Clinical guidelines for using cannabis in chronic pain management

From 70 articles (19 systematic reviews, 51 original studies), research demonstrates moderate benefit of cannabinoid-based medicines for chronic pain. Evidence also supports efficacy for sleep problems, anxiety, appetite suppression, and pain in HIV, MS, fibromyalgia, and arthritis. Patients should be educated on risks, and clinicians should collaborate on dosing and titration.

Systematic review following PRISMA guidelines with dual review. 70 articles met inclusion criteria. Clinical recommendations developed using GRADE system to rate strength of recommendations and quality of evidence. PROSPERO registration #135886.

Healthcare providers consistently report lacking information about cannabis for pain. These guidelines provide an evidence-based framework for clinicians and patients to navigate cannabis use for chronic pain, filling a major clinical knowledge gap.

One in five people globally lives with chronic pain, often co-occurring with sleep problems, anxiety, depression, and substance use disorders. Guidelines that address cannabis for pain alongside these comorbidities reflect the clinical reality of treating the whole patient.

Based on available evidence which has significant heterogeneity in cannabinoid formulations, doses, and outcomes. Many studies use pharmaceutical cannabinoids rather than whole-plant products. GRADE ratings reflect moderate quality overall. Cannabis product variability makes standardized recommendations difficult.