad/advierten-una-gran-circulacion-aceites-cannabis-fraudulentos-n1761003.html
Braithwaite I, Bhagavan C, Doppen M, Kung S, Oldfield K, Newton-Howes G. Medicinal applications of cannabis/cannabinoids. Curr Opin Psychol. 2021 Apr;38:1-10. doi: 10.1016/j.copsyc.2020.06.002.
Cáceres Guido P, Riva N, Calle G, Dell'Orso M, Gatto M, Sberna N, Schaiquevich P. Medicinal cannabis in Latin America: History, current state of regulation, and the role of the pharmacist in a new clinical experience with cannabidiol oil. J Am Pharm Assoc (2003). 2020 Jan-Feb;60(1):212-215. doi: 10.1016/j.japh.2019.09.012.
Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA. 2017 Nov 7;318(17):1708-1709. doi: 10.1001/jama.2017.11909.
O’Brien K. Medicinal Cannabis: Issues of evidence. Eur J Integrat Med. 2019; 28: 114–20. doi: 10.1016/j.eujim.2019.05.009
Cáceres Guido P, Riva N, Caraballo R, Reyes G, Huaman M, Gutierrez R, Agostini S, Fabiana Delaven S, Pérez Montilla CA, García Bournissen F, Schaiquevich P. Pharmacokinetics of cannabidiol in children with refractory epileptic encephalopathy. Epilepsia. 2021 Jan;62(1):e7-e12. doi: 10.1111/epi.16781.
Reglamentación de la Ley 27350. Investigación Médica y Científica de Uso Medicinal de la Planta de Cannabis y sus derivados”, Anexo (IF-2020-77460970-APN-SSMEIE#MS). Decreto 883/2020. Buenos Aires: Poder Ejecutivo Nacional, República Argentina; 2020. Disponible en: http://servicios.infoleg.gob.ar/infolegInternet/anexos/340000-344999/344131/norma.htm
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Universidad Nacional de Córdoba
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The Faculty of Medical Sciences Journal (RFCM) subscribes to the Open Access policy and does not charge authors fees for publishing, nor does it charge readers fees for accessing published articles (APC).
