Making a joint decision: Cannabis as a potential substitute for opioids in obstetrics and gynecology |
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| Institution: | 1. Departent of Pharmaceutical Sciences, Regis University School of Pharmacy, 3333 Regis Blvd. H-28, Denver, CO, 80221, USA;1. Department of Global and Community Health, George Mason University, 4400 University Dr., MS 5B7, Fairfax, VA 22030, USA;2. Department of Obstetrics and Gynecology, Medical University of South Carolina, Rm 634, Clinical Science Bldg., 96 Jonathan Lucas St., Charleston, SC 29425, USA;1. Andrology and Human Reproduction Clinic, Av. Dr. Heitor Penteado, 1464, Campinas, Brazil;2. Faculty of Health, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark;3. Anatolia IVF and Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey;4. Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam;5. IVFMD, My Duc Hospital, Ho Chi Minh City, Viet Nam;6. HOPE Research Center, My Duc Hospital, Ho Chi Minh City, Viet Nam;7. Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples, Federico II, Naples, Italy;8. Fertility Clinic Skive, Skive Regional Hospital, Skive & Aarhus University, Aarhus, Denmark;1. Global Market Access Solutions, Health Economics Unit, St-Prex, Switzerland;2. University Medical Center Groningen, University of Groningen, Groningen, the Netherlands;3. Unit of Pharmacoepidemiology & Pharmacoeconomics, Department of Pharmacy, University of Groningen, Groningen, the Netherlands;1. Merck Healthcare KGaA, Frankfurter Str. 250, 64293, Darmstadt, Germany;2. Centre for Big Data Research in Health & School of Women''s and Children''s Health, UNSW Medicine & Health, Sydney, NSW, 2052, Australia;3. IVF Australia, Level 3, 15 Bowden Street, Alexandria, NSW, 2015, Australia;4. Department of Obstetrics, Gynecology and Reproductive Medicine, La Paz University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain;5. Department of Reproductive Medicine, Ruber Internacional Hospital, C/ La Maso, 38, Mirasierra, Madrid, 28034, Spain;6. IQVIA Real World Solutions, London, UK;7. IQVIA Real World Solutions, Herikerbergweg 314, 1101, CT, Amsterdam, Netherlands;8. Merck, S.L.U., C/ Maria de Molina 40, Madrid, Spain, an affiliate of Merck KGaA;9. Department of Development and Regeneration, Laboratory of Endometrium, Endometriosis & Reproductive Medicine, KU Leuven, Herestraat 49 – Box 805|B-3000, Leuven, Belgium;10. Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University Medical School, New Haven, CT, 06510, USA;11. Pharma Value Consulting, Pilatusweg 6 Oberwil-Lieli, 8966, Switzerland;12. Department of Obstetrics and Gynecology, Human Reproduction Unit, Cruces University Hospital, Basque Country University, Plaza de Cruces, S/N 48903 Barakaldo, Bizkaia, Bilbao, Spain;13. Instituto Valenciano de Infertilidad, IVI Bilbao, IVIRMA, Landabarri Bidea, nº 3 – 2nd Floor, 48940, Leioa, Vizcaya, Bilbao, Spain |
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| Abstract: | There is a growing body of evidence that cannabis may be effective as an analgesic with potential to reduce opioid usage in chronic pain. This review synthesizes the available literature to elucidate the possible role that cannabis might play in reducing opioid use in gynecological disorders that may potentially lead to a recommendation of substituting opioids with cannabis. With reports of a decrease in opioid use after cannabis initiation, an opioid-sparing effect has been seen in gynecologic malignancies such as ovarian, uterine, endometrial, and cervical cancers, in addition to chronic pelvic pain (CPP). Though many studies have found an association between cannabis and various adverse maternal and neonatal outcomes, there is a lack of randomized controlled trials making it difficult to claim a directly causal relationship between cannabis and these adverse outcomes. Additionally, with increased use of cannabis during pregnancy, the evidence of possible benefits and risks to mothers and fetuses is examined. |
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| Keywords: | Pregnancy Opioid-sparing Cannabinoid Endometriosis Cervical cancer Chronic pain |
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