Dra Leticia Cuñetti June 2018 I declare that I have no conflicts of interest to make this presentation Dra Leticia Cuñetti Delmonte June 2018 Chronic pain is a major therapeutic problem in patients with kidney transplant due to the nephrotoxicity of NSAIDs ID: 805445
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Implications of cannabis international regulation and its impact on medicinal useDra. Leticia CuñettiJune 2018
Slide2I declare that I have no conflicts of interest to make this presentation. Dra. Leticia Cuñetti
Delmonte
June 2018
Slide3Chronic pain is a major therapeutic problem in patients with kidney transplant due to the nephrotoxicity of NSAIDsIn 2013, Law 19.172 approves the use of cannabis for medicinal purposes in UruguayThere is a benefit in the modulation of eCS in the treatment of chronic pain
JAMA.2015;313(24):2456-2473.doi:10.1001/jama.2015.6358
https://parlamento.gub.uy/documentosyleyes/leyes/ley/19172
Slide4Slide5Slide6Studies that evaluate cannabis toxicity as an abuse substance can not be extrapolated to evaluate safety of Cannabis-based medicines % Effect
T
hey allow to set follow-up strategies to evaluate possible adverse effects
Slide7JAMA.2015;313(24):2456-2473.doi:10.1001/jama.2015.6358 Common adverse effects reported in cannabinoid treatments
Slide8In Uruguay, cannabis recreational use is not a main public health problemCurrently the biggest problem is access to quality controlled cannabinoids´ products for the relief of neurological diseases, cancer related disorders or chronic painThe high cost of regulated products with adequate quality controls has determined a black market of supposed medicinal products without quality control or medical follow-uphttp://monitorcannabis.uy/investigaciones/
Slide9Great variability of effect according to the preparation, route of administration, amount and proportion of different cannabinoidsIt is imperative the accessibility to quality controlled products in order to make a rational prescription
http://w3.icf.uab.es/ficf/es/bin/view/Cannabis/FarmacologiaBasica
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Slide11Our main objective as doctors is to achieve universal access to these medicines that alleviate chronic pain and neurological and cancer-related conditions for a significant number of patients.This will only be achieved if these medicines of proven efficacy and safety are included in the national therapeutic formulary (FTN).The main limitation of the medicinal use of cannabinoids even in Uruguay is the currentclassification of cannabis in the international drug conventions.This classification determines great difficulties in prescribing, investigating its medicinal uses and also makes it very difficult to include it within any FTN making its use only available for the rich ones or in the black market without medical follow-up .
Slide12GREAT RESPONSIBILITY: as regulators as doctors as researchers as members of our society