American College of Physicians Issues New Guidance on Cannabis for Chronic Pain

The ACP developed best practice advice based on systematic reviews, recommending clinicians counsel patients about cannabis for chronic noncancer pain while identifying specific subgroups where harms likely outweigh benefits: young adults and adolescents, patients with substance use disorders, those with serious mental illness, and frail patients at risk for falls.

Clinical guidance developed by the ACP Population Health and Medical Science Committee based on living systematic reviews and primary studies on cannabis and cannabinoid treatments for chronic noncancer pain.

This represents one of the first major U.S. medical society guidelines specifically addressing cannabis for chronic pain. Rather than a blanket endorsement or rejection, it takes a nuanced position that acknowledges potential benefits while drawing clear lines around higher-risk populations.

As cannabis legalization expands, clinicians increasingly face questions about its role in pain management. Having guidance from a major medical society gives practitioners a framework for these conversations rather than relying on anecdotal evidence or patient self-direction.

Best practice advice is based on available evidence, which remains limited in quality and quantity. The guidance acknowledges uncertainty in many areas and relies on systematic reviews that may not capture the full range of cannabis products and formulations patients actually use.