Rev. Soc. Esp. Dolor. 2022; 29(13): 52-57 / DOI: 10.20986/resed.2022.4032/2022
Jesús de Santiago
ABSTRACT
Introduction: In Spain, the prescription of medical cannabis is currently in the process of being regulated. To date, there are no studies regarding the attitude and knowledge of the Spanish pain treatment specialists regarding the use of medical cannabis in the field of pain treatment.
Methods: An online survey was carried out and was available on internet from July 2020 to October 2021. The survey consisted of 10 questions related to three main areas of interest: 1) personal experience of the specialists; 2; the role of cannabis in pain medicine; and 3) need for training and legalization of medicinal cannabis.
Results: 94 pain treatment specialists responded to the survey. 38 % of those who responded had experience in treating pain with medical cannabis and considered it effective. 78 % believed that it was safe to prescribe medical cannabis. Common indications are neuropathic pain (72 %), cancer pain (56 %), fibromyalgia (39 %), arthralgia (30 %) and visceral pain 29 %. The main contraindications are schizophrenia (73 %), pregnancy/lactation (65 %), cardiovascular disease (32 %), and age < 18 years (61 %). Only 35 % rated cannabis as more dangerous than opioids. 95 % considered more specific training necessary. 47 % considered the need of an specific unit for the prescription of medical cannabis, while 34 %, on the contrary, think that the prescription should be carried out by an specialist with specific training.
Conclusion: Despite the lack of clinical experience in the treatment of pain with medical cannabis in our country, the knowledge, attitudes and beliefs of Spanish pain specialists are in line with current general medical knowledge in countries with more clinical experience.
RESUMEN
Introducción: En España la prescripción de cannabis medicinal está actualmente en proceso de ser regulada. Hasta la fecha no existen estudios respecto a cuál es la actitud y el conocimiento del especialista español en tratamiento del dolor respecto a la utilización del cannabis medicinal en el tratamiento del dolor.
Métodos: Se llevó a cabo una consulta online que estuvo disponible en internet desde julio de 2020 a octubre de 2021. La encuesta constaba de 10 preguntas relacionadas con tres principales áreas de interés: 1) experiencia personal de los especialistas; 2) el papel del cannabis en la medicina del dolor; y 3) la necesidad de formación y legalización del cannabis medicinal.
Resultados: 94 especialistas en tratamiento del dolor respondieron a la encuesta. El 38 % de los que respondieron tenía experiencia en el tratamiento del dolor con cannabis medicinal y lo consideraban eficaz. El 78 % creía que era seguro recetar cannabis medicinal. Las indicaciones comunes son dolor neuropático (72 %), dolor oncológico (56 %), fibromialgia (39 %), artralgias (30 %) y dolor visceral el 29 %. Las principales contraindicaciones son la esquizofrenia (73 %), el embarazo/lactancia (65 %), enfermedad cardiovascular (32 %) y la edad < 18 años (61 %). Solo el 35 % calificó al cannabis como más peligroso que los opiáceos. El 95 % consideró necesaria más formación específica. El 47 % consideró la necesidad de que la prescripción del cannabis medicinal se realizara a través de una unidad específica, mientras que el 34 %, por el contrario, piensa que la prescripción debería realizarla un especialista con formación específica.
Conclusión: A pesar de la falta de experiencia clínica en el tratamiento del dolor con cannabis medicinal en nuestro país, el conocimiento, las actitudes y las creencias de los especialistas en dolor españoles están en línea con el conocimiento médico general actual de países con más experiencia clínica.
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