Medicinal cannabis ‘worth trialling for chronic pain’

An international panel suggests there is a role for the medication when other interventions fail

Evidence supports doctors offering a trial of non-inhaled medicinal cannabis or cannabinoids for the treatment of chronic pain if standard care proves inadequate, according to new guidance.

Developed by a panel of international experts, including GPs, the recommendation applies to all patients living with moderate to severe chronic pain, including cancer pain, neuropathic pain, nociceptive pain and nociplastic pain.

It “reflects a high value placed on small to very small improvements in self-reported pain intensity, physical functioning and sleep quality, and willingness to accept a small to modest risk of mostly self-limited and transient harms,” the authors wrote.

Australia’s first GP authorised to prescribe medicinal cannabis, Associate Professor Vicki Kotsirilos, said the guidance would be helpful in the face of conflicting advice.

“The overall paper is extremely useful,” she told Australian Doctor.

She said The BMJ’s guidance recommended a “start low, go slow” approach and included a higher maximum dose for products containing tetrahydrocannabinol (THC) than previous guidelines.

“The guideline recommends … up to 40mg per day versus what we were previously taught, which was 20-30mg per day,” she said.

“They also found that psychosis was unlikely to occur at these dosages.

“I have found that when patients have had chronic pain relief, they sleep better and often wake up feeling better with more energy.”

“It’s encouraging that their extensive review has identified a number of randomised controlled trials, systematic reviews and meta-analyses. It shows there is research out there.”


Australian doctor