A review of 68 studies found medical marijuana shares similar uses with FDA-approved cannabis medications, mainly for pain and nausea, but evidence for marijuana specifically remains limited and conflicting.
Read this if you use medical cannabis and want to know what conditions have the strongest evidence, or if you are a healthcare professional counseling patients.
68 studies reviewed: only moderate evidence supports medical marijuana for pain and seizure management.
What the researchers found
Researchers reviewed 68 studies comparing the three FDA-approved cannabis-based medications (dronabinol, nabiximols, nabilone) with smoked and orally ingested marijuana. All share similar medical uses: neuropathic pain was the most common application across all forms.
Dronabinol (Marinol) was most used for weight gain, chemotherapy nausea, and neuropathic pain. Nabiximols (Sativex) was most used for multiple sclerosis spasticity and neuropathic pain. Nabilone (Cesamet) was most used for chemotherapy nausea and neuropathic pain.
Smoked marijuana was most studied for neuropathic pain and glaucoma. Orally ingested marijuana was most studied for sleep improvement, pain reduction, and seizure control in multiple sclerosis.
All forms shared similar adverse effects, predominantly central nervous system effects, along with cardiovascular and respiratory effects. The review concluded there was insufficient high-quality evidence to support widespread medical marijuana use, with only moderate evidence supporting its use in pain and seizure management.
Why it matters
As medical marijuana programs expand, healthcare professionals increasingly face patient questions about cannabis for various conditions. This review provides a structured comparison of what the evidence supports for approved cannabis medications versus marijuana itself, giving clinicians a practical reference for counseling.
The numbers in context
68 studies reviewed. Three FDA-approved cannabis medications compared with smoked and oral marijuana. CNS-related adverse effects were the most common category across all forms.
How the study worked
The authors conducted a literature review using key search terms across cannabis medications and medical conditions. They reviewed 68 abstracts, analyzing and organizing them by medical use, efficacy, and adverse effects for each cannabis formulation.
What this study cannot tell us
The review methodology was not systematic, and the search strategy was not exhaustive. The evidence landscape for medical marijuana has evolved significantly since 2016. The review focused on efficacy data available at the time and may not reflect current clinical practice.
How to read the evidence
Moderate evidence from a literature review of 68 studies, providing a broad overview of the evidence landscape for cannabis-based therapies.
When this study was published
Published in 2016. The evidence base for medical cannabis has expanded substantially since this review, with more controlled trials and additional approved indications.
The bigger picture
There is an inherent tension in medical marijuana policy: FDA-approved cannabinoid medications exist with established dosing and safety profiles, but patients often prefer whole-plant marijuana for reasons including cost, access, and perceived effectiveness. This review highlights that the evidence base for approved medications is substantially stronger than for marijuana itself.
Questions still open
- Has the evidence for medical marijuana strengthened since 2016? How do whole-plant cannabis products compare to isolated cannabinoid medications in head-to-head trials? What counseling approaches are most effective for patients using medical marijuana alongside prescription medications?
Common questions
What conditions have the most evidence for medical marijuana?
Is medical marijuana the same as FDA-approved cannabis medications?
Read the original research
Medical marijuana patient counseling points for health care professionals based on trends in the medical uses, efficacy, and adverse effects of cannabis-based pharmaceutical drugs.
Research in social & administrative pharmacy : RSAP, 12(4), 638-54
Citation
Parmar, Jayesh R; Forrest, Benjamin D; Freeman, Robert A. (2016). Medical marijuana patient counseling points for health care professionals based on trends in the medical uses, efficacy, and adverse effects of cannabis-based pharmaceutical drugs.. Research in social & administrative pharmacy : RSAP, 12(4), 638-54. https://doi.org/10.1016/j.sapharm.2015.09.002
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