[Evidence of the efficacy and safety of cannabis medicines for chronic pain management: A methodological minefield]
Five pages on PainSci cite Häuser 2019: 1. The Complete Guide to Low Back Pain 2. The Complete Guide to Chronic Tension Headaches 3. The Complete Guide to Neck Pain & Cricks 4. Complete Guide to Frozen Shoulder 5. Marijuana for Pain
PainSci notes on Häuser 2019:
From the abstract: “The more detailed the search of literature and the higher the criteria of the inclusion of studies and of the clinical relevance of the study findings, the more disappointing are the conclusions of systematic reviews on the efficacy and safety of cannabis medicines. … Cannabis medicines can be regarded to be third-line therapy for chronic neuropathic pain. There are signals of a lack of efficacy for all other chronic pain syndromes.”
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Recent systematic reviews (SRs) came to divergent conclusions on the efficacy and safety of medical marijuana and cannabis-based medicines for chronic pain management. This paper gives an overview and critical appraisal of the methods of recent SRs of randomized controlled trials (RCTs) with cannabis medicines for chronic pain. Selective search of the literature, incorrect data analyses and presentation in favor of cannabis medicines can be detected in both RCTs and SRs. The more detailed the search of literature (e.g. inclusion of so-called grey literature) and the higher the criteria of the inclusion of studies (such as study duration) and of the clinical relevance of the study findings, the more disappointing are the conclusions of SRs on the efficacy and safety of cannabis medicines. There is moderate quality evidence of a moderate relief of neuropathic pain. Cannabis medicines can be regarded to be third-line therapy for chronic neuropathic pain. There are signals of a lack of efficacy for all other chronic pain syndromes. New high-quality RCTs and approaches, such as network meta-analyses combining different treatments and controlled and observational including additional outcomes than pain relief, are necessary to better define the importance of cannabis medicines for chronic pain management.
related content
- “The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research,” {The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research}, NationalAcademies.org.
- “Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS),” Ware et al, Journal of Pain, 2015.
- “The Effects of Cannabis Among Adults With Chronic Pain and an Overview of General Harms: A Systematic Review,” Nugent et al, Annals of Internal Medicine, 2017.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Gabapentinoids and Risk of Hip Fracture. Leung 2024 JAMA Netw Open.
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
- Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Hohenschurz-Schmidt 2024 Eur J Pain.
- Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes. Aasdahl 2021 BMC Musculoskelet Disord.