Objective:

To provide best practice advice for clinicians counseling patients about cannabis or cannabinoid use for chronic noncancer pain.

Approach:

• Counseling Recommendations: Counsel patients about benefits and harms of cannabis or cannabinoids for chronic noncancer pain, particularly for specific subgroups.
• Evidence Base: Recommendations based on an AHRQ living systematic review of 26 randomized controlled trials and 12 observational studies.

Key Findings:

• Current evidence suggests that the harms of cannabis use for chronic noncancer pain outweigh the small potential benefits.
• Nabiximols and synthetic THC preparations show limited effectiveness.
• Cannabis use poses risks including dizziness, sedation, nausea, and long-term issues like cannabis use disorder, cognitive effects, and mental health impacts.

Interpretation:

Limitations:

• Evidence was insufficient to show benefit for types of chronic noncancer pain beyond neuropathic pain.
• Potential cognitive and mental health effects in adolescents and young adults.

Conclusion:

The ACP's best practice advice provides clinicians with guidance for informed discussions about cannabis use in chronic noncancer pain.

Sources:

• Annal of Internal Medicine