An ACOEM guideline found no quality evidence supporting cannabis for common work-related pain conditions, documented many adverse effects, and recommended against use in safety-sensitive positions.
Occupational medicine physicians, employers, workers' compensation professionals, safety officers.
No quality evidence of efficacy for back pain, neuropathic pain, or other common work conditions
What the researchers found
Some evidence for MS spasticity, but no quality evidence for back pain, radiculopathy, neuropathic pain, or other common work-related pain. Quality evidence supports lack of efficacy for postoperative pain. Documented adverse effects include cancers, cardiovascular diseases, psychotic disorders, and safety risks.
Why it matters
As legalization expands, employers face pressure to allow cannabis. This provides evidence-based grounds for workplace policies, particularly for safety-sensitive positions.
The numbers in context
Efficacy evidence: some for MS spasticity only. No quality evidence for: back pain, radiculopathy, neuropathic pain. Evidence against: postoperative pain. Harms: cancers, cardiovascular, psychotic disorders, safety risks.
How the study worked
Evidence-based guideline developed using ACOEM methodology, systematically reviewing evidence on cannabis efficacy and safety for work-related conditions.
What this study cannot tell us
Guidelines reflect evidence at publication; new trials may change recommendations. May reflect conservative occupational medicine perspective.
How to read the evidence
Systematic evidence-based guideline using ACOEM methodology, a high standard for occupational medicine recommendations.
When this study was published
Published in 2025.
The bigger picture
The gap between public perception of cannabis as a pain treatment and the evidence base has direct workplace safety implications.
Questions still open
- Will ongoing trials change the chronic pain picture? How should employers handle workers using cannabis for other conditions?
Common questions
Does cannabis work for workplace injury pain?
Can workers use cannabis in safety-sensitive jobs?
Read the original research
Cannabis.
Journal of occupational and environmental medicine, 67(12), e860-e871
Citation
Feinberg, Steven D; Aronoff, Gerald M; Ausfahl, James; Bruns, Daniel; Darnall, Beth D; Goldberg, Robert L; Haldeman, Scott; Lessenger, James E; Mandel, Steven; Mayer, Tom G; Navani, Annu H; Osbahr, Albert J; Warren, Pamela A; Winters, Thomas H; Harris, Jeffrey S; Hegmann, Kurt T. (2025). Cannabis.. Journal of occupational and environmental medicine, 67(12), e860-e871. https://doi.org/10.1097/JOM.0000000000003548
Explore the wider topic
- CBD Oil Quality Guide: How to Avoid Snake Oil
- Anxiety After Quitting Weed: When to Consider Medication
- Cannabis for Chemotherapy Nausea: What the Evidence Actually Shows
- Cannabis for Chronic Pain: What the Research Actually Supports
- Cannabis and Epilepsy: The Epidiolex Story and What It Means
- Does CBD Actually Work for Anxiety? What the Evidence Shows
- Does CBD Help with Weed Withdrawal? What Studies Show
- CBD vs THC: The Differences That Actually Matter
- The Proven Medical Benefits of Cannabis: What Research Supports
- Quitting Weed Before Surgery
- Weed and Medications: What Changes When You Quit
- Quitting Weed During Pregnancy: What You Need to Know
- Quitting Weed While Pregnant: What You Need to Know
- Cannabis and Older Adults: Risks Seniors Should Know
- Cannabis and Breastfeeding: THC in Breast Milk
- Cannabis and Security Clearances: What the Federal Government Actually Checks
- THC and Exercise: What Happens When You Work Out High
- Using Cannabis at Work: Risks, Rights, and What the Science Says