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Note to students and readers: Despite its initial conclusions, the study featured in the following summary is good science. Good science is cynical and demands repeated proof from different research teams and areas of the world, including robust (and very expensive) double- and triple-blind placebo-controlled clinical trials involving humans.
This study does not, explicitly, state that cannabis is not a valid candidate for the treatment of chronic pain. Rather, it states that more research is needed and the current body of literature insufficient to conclude that cannabis or any of its constituent molecules can reasonably be considered effective treatment for pain.
Cannabis for Chronic Pain Study
A 2024 study entitled "Thoughtfully Integrating Cannabis Products Into Chronic Pain Treatment" that was published in the peer-reviewed medical journal Anesthesia & Analgesia explained that its goal was to "narratively synthesize relevant evidence to provide practical advice on cannabis use for chronic pain."
The study's authors declared that the societal status of cannabis has been changing rapidly since the mid-1990s when California became the first state to legalized the medical use of marijuana.
Wave of Legalization Since 1996
Cannabis for Chronic Pain. "However, 36 states and the District of Columbia (D.C.) have enacted laws allowing medical cannabis use since 1996, and 17 states and D.C. decriminalized or legalized adult cannabis use since 2012," reported the scientists. They identified the following contributing factors for this pro-cannabis wave of legalization in the U.S.:
Increasing acknowledgment of the therapeutic properties of cannabis.
Growing perceptions of cannabis as minimally harmful.
Recognition of societal harms (e.g., incarceration and trauma) associated with criminalization.
The opioid crisis that has highlighted cannabis as an opioid alternative.
"Unsurprisingly, the number of Americans using legal medical cannabis has grown with liberalizing laws, to an estimated 5.5 million people in July 2021," reported the research. It noted that the most common reason a patient obtains a medical cannabis license/card is chronic pain and that this condition accounts for an astonishing "two-thirds of qualifying conditions listed in state registries."
CBMs vs. Dispensary Products
Cannabis for Chronic Pain. The study explained that a class of pharmaceutical products exists called cannabis-based medicines, or CBMs. These have undergone stringent testing and clinical trials involving humans and include non-organic products such as dronabinol (synthetic THC) and plant-derived products like Epidiolex (CBD).
"CBMs are, scientifically speaking, very distinct from the cannabis products available via state-licensed dispensaries called cannabis products, or CPs."
"For the purposes of this review, CBMs also include the standardized, research-grade herbal cannabis provided for clinical studies through the National Institute on Drug Abuse-funded facility at the University of Mississippi," clarified the scientists.
CBMs are, scientifically speaking, very distinct from the cannabis products available via state-licensed dispensaries (including medical-only dispensaries) called cannabis products, or CPs. None of the cannabis products available via licensed dispensaries have been approved by the U.S. Food & Drug Administration.
Cannabinoids, Flavonoids, & Terpenes
Cannabis for Chronic Pain. The study explained that the chemical compounds produced by the nearly microscopic trichome glands of the mature flowers of the female plant number in the hundreds. These include flavonoids (responsible for pigment and pronounced anti-cancer properties), phytocannabinoids (such as the most popular chemical compounds produced by marijuana, CBD and THC), and terpenes (more than 100 types of which are produced by cannabis; in nature, 20,000 botanical species produce 40,000 varieties of terpenes and terpenoids.
Cannabis for Chronic Pain Study Conclusions
The study concluded that the clinical trial data involving actual human study participants treated with cannabis products and CBMs for chronic pain "is inadequate to provide the same kind of clinical structure and prescription medicine model used for other medications."
The study concluded that the clinical trial data involving actual human study participants treated with cannabis products and CBMs for chronic pain "is inadequate."
The scientists tempered their conclusions: "However, given recent trends in cannabis liberalization, clinicians cannot wait years for definitive clinical trials before engaging with patients about these products. Instead, clinicians can better serve their patients by focusing on maintaining and strengthening the therapeutic alliance with patients using cannabis, harm reduction, and applying pragmatic clinical judgment complemented by the latest scientific literature."
View the original study.
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