Indications of cannabis use are numerous although the indication to relief pain remains a major research interest and clinical application. Studies investigating the effect of herbal cannabis and cannabis-based medicine on neuropathic, non-neuropathic pain, acute pain and experimentally induced pain were reviewed. A search was performed in PubMed and Cochrane library for articles published in English between January 1, 2000 and May 8, 2020. The search terms used were related to cannabis and pain in adults. We identified 34 studies, of which 30 were randomized controlled clinical trials (RCTs). Varying effects were identified from the RCTs, and as expected more promising effects from non-RCTs. Cannabis-based medications were found most effective as an adjuvant therapy in refractory multiple sclerosis, and weak evidence was found to support the treatment of cancer pain especially in advanced stages. Chronic rheumatic pain showed promising results. Adverse events of cannabis-based treatment were found to be more frequent with tetrahydrocannabinol herbal strains compared to other cannabis-derived products.
Keywords: Cannabidiol; Cannabis; Dose; Pain; Safety.
Copyright 2020, Haleem et al.
Conflict of interest statement
None to declare.
Cannabis-based medicines for chronic neuropathic pain in adults.
Cochrane Database Syst Rev. 2018 Mar 7;3(3):CD012182. doi: 10.1002/14651858.CD012182.pub2. Cochrane Database Syst Rev. 2018. PMID: 29513392 Free PMC article. Review.
[Systematic review of safeness and therapeutic efficacy of cannabis in patients with multiple sclerosis, neuropathic pain, and in oncological patients treated with chemotherapy].
Epidemiol Prev. 2017 Sep-Dec;41(5-6):279-293. doi: 10.19191/EP17.5-6.AD01.069. Epidemiol Prev. 2017. PMID: 29119763 Review. Italian.
Palliative Treatment of Cancer-Related Pain [Internet].
Oslo, Norway: Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH); 2005 Dec. Report from Norwegian Knowledge Centre for the Health Services (NOKC) No. 09-2005. Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH). 2005. PMID: 29320015 Free Books & Documents. Review.
Cannabis-based medicines–GW pharmaceuticals: high CBD, high THC, medicinal cannabis–GW pharmaceuticals, THC:CBD.
Drugs R D. 2003;4(5):306-9. doi: 10.2165/00126839-200304050-00005. Drugs R D. 2003. PMID: 12952500 Review.
Cannabis for the treatment of ulcerative colitis.
Cochrane Database Syst Rev. 2018 Nov 8;11(11):CD012954. doi: 10.1002/14651858.CD012954.pub2. Cochrane Database Syst Rev. 2018. PMID: 30406638 Free PMC article.
- Krcevski-Skvarc N, Wells C, Hauser W. Availability and approval of cannabis-based medicines for chronic pain management and palliative/supportive care in Europe: A survey of the status in the chapters of the European Pain Federation. Eur J Pain. 2018;22(3):440–454. doi: 10.1002/ejp.1147. – DOI – PubMed