Medical cannabis for chronic painBMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1942 (Published 09 September 2021) Cite this as: BMJ 2021;374:n1942
- Edeltraut Kröger, research scientist and adjunct professor1,
- Clermont E Dionne, professor and chair2
- 1Centre d’excellence sur le vieillissement de Québec, CIUSSSS CN Hôpital St-Sacrement, Québec, QC G1S 4L8, Canada
- 2Department of social and preventive medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Québec, QC G1V 0A6, Canada
- Corresponding author: E Kröger
Patients with persistent pain continue to search for new therapeutic options and often perceive cannabis as a worthwhile alternative.1 Clinicians need guidance on this option to inform shared decision-making with patients.2 The linked clinical guidance by Busse and colleagues was developed for this purpose and comes from an international panel combining several disciplines, specialties, and patient groups.3 The new guidance is based on a systematic review of the effectiveness of medical cannabis for chronic pain,4 offers an online tool, and has the potential to fill a critical gap in information for decision making, enabling more inclusive management of chronic pain.
The guidance offers a weak recommendation for a trial of non-inhaled medical cannabis for the treatment of chronic pain. Its summary indicates moderate evidence of a clinically important decrease in pain for a small to very small proportion of patients. The recommendation for a trial of treatment is based on two meta-analyses of randomised trials within the systematic review4: first, a meta-analysis of …