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Use of a synthetic cannabinoid in a correctional population for posttraumatic stress disorder-related insomnia and nightmares, chronic pain, harm reduction, and other indications: a retrospective evaluation.

Abstract

Nabilone is a synthetic cannabinoid that has shown promise for the treatment of posttraumatic stress disorder (PTSD)-related insomnia and nightmares as well as efficacy in the management of chronic pain. It has also been proposed for harm reduction in cannabis dependence. Its effectiveness for management of concurrent disorders in seriously mentally ill correctional populations has not been evaluated. This retrospective study of 104 male inmates with serious mental illness prescribed nabilone analyzes the indications, efficacy, and safety of its use. Medications discontinued with the initiation of nabilone were also reviewed. The results showed nabilone targeting a mean of 3.5 indications per patient, thus likely reducing polypharmacy risk. The mean final dosage was 4.0 mg. Results indicated significant improvement in PTSD-associated insomnia, nightmares, PTSD symptoms, and Global Assessment of Functioning and subjective improvement in chronic pain. Medications associated with greater risk for adverse effects or abuse than nabilone were often able to be discontinued with the initiation of nabilone, most often antipsychotics and sedative/hypnotics. There was no evidence of abuse within this high-risk population or reduction of efficacy when nabilone was given in powder form with water rather than as a capsule. This study supports the promise of nabilone as a safe, effective treatment for concurrent disorders in seriously mentally ill correctional populations. Prospective, randomized controlled trials are required to confirm our preliminary results. Follow-up in the community will be required to confirm effectiveness in harm reduction.

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  • Authors+Show Affiliations

    ,

    From the Integrated Forensic Program, Royal Ottawa Health Care Group, Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada.

    ,

    Source

    MeSH

    Adult
    Cannabinoids
    Chronic Pain
    Dreams
    Dronabinol
    Harm Reduction
    Humans
    Male
    Middle Aged
    Prisoners
    Retrospective Studies
    Sleep Initiation and Maintenance Disorders
    Stress Disorders, Post-Traumatic
    Treatment Outcome
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    24987795

    Citation

    Cameron, Colin, et al. "Use of a Synthetic Cannabinoid in a Correctional Population for Posttraumatic Stress Disorder-related Insomnia and Nightmares, Chronic Pain, Harm Reduction, and Other Indications: a Retrospective Evaluation." Journal of Clinical Psychopharmacology, vol. 34, no. 5, 2014, pp. 559-64.
    Cameron C, Watson D, Robinson J. Use of a synthetic cannabinoid in a correctional population for posttraumatic stress disorder-related insomnia and nightmares, chronic pain, harm reduction, and other indications: a retrospective evaluation. J Clin Psychopharmacol. 2014;34(5):559-64.
    Cameron, C., Watson, D., & Robinson, J. (2014). Use of a synthetic cannabinoid in a correctional population for posttraumatic stress disorder-related insomnia and nightmares, chronic pain, harm reduction, and other indications: a retrospective evaluation. Journal of Clinical Psychopharmacology, 34(5), pp. 559-64. doi:10.1097/JCP.0000000000000180.
    Cameron C, Watson D, Robinson J. Use of a Synthetic Cannabinoid in a Correctional Population for Posttraumatic Stress Disorder-related Insomnia and Nightmares, Chronic Pain, Harm Reduction, and Other Indications: a Retrospective Evaluation. J Clin Psychopharmacol. 2014;34(5):559-64. PubMed PMID: 24987795.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Use of a synthetic cannabinoid in a correctional population for posttraumatic stress disorder-related insomnia and nightmares, chronic pain, harm reduction, and other indications: a retrospective evaluation. AU - Cameron,Colin, AU - Watson,Diane, AU - Robinson,Jeffrey, PY - 2014/7/3/entrez PY - 2014/7/6/pubmed PY - 2016/2/26/medline SP - 559 EP - 64 JF - Journal of clinical psychopharmacology JO - J Clin Psychopharmacol VL - 34 IS - 5 N2 - Nabilone is a synthetic cannabinoid that has shown promise for the treatment of posttraumatic stress disorder (PTSD)-related insomnia and nightmares as well as efficacy in the management of chronic pain. It has also been proposed for harm reduction in cannabis dependence. Its effectiveness for management of concurrent disorders in seriously mentally ill correctional populations has not been evaluated. This retrospective study of 104 male inmates with serious mental illness prescribed nabilone analyzes the indications, efficacy, and safety of its use. Medications discontinued with the initiation of nabilone were also reviewed. The results showed nabilone targeting a mean of 3.5 indications per patient, thus likely reducing polypharmacy risk. The mean final dosage was 4.0 mg. Results indicated significant improvement in PTSD-associated insomnia, nightmares, PTSD symptoms, and Global Assessment of Functioning and subjective improvement in chronic pain. Medications associated with greater risk for adverse effects or abuse than nabilone were often able to be discontinued with the initiation of nabilone, most often antipsychotics and sedative/hypnotics. There was no evidence of abuse within this high-risk population or reduction of efficacy when nabilone was given in powder form with water rather than as a capsule. This study supports the promise of nabilone as a safe, effective treatment for concurrent disorders in seriously mentally ill correctional populations. Prospective, randomized controlled trials are required to confirm our preliminary results. Follow-up in the community will be required to confirm effectiveness in harm reduction. SN - 1533-712X UR - https://www.unboundmedicine.com/medline/citation/24987795/Use_of_a_synthetic_cannabinoid_in_a_correctional_population_for_posttraumatic_stress_disorder_related_insomnia_and_nightmares_chronic_pain_harm_reduction_and_other_indications:_a_retrospective_evaluation_ L2 - http://Insights.ovid.com/pubmed?pmid=24987795 DB - PRIME DP - Unbound Medicine ER -