First large Italian study of cannabis for chronic pain found 76% of patients continued treatment after initial follow-up
Among 614 Italian chronic pain patients treated with cannabis (primarily as tea), 76.2% continued treatment at initial follow-up, and fewer than 15% stopped due to side effects, none of which were severe.
Quick Facts
What This Study Found
Following Italy's 2015 authorization of medical cannabis, researchers analyzed the first year of clinical use for chronic pain across six treatment centers. Only one center (Pisa) had extensive experience, treating 614 of 659 total patients.
Cannabis tea was the primary delivery method, and in nearly all cases, cannabis was used alongside existing pain treatments rather than as a replacement. Initial and follow-up cannabinoid concentrations varied considerably across patients.
At the first follow-up, 76.2% of patients continued treatment. Fewer than 15% discontinued due to side effects, and none of the side effects were severe.
Key Numbers
614 patients from Pisa center (of 659 total across six centers). 76.2% continued treatment at initial follow-up. <15% stopped due to side effects (none severe). Primary delivery: cannabis tea. Treatment period: December 2015-November 2016.
How They Did This
Retrospective case series analyzing all chronic pain patients treated with oral or vaporized cannabis at six Italian centers from December 2015 to November 2016. Evaluated routes of administration, cannabis products used, dosing, effectiveness, and safety.
Why This Research Matters
This is the first large-scale snapshot of real-world cannabis use for chronic pain in Italy, providing data from a clinical setting rather than a controlled trial. The high continuation rate and low rate of severe side effects suggest acceptable tolerability in a diverse chronic pain population.
The Bigger Picture
Italy's approach of authorizing cannabis through clinical centers rather than dispensaries created an opportunity to systematically track patient outcomes. The high continuation rate is encouraging, though it could reflect patient self-selection or placebo effects. The variability in cannabinoid concentrations highlights the need for standardization.
What This Study Doesn't Tell Us
Retrospective, uncontrolled case series with no placebo comparison. Continuation rate does not equal efficacy. Concentration variability limits reproducibility. Only one center contributed the vast majority of patients. Pain type heterogeneity makes it difficult to identify which conditions respond best. Short follow-up period.
Questions This Raises
- ?Which specific chronic pain conditions responded best to cannabis treatment?
- ?Would standardized dosing improve outcomes?
- ?How do the Italian results compare to similar programs in other countries?
Trust & Context
- Key Stat:
- 76.2% of patients continued cannabis treatment; <15% stopped due to side effects
- Evidence Grade:
- Large retrospective case series providing real-world data. No control group or standardized outcomes limit the strength of conclusions.
- Study Age:
- Published in 2017. Italy's medical cannabis program has continued to evolve with accumulating clinical experience.
- Original Title:
- Cannabis and intractable chronic pain: an explorative retrospective analysis of Italian cohort of 614 patients.
- Published In:
- Journal of pain research, 10, 1217-1224 (2017)
- Authors:
- Fanelli, Guido, De Carolis, Giuliano, Leonardi, Claudio, Longobardi, Adele, Sarli, Ennio, Allegri, Massimo, Schatman, Michael E
- Database ID:
- RTHC-01374
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Frequently Asked Questions
How was the cannabis administered?
The primary method was cannabis tea, and in nearly all cases it was used alongside existing pain medications rather than as a standalone treatment. This reflects a conservative clinical approach of adding cannabis to existing regimens.
Does 76% continuation mean it works?
Not necessarily. Continuation rate indicates tolerability and perceived benefit, but without a control group, placebo effects, natural symptom fluctuation, and patient expectations cannot be separated from actual drug effect.
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Cite This Study
https://rethinkthc.com/research/RTHC-01374APA
Fanelli, Guido; De Carolis, Giuliano; Leonardi, Claudio; Longobardi, Adele; Sarli, Ennio; Allegri, Massimo; Schatman, Michael E. (2017). Cannabis and intractable chronic pain: an explorative retrospective analysis of Italian cohort of 614 patients.. Journal of pain research, 10, 1217-1224. https://doi.org/10.2147/JPR.S132814
MLA
Fanelli, Guido, et al. "Cannabis and intractable chronic pain: an explorative retrospective analysis of Italian cohort of 614 patients.." Journal of pain research, 2017. https://doi.org/10.2147/JPR.S132814
RethinkTHC
RethinkTHC Research Database. "Cannabis and intractable chronic pain: an explorative retros..." RTHC-01374. Retrieved from https://rethinkthc.com/research/fanelli-2017-cannabis-and-intractable-chronic
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.