Document Detail


Cannabis; adverse effects from an oromucosal spray.
MedLine Citation:
PMID:  17703180     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: An oromucosal spray has been developed from the major components of marijuana (cannabis), including tetrahydrocannabinol (THC) and cannabidiol (CBD), in alcohol with a peppermint flavouring, designed to be administered as a spray under the tongue or on the buccal mucosa to relieve pain in multiple sclerosis. Although the available evidence indicates its efficacy in this respect, some patients develop oral burning sensation, stinging or white lesions, probably burns. OBJECTIVE: To investigate the oral side-effects of oromucosal cannabis spray in multiple sclerosis (MS) patients. DESIGN: A small open observational study. SUBJECTS AND METHODS: A series of nine patients with MS who had been using a marijuana oromucosal spray for at least four weeks, were asked to attend for oral examination. Patients were asked whether they had ever experienced symptoms (dryness; bad taste; stinging) associated with use of the spray. A standard oral examination was carried out using a dental light, and the presence of any mucosal lesions recorded. Where mucosal lesions were present, patients were advised to discontinue the spray and re-attend after four weeks for re-examination. For ethical reasons, biopsies were not undertaken at the first visit. RESULTS: Of nine patients invited to participate, eight attended. All admitted to a stinging sensation on using the oromucosal cannabis spray, and four had visible oral mucosal white lesions in the floor of the mouth. CONCLUSIONS: Although the white lesions observed were almost certainly burns, resolving or improving on discontinuation of use of the medication, the high alcohol concentration of the oromucosal cannabis spray raises concern in relation to chronic oral use.
Authors:
C Scully
Publication Detail:
Type:  Journal Article     Date:  2007-08-17
Journal Detail:
Title:  British dental journal     Volume:  203     ISSN:  1476-5373     ISO Abbreviation:  Br Dent J     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-24     Completed Date:  2007-10-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513219     Medline TA:  Br Dent J     Country:  England    
Other Details:
Languages:  eng     Pagination:  E12; discussion 336-7     Citation Subset:  D; IM    
Affiliation:
Department of Oral Medicine, UCL Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD. c.scully@eastman.ucl.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adult
Aerosols
Aged
Burns, Chemical / etiology*
Cannabinoids / administration & dosage*,  adverse effects*
Cannabis / adverse effects*
Female
Humans
Male
Middle Aged
Mouth Mucosa / drug effects*
Multiple Sclerosis / drug therapy
Pain / drug therapy
Phytotherapy / adverse effects
Plant Extracts / administration & dosage,  adverse effects
Chemical
Reg. No./Substance:
0/Aerosols; 0/Cannabinoids; 0/Plant Extracts; 0/tetrahydrocannabinol-cannabidiol combination

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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