Cannabinoids work for treatment resistant chronic pain, but not for everybody

Treatment refractory chronic pain (TRCP) is chronic pain that is resistant to conventional analgesics (pain killers), or those analgesics create intolerable adverse events (AEs) so patients can't take them. This study examined the effectiveness of oral cannabinoids on this condition and was published in November 2022 in the European Journal of Pain.

529 Danish patients were included in this retrospective observational study that included follow ups at 56 days and 126 days (median values). The average age was 60 years and 70% were women.

The data was collected between August 2018 and February 2021 at the North Denmark Regional Hospital in collaboration with a Danish pain clinic. The study used CBD and THC isolates for monotherapy (a single cannabinoid) and a mix of CBD + THC isolates. The median daily doses were 7.5mg for THC alone (25mg max), 33mg for CBD alone (125mg max), or 7mg THC + 32mg CBD when combined.

As with many of the studies on cannabinoid medicine effectiveness, some patients do not experience any real improvement. However, those patients that do see an improvement usually see a significant improvement. 

The findings in this retrospective study conducted in a real-world clinical setting suggest a favourable safety profile of cannabinoids. 

Combination of THC and CBD seems overall more effective than cannabinoid monotherapy. 

one-third (per-protocol) of patients with chronic pain refractory to conventional analgesics, or experiencing intolerable adverse effects, benefited significantly from therapy with oral cannabinoid regimens.

The full text article is here at the Wiley Online Library.