The BMJ has published a clinical practice guideline summarizing the evidence for the use of medical cannabis and cannabinoids in chronic pain.
There has been a recent push in the United States for certain jurisdictions to allow medical use of cannabis or cannabinoids, particularly in jurisdictions where policies exist to reduce opioid use for pain management.
The authors’ recommendation was informed by a linked series of 4 systematic reviews that summarized the current body of evidence for benefits and harms, as well as patient preferences and values, associated with the use of medical cannabis or cannabinoids for chronic pain.
The resulting systematic review reports on the effects of medical non-inhaled cannabis or cannabinoids, added to standard care, in people with chronic pain due to cancer or non-cancer-related causes.
They noted that currently published trials have found that at 1-4 months post initiation of therapy, cannabis reduced pain and improved physical function and sleep quality.
Clinicians who choose to advocate for cannabis use should advise their patients to begin their trial period using low dose, non-inhaled products, increasing their intake slowly depending on clinical response and tolerability, the authors wrote.
Younger patients should be given cannabidiol-predominant preparations, since the effect of tetrahydrocannabinol on neurocognitive development remains unclear.
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