In most cases, the findings were dissonant between assessments for measured pain outcomes. However, for chronic non-cancer pain, two reviews preferred cannabis over placebo to reduce pain. A review that reviewed acute pain for postoperative pain relief found Worcester medical marijuana card no difference between different cannabinoid drugs and placebo. That puts patients trying medical marijuana products at a crossroads: In 23 states and Washington, D.C., laws allow doctors to recommend cannabis products for their patients for medical reasons.
With the maturity of the evidence base, future systematic reviews should seek and include unpublished reports in journals and ideally evaluate all articles other than in English; authors should also adequately assess the risk of bias and perform an appropriate literature synthesis. There was disparity in reported outcomes between assessments, including unsypsified data (study by study), and many were unable to provide a definitive explanation about the effectiveness of cannabis, nor the degree of increased side effects and harm. This is consistent with the limitations generally reported in all assessments, such as the small number of relevant studies, the small sample size of individual studies and the methodological shortcomings of the available studies.
CB2 receptor stimulation occurs in the sensory neurons of the dorsal root ganglion, spinal cord, and brain areas that are highly relevant to nociceptive modulation. The authors stated that the effects produced by cannabis were similar to opioid analgesia with an improvement in the affective and sensory component, but not due to a relaxing or calming effect. In addition, a similar study showed better sleep quality with higher THC levels, in addition to pain relief.9 Side effects were more common and were very mild at the higher dose of THC. We identified a combination of reviews that support and do not support cannabis use, based on the authors’ conclusions. Readers may consider the quality of reviews, the use of different quality assessment tools, additional considerations covered by the GRADE framework, and the potential for spin as possible reasons for these inconsistencies. It is also possible that cannabis has different effects depending on the type (e.g. synthetic), dosage, indication, the type of pain being assessed (e.g. neuropathic) and the tools used for outcome assessment, which may depend on variations in the condition.
Evidence of longer-term, adequately driven, methodologically sound RCTs investigating different types of cannabis-based drugs is needed to obtain conclusive recommendations. Our findings are consistent with a recently published summary of cannabis-based medications for chronic pain management. This report found inconsistent results in systematic reviews of cannabis-based medications compared to placebo for chronic neuropathic pain, pain management in rheumatic diseases, and painful spasms in MS. The authors also concluded that cannabis was not superior to placebo in reducing cancer pain.
Plant-based and plant-based cannabis products are not controlled like more traditional medicines, increasing uncertainty about their potential risks to patients’ health. Although synthetic forms of cannabis are available on prescription, different cannabis plants and products contain different concentrations of THC and CBD, making the effects of exposure unpredictable. Although short-term side effects, such as drowsiness, short-term memory loss and dizziness, are relatively well known and can be considered minor, other possible effects (e.g., psychosis, paranoia, anxiety, infection, withdrawal) may be more harmful to patients. Medical cannabis is somewhat effective for chemotherapy-induced nausea and vomiting and may be a reasonable option in people who do not improve after preferential treatment. Comparative studies have shown that cannabinoids are more effective than some conventional antiemetics such as prochlorperazine, promethazine, and metoclopramide at controlling CINV, but these are used less frequently due to side effects such as dizziness, dysphoria, and hallucinations. Long-term cannabis use can cause nausea and vomiting, a condition known as cannabinoid hyperemesis syndrome.
He sat down and started coughing and while coughing he lost his ability to breathe in and out until he almost lost consciousness. The respiratory treatments he’s working on to help this didn’t work as well as the doctor expected. My father says that he “coughs things up” and that he couldn’t even breathe deeply enough to try. You seem to think it helps your ability to breathe deeply and therefore your respiratory treatment medication can reach more lungs to do its job.
The differences between the two tools can be attributed to differences in our overall reviews. Finally, the summary report included two reviews that were not localized in the original search because of the language and full text of a summary not found in the search. The evidence for cannabis-based medicines is not well established, as it has not been widely tested in clinical trials. Two studies compared cannabis with placebo cannabis in combination with an active medicine (Fig. 10 and 11). While one review showed that cannabis plus opioids reduced chronic pain, another review on pain in MS included only one study, which hindered the ability to determine the concordance of results. Cannabis showed several effects on painless outcomes, including the superiority of placebo over cannabis for some outcomes.
There is increased interest in the role of cannabis in the treatment of medical conditions. The availability of various cannabis-based products can make the side effects of exposure unpredictable. We wanted to run an overview of the scope of systematic reviews that assess the pros and cons of cannabis-based medicines for each condition.