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Medical cannabis: A solution for chronic pain?

Although 'medical marijuana' has been available for several years, since the legalization of recreational cannabis in Canada, there has been renewed interest in the potential medical uses for cannabis; particularly for managing chronic pain.

We've asked Dr. Jason Busse to talk with us about how cannabis works to relieve pain, what the research says about its effectiveness and potential side effects, and what benefits there may be compared to opioids to assist with chronic pain relief. You'll meet Anne, who has arthritis in her knee and has been talking to her doctors about alternative methods for her pain management; one of which is cannabis.

 

Learn the answers to the following questions:

  • 0:29 - What are chronic pain and medical cannabis?
  • 1:33 - How does cannabis work to help relieve pain?
  • 2:27 - What are the different formats of medical cannabis?
  • 3:17 - What does the research say about using medical cannabis for chronic pain?
  • 5:08 - What is the quality of the research?
  • 9:00 - What are some of the benefits of medical cannabis in comparison to opioids for chronic pain relief?
  • 12:30 - What are the side effects or risks of cannabinoids used for medical purposes?
  • 17:00 - Who should avoid using medical cannabis for chronic pain?
  • 20:49 - What is a 'weak' medical recommendation?

 

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References

  1. McMaster Optimal Aging Portal. Cannabis for chronic nerve pain: A half-baked solution? (2018 Aug 7). Accessed August 30, 2021. Available from: https://www.mcmasteroptimalaging.org/blog/detail/blog/2018/08/07/cannabis-for-chronic-nerve-pain-a-half-baked-solution
  2. McMaster Optimal Aging Portal. What the research says about cannabis use. (2018 Oct 16). Accessed August 30, 2021. Available from: https://www.mcmasteroptimalaging.org/blog/detail/hitting-the-headlines/2018/10/16/what-the-research-says-about-cannabis-use
  3. Busse JW, Vankrunkelsven P, Zeng L, et al. Medical cannabis or cannabinoids for chronic pain: a clinical practice guideline. BMJ. 2021; 374:n2040. doi:10.1136/bmj.n2040
  4. Wang L, Hong PJ, May C, et al. Medical cannabis or cannabinoids for chronic non-cancer and cancer-related pain: a systematic review and meta-analysis of randomised clinical trials. BMJ. 2021; 374:n1034. doi:10.1136/bmj.n1034
  5. Schopflocher D, Taenzer P, Jovey R. The prevalence of chronic pain in Canada. Pain Res Manag. 2011; 16(6):445-450. doi: 10.1155/2011/876306
  6. Cohen SP, Mao J. Neuropathic pain: Mechanisms and their clinical implications. BMJ. 2014; 348:f656. doi: 10.1136/bmj.f7656
  7. Holland K. What You Should Know About Neuropathic Pain. Healthline. (2020 Feb 5). Accessed August 30, 2021. Available from: https://www.healthline.com/health/neuropathic-pain
  8. Mayo Clinic. Peripheral neuropathy. (n.d.). Accessed August 30, 2021. Available from: https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061
  9. Mucke M, Phillips T, Radbruch L, et al. Cannabis-based medicines for chronic neuropathic pain in adults (Review). Cochrane Database Syst Rev. 2018; 3:CD01282. doi: 10.1002/14651858.CD012182.pub2
  10. Mathieson S, Wertheimer G, Maher CG, et al. What proportion of patients with chronic noncancer pain are prescribed an opioid medicine? Systematic review and meta-regression of observational studies. J Intern Med. 2020;287(5):458-74. doi: 10.1111/joim.13026
  11. Chou R, Hartung D, Turner J, et al. Opioid Treatments for Chronic Pain. Comparative Effectiveness Review No. 229. AHRQ Publication No. 20-EHC011. Rockville, MD: Agency for Healthcare Research and Quality; April 2020. doi: 10.23970/AHRQEPCCER229
  12. Safakish R, Ko G, Salimpour V, et al. Medical cannabis for the management of pain and quality of life in chronic pain patients: A prospective observational study. Pain Med. 2020 Nov 1;21(11):3073-3086. doi: 10.1093/pm/pnaa163
  13. Hill KP, Saxon AJ. The role of cannabis legalization in the opioid crisis. JAMA Intern Med. 2018;178(5):679–680. doi:10.1001/jamainternmed.2018.0254

Acknowledgements

This work is supported through the McMaster Institute for Research on Aging and funds provided by the Dean and Vice-President, Faculty of Health Sciences at McMaster University. 

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of these blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations such as social distancing and frequent hand washing. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with current social distancing recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.

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