New review a bit less bullish on cannabis

Earlier this year, we heard that there is “substantial evidence that cannabis is an effective treatment for chronic pain in adults,” according to a major report produced by the National Academies of Sciences, Engineering, and Medicine. That encouraged me to finally start recommending cannabis on PainScience.com, and it officially made it onto my master list of pain tips.

Predictably, new science is now harshing my buzz: a fresh review in Annals of Internal Medicine is more focused on cannabis for pain, and much less optimistic (see Nugent et al). It affirms that “cannabis may alleviate neuropathic pain in some patients” — hardly a ringing endorsement — and warns that there’s just not enough evidence about any other kind of chronic pain. It also confirms some risks of short term mental fog (ya think?), car accidents, and — this is the one that really matters — psychosis. The psychosis thing is going to be the sub-topic to keep an eye on over the next few years. See Marijuana for Pain: The hype versus the science! What does the evidence actually show about cannabis and chronic pain?.