Doctors Get New Clinical Guidelines for Managing Chronic Pain With Cannabis, Courtesy of Canadian Researchers

Chronic pain—a condition that affects 50.2 million people in the U.S. annually—is one of the most common reasons why medical marijuana is sought out by patients in the United States, Canada, and beyond. Nonetheless, guidelines pertaining to the use of cannabis-based treatments for chronic pain relief have been somewhat hazy…up until now.

New guidelines for cannabis in chronic pain were recently published by a group of Canadian researchers. Featured in the journal Cannabis and Cannabinoid Research, the guidelines were compiled after researchers perused scientific databases for peer-reviewed English articles on cannabis and pain. 

The team peered into the findings of numerous articles published between 2001 and 2019. Using this information, they composed a list of valuable suggestions for consuming cannabis to treat various types of chronic pain. The list is designed to help patients determine whether or not they are a good candidate for (and would benefit from) a medical marijuana card.

How Were the New Guidelines for Cannabis in Chronic Pain Developed?

After devoting their time to analyzing peer-reviewed English articles, the study authors graded their findings based on the quality of evidence proving cannabis’ pain-relieving benefits. Once they felt satisfied with their takeaways, they put together specific guidelines featuring data from 70 studies, 51 of which were original studies and 19 of which were systematic reviews.

The guidelines provide indications as to how cannabis and cannabis-based natural medicines may benefit patients with anxiety, appetite loss, chronic pain, and sleep problems. Most of the recommendations outlined in the research were drawn from moderate-quality evidence, whereas others were inspired by low-quality evidence. 

Using moderate-quality evidence, the Canadian researchers determined that medical marijuana and cannabis-based natural medicines would be suitable in the following instances:

• As a primary or supplementary treatment for chronic pain, e.g. central and/or peripheral pain
• As a supplementary treatment for treatment-resistant multiple sclerosis-related pain
• To control muscular or neuropathic pain in HIV patients who experience minimal or no relief from existing treatment, as well as those who experience adverse effects from other treatments
• As a primary or supplementary treatment for sleep problems in chronic pain patients who experience minimal or no relief from existing treatment
• As a supplementary treatment for anxiety in chronic pain patients who haven’t responded to nonpharmacologic treatment 
• As a supplementary treatment for chronic pain patients who struggle to get satisfactory relief from opioids alone
• As a supplementary treatment for chronic pain patients who are medicating with high doses of opioids and are either lacking relief or want to reduce opioid dependence

In addition to these recommendations, the Canadian group also used low-quality evidence to recommend the use of cannabis for the following purposes:

• As a supplementary treatment for chronic pain related to cases of fibromyalgia in which patients lack sufficient pain relief
• As a supplementary treatment for chronic pain in arthritis patients who are dissatisfied with other treatments
• To help relieve “problematic loss of appetite” in chronic pain patients (THC-rich cannabis)

Medical Cannabis Interest Is Growing Among Pain Population

The publication of these guidelines for cannabis and chronic pain is consistent with the rise in interest in medical cannabis products among pain patients. A study published in the Journal of the American Medical Association (JAMA) by a team of researchers at Michigan Medicine discovered that 31% of people with chronic pain use medical marijuana to ease their symptoms; approximately 36% of respondents said they used the drug to deal with pain in the last year, and 23.2% used it in the last month.

Although more research into the cannabis plant’s pain-relieving qualities is needed, the fact that a growing number of states are decriminalizing or legalizing cannabis is further fueling the prospect of federal cannabis legalization materializing. If it indeed does become a reality and the plant’s federally-illegal status is lifted, more studies can be legally carried out. For now, doctors are encouraged to use the new guidelines for chronic pain as a way of advising patients of their suitability for medical marijuana.

While medical cannabis may offer therapeutic relief via its ability to bind with receptors that modulate pain, it should not be used as a replacement for doctor-advised and guideline-based treatments. Keep in mind that cannabis may interact with certain types of medications, such as blood thinners, so it’s vital to consult with your healthcare practitioner beforehand. 

Moreover, as a drug that is not FDA-approved in the U.S., the potency and purity of medical cannabis products may vary. To ensure you use only the highest quality products when treating chronic pain, consider applying for a medical marijuana card, and seek advice regarding finding the most reliable and trustworthy dispensaries in your area.