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New Treatment Guidelines Released for Cannabis as Treatment for Chronic Pain

11 Apr, 2023 F.J. Thomas

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Sarasota, FL (WorkersCompensation.com) – Several studies suggest that the prevalence of chronic pain could be as high as 20 to 25 percent of the population in some countries and regions, with 1 in 5 individuals as a common average globally. Two-thirds of those with chronic pain report that it is moderate to severe. Around 50 percent of those with moderate to severe chronic pain have dealt with the pain for more than 10 years.
Insomnia, depression, anxiety, post-traumatic stress disorder, as well as substance abuse disorders commonly co-occur in those with chronic pain. Interestingly enough, these co-conditions are the most common conditions for which cannabinoid-based medicine (CBM) is used therapeutically.
Although legal in some states, cannabis as a method for controlling pain is viewed with some skepticism by many healthcare providers. A large part of the criticism of CBM as a pain management strategy is based largely on lack of medical guidelines paired with a lack of recognized research supporting its therapeutic ability. However, that may soon change thanks to a new study released on March 27th in the medical journal, Cannabis and Cannabinoid Research.
Researchers from the University of Toronto, and University of British Columbia in Vancouver, Canada reviewed 47 peer reviewed pain management studies with more than 11,000 patients enrolled. Around half of the studies were randomized controlled trials. Together with clinicians and patients, based on the results of their review the research group developed clinical practice guidelines for the use of CBM in chronic pain management.
Thirty-eight of the 47 studies suggested that CBMs do provide at least moderate relief of pain. Based on the results, the researchers made several strong recommendations for the use of CBM as the only therapy as a replacement, or as an additional therapy for those with nerve pain.
The researchers made a strong recommendation for the use of CBM as a co-treatment of HIV symptoms such as nausea, depression and anxiety, and lack of appetite in conjunction with other therapies. Additionally, strong recommendations were made for use in multiple sclerosis cases. The researchers recommended CBM for not only pain management, but also for the management of muscle spasms and sleep disorders in multiple sclerosis patients.
For patients with arthritic pain, a strong recommendation was made for CBM treatment as an additional treatment for those not responding well to other modalities. Additionally, the researchers made strong recommendations for CBM as an additional treatment in cases of back pain and fibromyalgia.
In some cases, such as patients that were not receiving enough relief from opioids, the researchers recommended the use of CBM in conjunction with stepped down opioid regimens. The researchers highlighted the fact the CBM could be a tool in tapering the use of opioids.
The researchers were conservative in their recommendations for certain cases such as chronic headache and migraine, depression, and PTSD.
In a statement to Medscape Medical News, lead study author Alan Bell, MD from the University of Toronto cautioned that he doesn’t recommend CBM as the first line of defense in combating pain if there are other alternatives. However he does believe CBM has its place stating, “But, I would strongly argue that I would use cannabis-based medicine over opioids every time. Why would you use a high potency-high toxicity agent when there's a low potency-low toxicity alternative?”
While the FDA may not endorsing CBM treatment any time soon, the guidelines at least offer a clear alternative in certain cases.

https://pubmed.ncbi.nlm.nih.gov/22048225/
https://www.medscape.com/viewarticle/990506?ecd=WNL_trdalrt_pos1_230409&uac=397985CR&impID=5322032

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    About The Author

    • F.J. Thomas

      F.J. Thomas has worked in healthcare business for more than fifteen years in Tennessee. Her experience as a contract appeals analyst has given her an intimate grasp of the inner workings of both the provider and insurance world. Knowing first hand that the industry is constantly changing, she strives to find resources and information you can use.

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