Review: Cannabinoids Reasonable Option For Chronic Pain Treatment

  • by Paul Armentano, NORML Deputy Director February 9, 2016

    cannabis_pillsCannabinoids are safe and effective in the treatment of chronic pain conditions, according to a review of recent clinical trials published online ahead of print in the Canadian Journal of Anesthesia.

    Investigators at the University of Montreal, Department of Anesthesiology evaluated the results of 26 clinical trials “of good or excellent quality” involving 1,364 subjects. Trials assessed the use of various types of cannabinoid preparations, including herbal cannabis, liquid and oral cannabis extracts, and synthetic cannabinoid agents in pain treatment.

    Authors reported that cannabinoids were efficacious in alleviating various types of pain, including pain due to neuropathy, musculoskeletal disorders, fibromyalgia, HIV, and other chronic pain conditions.

    They concluded, “Overall, the recent literature supports the idea that currently available cannabinoids are modestly effective analgesics that provide a safe, reasonable therapeutic option for managing chronic non-cancer-related pain and possibly cancer-related pain.”

    Their conclusion mimics that of a 2015 systematic review published in the Journal of Neuroimmune Pharmacology that reported, “[C]annabinoids are safe, demonstrate a modest analgesic effect, and provide a reasonable treatment option for treatment of chronic non-cancer pain.”

    An abstract of the study, “Medical cannabis: considerations for the anesthesiologist and pain physician,” appears online here.

    23 Responses to “Review: Cannabinoids Reasonable Option For Chronic Pain Treatment”

    1. bobwv says:

      Wow I guess that’s why my 8-10 level 24/7 pain stays at about a 1 or 2.

    2. alley says:

      Why does the USA always have to come in last, again.

    3. Mark Mitcham says:

      Serious, chronic pain affects at least 116 million Americans each year, many of whom are inadequately treated by the health-care system, according to a report by the Institute of Medicine (IOM) in 2011. And, as Paul reports above, cannabinoids are safe and effective in the treatment of chronic pain conditions.

      You would think it would be a simple matter of putting two and two together, right?

      But many people are skeptical, if not outright hostile to the idea of marijuana as medicine. Talk to enough of these folks, and you will begin to see that the efficacy of cannabis as a treatment is not the real issue for them. You begin to see a pattern; they view your appeal for compassion as a hoax. “You just want to get high,” is a typical response.

      Which tells you we have a bigger cultural problem. I think it relates, in part, to our society’s schizoprenic relationship to drugs in general (doctors administrating life-saving drugs are heros while dealers doing the same thing are terrorists.) Also, in part, it relates to our society’s latent puritanical issues (they’re not neccessarily opposed to pain — your pain, anyway. Feeling good is a sign of moral weakness to these types.)

      And so an appeal to people’s compassion and humanity doesn’t take you as far as one might have thought!

      But I tell them, “Look, the cannabis is going to have it’s pharmacological effect, once you take it, regardless of WHY you took it — if it was to treat your chronic pain, or to get high, or to talk to God, or to thumb your nose at the law, or just to get back at your parents. The THC doesn’t care why you smoked it. That’s the point: marijuana is real medicine.”

      • Julian says:

        Good points. I would add that cannabinoids don’t kill people. Not one overdose, not even possible.

        Then ask them if they would like to visit the website for the CDC and read how many overdoses we get annually in the U.S. from the main prescribed pain treatment used today, opiates?


        Every day, 44 Americans die from prescription drug overdose from painkillers.

        If we dont start prescribing marijuana for pain management now, we should at least change prescription painkillers to their appropriate name;

        Prescription Killers.

        • Mark I. says:

          Cannabis medications used to be prevalent, well used until demonized under the guise of protecting the youth and ignorant. Instead we found out it was a control effort by the wealthy and powerful to subject and subdue dissent.

          • Julian says:

            Funny you mention that Mark. I occasionally get to go back and read up on US hemp history and slavery and it interests me that slaveowners traditionally grew their hemp up hill and close to the house, despite the better soil down on the river side where tobacco or, if further south, sugar cane was grown. One can still travel to Mount Vernon, Washington’s home just south of D.C., and see the modern layout of his plantation, ( a recommended stop to anyone traveling to citizen lobby day, May 27th).
            Part of the reason why hemp was grown close to the house was its plain, practical utility… We may recall that Martha Washington sewed our first flag out of hemp, or that the Declaration of Independence was written on hemp paper, but we can suspect a few buds of relatively more relaxing sativas made it into Washington’s pipe. Cannabis was medicine, food, building material, paper and clothing. No matter how labor intensive the harvest, it was too valuable to grow away from the house or down at the ports.
            For rope and sails hemp was too stategically important to grow out of watchful eyes. Also, European Americans were not as resistant to malaria as West African Americans so participating in hemp harvests required keeping the hemp up hill and away from the riversides where malaria was rampant. This made African Americans not only vital to the Revolutionary economy, but Washington’s entire strategy that defeated Cornwallis in the Northern Virginian swamps using African American soldiers promised liberty for their victory. These military tactics would continue with the Buffalo soldiers, but African American soldiers were never honored with land or title; much less a hemp field. When slavery slowly ended after reconstruction it was not long before we had alcohol prohibition followed by the marijuana Stamp Act of 1937.

            • Julian says:


              This leads me to conclude a more deceptive rational for the tight control of the hemp field through US policy; A slaveowner does not wish for the slaves to empower themselves with their own harvest. This is the institutionalized slavery of prohibition; preventing Americans from growing their own self-sustenance.
              Over the last few years, the hemp research amendment to the farm bill has been slowly turning back this corrupt subjugation. We must continue to educate our Congressman and vote them out when they declare themselves part of the modern unsustainable establishment. For when we contemplate the Controlled Substances Act through the eyes of hemp history, we discover that the substance we are “controlling” is ourselves.
              It is time we Declare our Independence from prohibition;

              We the People, in order to form a more perfect union, renounce the prohibition of any agricultural plant or crop and declare our independence from unsustainable agricultural policies of any government, whose only role is in the fair regulation, zoning and taxation of commerce that improves human coexistence with our environment through completely voter initiated elected representation in accordance with the pursuit of sustainable life, liberty and happiness. We hold these truths to be self evident that all life was created equal, and no plant, molecule or animal can be held in patent or prohibition without the enslavement of the life in which it sustains, including ourselves.
              Therefore We the People of these United States of America hereby declare that the only prohibition we shall honor is that of prohibition itself, that any existing prohibition of a living component of life shall be repealed and any patent of the molecules in which life is sustained must be made open source, in accordance with the Bill of Rights, in order to achieve multi-cultural and religious coexistence, sustainable liberty and uncolluded justice for all.

        • Pam says:

          While ill agree marijuana helps tremendously with chronic pain,it doesnt help everyone.Those statistics about pain meds is a joke. The CDC uses FALSE data when recording the overdose deathrate, they even admitted to it but are not being held accountable for &why!? The FALSIFIED statistics were created to fit the governments addiction driven agenda!!They have doubled &tripled one persons death, they labeled all heroin deaths as prescription pills, if alcohol played a role they were told to turn the other way, if the person obtained their drug of choice illegally off the streets, told to turn the other way & label as a prescription pill death,much easier to target our doctors, &so much more, I am in for the fight of my life, as thousands & thousands if not millions are. The CDC &their INHUMANE restrictions is FORCING innocent law abiding citizens who are disabled /chronically ill to the streets for relief or worse KILLING THEMSELVES DUE TO INADEQUATE PAIN RELIEF! I am sick & tired of paying the very high price with my health & overall well being because of those who CHOOSE TO ABUSE! LEGITIMATE chronic intractable pain sufferers are NEGLECTED, ABUSED, MISTREATED &DISCRIMINATED AGAINST, WE ARE LABELED AS ADDICTS &PILL SEEKING JUNKIES &ITS A DISGRACE! The DEA is targeting our drs,instilling fear with loss of license if they treat intractable pain with opiods. For nearly all legitimate patients opiod therapy is the LAST RESORT, We do NOT get high, we get RELIEF.the DEA/ government is DENYING our RIGHT TO MEDICINE THAT WORKS,They are stripping LIFE SAVING medications from those of us who DEPEND, NOT ADDICTED to, on them for relief. .UNTREATEDCHRONIC INTRACTABLE PAIN KILLS, google this: petition2congress first do no harm

    4. Anonymous says:

      should marijuana be legal every where?

      • Julian says:

        Well theres a loaded question;

        Legally regulated meaning if a kid has epilepsy should there exist a medical card and a vaporizer on school property?


        The rest of you high school kids that cant get a medical card are going to have to consume off school grounds, with reasonable penalties implemented by the school, not law enforcement.

        However, zanex and opiates are already available in anti-depressants prescribed by school councilors with 24-hour parental approval. And these are prescriptions for fabricated diagnosis of everything from “ADD” for simply being too active for the teacher in class to handle, so for decades councilors and school health officials peddle every pill from riddlin to pro-zac to our CHILDREN with a 24-hour signature… hooking kids into an expensive legal addiction pandemic that was with an inexpensive, illegal seemingly unlimited supply of heroin due to made-to-fail US drug policy in Afghanistan and Mexico.

        So when we place marijuana, a non-toxic medicine, in that perspective, I believe school councilors should be prescribing whole plant cannabis permissions with 24 hour approval, and in the name of ganga-stank-kanneh-bosem stop giving kids zanex and opiates!

        • lockedoutofmyshed says:

          sorry jscott it did not work for you and just because it did not work for you does NOT mean it does not work for many others.I have had back and neck disc surgeries (3) gall bladder, 3 hernia as well. having said that, i did not fill my prescriptions for pain meds. i consumed cannabis in small doses in a reasonable manner. worked better than any pain med.just because YOU did not experience its benefits DOES NOT mean it does not help!

    5. jscott says:

      marijuana constricts blood vessels so it increases pain. The worst part of a new tattoo is when you get high it throbs because of… constricted blood vessels. more norml propaganda. vote against legal pot for rock stars while you will still get fired, legal or not.

      • Cajun dready says:

        Jscott could you give a link to your information? Which study, who conducted the study, when was it conducted please. It sounds like you pulled this information out of your ass.

        • jscott says:

          it was my study from getting tattooed then getting high on marijuana. thribing pain from constricted blood vessels just like cigarettes, JACK ASS! Heres my link republicans will end federal tax funding to legal marijuana states. have a nice bologna and apple in jail. I will continue to work and be prosperous, bitch.

          • Troll Alert says:

            jscott,so you blame the ‘thribing’ pain(learn to spell ) of your tattoo on marijuana because you happened to smoke some after the procedure? You know, i was wondering why NORML would let your post through,but i get it now,to give us an insight of what the retarded mind set of your average prohibitionist is like.Thanks for sharing your twisted logic.People like you, that like to occasionally indulge,but then support prohibition and all that it stands for,deserve more than a bologna sandwich in jail,you little hypocrite troll,you..

          • Galileo Galilei says:

            Your sample size is too small.

      • Troll Alert says:

        What the hell are you talking about? Cannabis is a vasodilator,it expands the arteries which is a healthy thing.You are spreading distorted lies like a propagandist would.Just because you will never be a rock star doesn’t mean that it should be illegal for everyone.Grow up and think beyond the boundaries of your own jealousies and limitations,and be careful where you put that tattoo.

      • Clint Waltz says:

        I beg to differ! I have an amputated right leg (BKA) and not only does marijuana help me with the PTSD, but it definitely helps with the physical stump pain (not phantom pain or phantom sensations, those are gone thankfully), the nausea & vomiting that goes along with extreme pain, the lack of sleep because of the pain, and all the other plethora of issues that go with chronic pain.

        Remember the Mark Twain line “Better to keep your mouth shut and be thought a fool than to open it and remove all doubt” (paraphrasing)? If not, look in to it please…

    6. Cajun dready says:

      Good quote Clint, jscott certainly removed all doubt.

    7. Edie says:

      I am going on 69 years of age, yes a sixties girl. I was in a very bad car accident in 2011, started smoking weed to help with the neuropathic pain. I could not use a dispensary to get it where we lived. Finally I was able to find medical marijuana, and both street weed and medical worked wonders on me with sleeping at night. It also got me off all e pain meds I was on. Now that we moved I am finally out, and can not go to the streets for help. Since being out my leg,foot and hip keep me awake & in pain. I truly know that medical marijuana does help, I know this for a fact for I have not slept all night in a long time. Remember I will be 69 yrs old very soon. Marijuana should be a free choice to every American, with out fear, but more than that medical marijuana should be a available in every State, that is my opinion. Pain is difficult to live with and I know for I live with it everyday, and without medical marijuana I also have notice that besides the pain, not having it has cause me to go backwards in rehab and I am losing muscle, which is needed to help me live a better life. I am taking steps backwards in stead forward in my recovery.

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