Cannabis in Pain Treatment: Clinical and Research Considerations

In this article important considerations in the use of cannabis are presented to better prepare clinicians to care for patients who use if and needed directions for research are identified.

Abstract: Cannabinoids show promise as therapeutic agents, particularly as analgesics, but theirdevelopment and clinical use has been complicated by recognition of their botanical source, cannabis,as a substance of misuse. Although research into endogenous cannabinoid systems and potential cannabinoidpharmaceuticals is slowly increasing, there has been intense societal interest in making herbal(plant) cannabis available for medicinal use; 23 U.S. States and all Canadian provinces currently permituse in some clinical contexts. Whether or not individual professionals support the clinical use of herbalcannabis, all clinicians will encounter patients who elect to use it and therefore need to be prepared to

advise them on cannabis-related clinical issues despite limited evidence to guide care. Expanded
research on cannabis is needed to better determine the individual and public health effects of increasing
use of herbal cannabis and to advance understanding of the pharmaceutical potential of cannabinoids
as medications. This article reviews clinical, research, and policy issues related to herbal cannabis to support
clinicians in thoughtfully advising and caring for patients who use cannabis, and it examines obstacles
and opportunities to expand research on the health effects of herbal cannabis and cannabinoids.
Perspective: Herbal cannabis is increasingly available for clinical use in the United States despite
continuing controversies over its efficacy and safety. This article explores important considerations
in the use of plant Cannabis to better prepare clinicians to care for patients who use it, and identifies
needed directions for research.
ยช 2016 by the American Pain Society

Authors: SR Savage, A Romero-Sandoval, M Schatman, M Wallace, G Fanciullo, B McCarberg and M Ware

The Journal of Pain (2016) 17:654-668

 

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Cannabis in Pain Treatment: Clinical and Research Considerations