Human Studies of Cannabinoids and Medicinal Cannabis 749tion without further compromising respiratory function. Opioids and benzodi-
azepines produce some relief but may have the dangerous side-effect of depressing
respiration.
Patients have reported anecdotally that cannabis can relieve breathlessness by
relieving anxiety and promoting relaxation. CB 1 receptors are virtually absent from
the part of the brain-stem which drives respiration (Herkenham et al. 1990), so it
seems possible that symptom relief may be achieved without negative effects upon
breathing. THC has been shown to have anxiety-reducing and sedating effects
(Fabre and McLendon 1981; Nicholson et al. 2004), as has CBD in larger doses
(Zuardi et al. 1997). CBD is also thought to have useful modulating effects on some
of the undesirable effects of THC (McPartland and Russo 2001).
At the time of writing, exploratory research of THC/CBD combinations in
refractory breathlessness is getting underway, incorporating careful monitoring of
respiratory function.
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