Medicinal cannabis can reduce or even eliminate opioid use in patients with chronic back pain and osteoarthritis. Two studies presented at the 2022 annual meeting of the American Academy of Orthopaedic Surgeons demonstrated that pain and quality of life scores improved after patients were prescribed the medicine. Patients also reported improved intensity, frequency and daily function after medicinal cannabis use.
The principal investigator from the Rothman Orthopaedic Institute and Thomas Jefferson University Hospital, Philadelphia, said: “Our studies show that medical cannabis can be an effective treatment for chronic back pain and osteoarthritis”, and added that more research is needed “to better understand the best routes and frequencies, potential adverse events and long-term outcomes of medical cannabis use”.
Another study, published in the Journal of Cannabis Research, brought together twenty global experts, from nine countries, to develop recommendations on how to dose and administer medical cannabis in patients with chronic pain. There was consensus that medical cannabis may be considered for patients experiencing neuropathic (nerve damage), inflammatory (nociceptive), nociplastic and mixed pain.
Despite the increased global use of medical cannabis to manage pain, systematic reviews and meta-analyses report low to substantial levels of evidence to support use of cannabis and cannabinoids for the treatment of chronic pain. Explanations as to why some describe the level of evidence as low may include limited availability of investigational products due to legal status, lack of standardisation of cannabis products, lack of standardisation of product administration and over-emphasis on pain scores to define efficacy.
However, despite the low to moderate level of evidence, patients are being treated with medical cannabis across the world. It is also important to note that every patient is different and medical cannabis treatment, like most other therapies, should be individualised to the patient.