Cannabinoids for the Treatment of Chronic Non-Cancer Pain: An Updated Systematic Review of Randomized Controlled Trials
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An updated systematic review of randomized controlled trials examining cannabinoids in the treatment of chronic non-cancer pain was conducted according to PRISMA guidelines for systematic reviews reporting on health care outcomes. Eleven trials published since our last review met inclusion criteria. The quality of the trials was excellent. Seven of the trials demonstrated a significant analgesic effect. Several trials also demonstrated improvement in secondary outcomes (e.g., sleep, muscle stiffness and spasticity). Adverse effects most frequently reported such as fatigue and dizziness were mild to moderate in severity and generally well tolerated. This review adds further support that currently available cannabinoids are safe, modestly effective analgesics that provide a reasonable therapeutic option in the management of chronic non-cancer pain.
KeywordsCannabinoids Chronic non-cancer pain Neuropathic pain Systematic review Marijuana
The authors thank Robin Parker for her excellent assistance in conducting the literature search for this review
Conflict of Interest
ML is a founding director of Panag Pharm Inc and is medical advisor to Abide Therapeutics both start up companies focused on development of nonpsychotropic cannabinoids for treatment of pain and other health conditions, she also sits on the Board of the Canadian Consortium for the Investigation of Cannabinoids (CCIC) a nonprofit organization dedicated to research and education on cannabinoids.
MW has received a grant from Prairie Plant Systems for a clinical trial of cannabis for pain management. MW is Executive Director of the Canadian Consortium for the Investigation of Cannabinoids (CCIC), a non-profit organization dedicated to research and education on cannabinoids.
- Huggins JP, Smart TS, Langman S, Taylor L, Young T (2012) An efficient randomised, placebo-controlled clinical trial with the irreversible fatty acid amide hydrolase-1 inhibitor PF-04457845, which modulates endocannabinoids but fails to induce effective analgesia in patients with pain due to osteoarthritis of the knee. Pain 153:1837–1846PubMedCrossRefGoogle Scholar
- Langford RM, Mares J, Novotna A, Vachova M, Novakova I, Notcutt W, Ratcliffe S (2013) A double-blind, randomised, placebo-controlled, parallel-group study of THC? CBD oralmucosal spray in combination with the existing treatment regimen, in the relief of central neuropathic pain in patients with multiple sclerosis. J Neurol 260:984–997PubMedCrossRefGoogle Scholar
- Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ionnidis JPA, CLarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analysis of studies that evaluate health care interventions: explanation and elaboration. Ann Int Med 15:W-65–W-94Google Scholar
- Pini LA, Guerzoni S, Cainazzo MM, Ferrari A, Sarchielli P, Tiraferri I, Ciccarese M, Zappaterra M (2012) Nabilone for the treatment of medication overuse headache: results of a preliminary double-blind, active-controlled, randomized trial. J Headache Pain 13:677–684PubMedCentralPubMedCrossRefGoogle Scholar
- Toth C, Mawani S, Brady S, Chan C, Liu C, Mehina E, Garven A (2012) An enriched-enrolment, randomized withdrawal, flexible-dose, double-blind, placebo controlled, parallel assignment efficacy study of nabilone as adjuvant in the treatment of diabetic peripheral neuropathic pain. Pain 153:2073–2082PubMedCrossRefGoogle Scholar