Inhaled cannabis (Cannabis sativa) may provide short-term (2 weeks) relief with an NNT of 5.6 (3.4–14) in patients with peripheral neuropathic pain , as compared with an NNT of gabapentin of 5.9 (4.6–8.3) for the same population. Thus, both drugs are not very effective. More relevant, the toxicity profile is not benign, militating against long-term use. According to a review, “Current efforts to normalize cannabis use are being driven largely by a combination of grassroots activism, pharmacological ingenuity, and private profiteering, with a worrisome disregard for scientific evidence, gaps in our knowledge, or the possibility of unintended consequences” . Neuropsychological impairment, a motivational state, and psychosis are recognized consequences from long-term use of cannabis . Cannabis is neurotoxic and accumulates in adipose tissues that act as a reservoir that continuously releases them. These neurotoxic effects can be especially relevant when treating multiple sclerosis patients, in whom cannabis can disrupt compensatory mechanisms . The findings related to pharmaceutically manufactured cannabis are equivocal.
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