This study reviewed 70 articles of published research to try to determine appropriate clinical guidelines for treating patients with chronic pain. It was published in the journal Cannabis & Cannabinoid Research in March 2023.
Chronic pain often comes with additional (co-occurring) conditions or symptoms such as: insomnia, anxiety, depression, post-traumatic stress disorder (PTSD), and substance use disorders such as opioid and alcohol use disorder. An interesting part of this study is that the authors focused on plant-derived cannabinoids as opposed to synthetically derived pharmaceutical cannabinoids.
The sections on dosing basically reinforced common knowledge about cannabinoid medicines, especially THC: start low (dose) and go slow (increasing that dose).
"A recommendation was deemed to be strong if the committee considered the benefit to clearly outweigh the risk for most individuals."
Authors' strong recommendations:
We recommend the use of CBM as monotherapy, replacement, or adjunct treatment, in people living with chronic pain, for the management of chronic pain including central and/or peripheral neuropathic pain to improve pain outcomes.
We recommend the use of CBM for the management of muscular and neuropathic pain in people living with HIV who are not achieving adequate response, or those experiencing adverse effects to other treatment modalities.
We recommend the use of CBM, as adjunct treatment, for pain management in people with MS not achieving adequate response to other modalities.
We recommend the use of CBM, as adjunct treatment, for the management of muscle spasm in people living with MS in those not achieving adequate response to other modalities.
We recommend the use of CBM, as adjunct treatment, for the management of chronic pain in people living with arthritic conditions in those not achieving adequate response to other modalities.
We recommend the use of CBM as adjunct treatment among people using moderate/high doses of opioids (>50 morphine equivalent) for the management of chronic pain and/or to increase opioid sparing.
The recommendations also outweigh the risks of non-serious adverse events with CBM (dizziness, disturbance in attention, somnolence, dry mouth, nausea, diarrhea) as compared with adverse events from standard analgesia (opioids and serotonin-norepinephrine reuptake inhibitors [SNRIs] or opioids monotherapy), including constipation, loss of appetite, unclear mentation, reduced affect, hemorrhoids, and substance use disorder.
The authors' also made strong recommendations for the use of cannabis for chronic pain accompanied by migraines, nausea, sleep deprivation, appetite loss, PTSD, anxiety, and depression.
The full text article is here at LiebertPub.com.