Cannabis Pain Research

Vaporized cannabis versus placebo for acute migraine: A randomized, double-blind, placebo-controlled crossover trial.

Schuster, Nathaniel M · 2026

THC+CBD (6% THC + 11% CBD) was superior to placebo for pain relief (67.2% vs 46.6%, OR 2.85), pain freedom (34.5% vs 15.5%, OR 3.30), and most bothersome symptom freedom (60.3% vs 34.5%, OR 3.32) at 2 hours, with sustained benefits at 24 and 48 hours.

Medical Cannabis and Opioid Receipt Among Adults With Chronic Pain.

Slawek, Deepika E · 2026

Compared to months with no medical cannabis dispensed, a 30-day supply of medical cannabis was associated with 3.53 fewer daily morphine milliequivalents (MME).

A within-subject, double-blind, placebo-controlled randomized evaluation of the combined effects of cannabidiol and hydromorphone in a human laboratory pain model.

Bergeria, Cecilia L · 2025

When combined with hydromorphone (which alone did not reliably produce analgesia), CBD increased analgesic effects for some acute pain measures but not chronic pain models.

Cannabinoids as a Potential Alternative to Opioids in the Management of Various Pain Subtypes: Benefits, Limitations, and Risks.

Chou, Roger · 2025

THC:CBD oral spray: small pain decrease (MD -0.54/10); high THC: small decrease (MD -0.78/10); CBD alone: no benefit (moderate SOE); THC products caused large dizziness increase (RR 3.57) and sedation increase (RR 5.04)..

Evaluating the Acute Effects of the Cannabinoid Dronabinol and the Opioid Hydromorphone Alone and in Combination: A Double-Blind, Randomized, Placebo-Controlled Trial in Knee Osteoarthritis.

Hamilton, Katrina R · 2025

In a within-subject, double-blind trial, hydromorphone showed some analgesic effects on specific pain measures (pressure pain threshold, mechanical temporal summation) but neither drug reduced clinical pain severity or most experimentally induced pain measures.

Cannabis Laws and Opioid Use Among Commercially Insured Patients With Cancer Diagnoses.

Lozano-Rojas, Felipe · 2025

Medical cannabis dispensary openings were associated with a reduction of 41 fewer patients per 10,000 with opioid prescriptions, 2.54 fewer days of supply per prescription, and 0.099 fewer prescriptions per patient.

Cannabis Legalization and Opioid Use Disorder in Veterans Health Administration Patients.

Mannes, Zachary L · 2025

OUD prevalence increased by 0.06 percentage points after medical cannabis law enactment and 0.07 points after recreational law enactment.

The Combined Relationship of Prescription Drug Monitoring Program Enactment and Medical Cannabis Laws with Chronic Pain-Related Healthcare Visits.

Mannes, Zachary L · 2025

Prescription drug monitoring programs alone were not associated with changes in chronic pain outpatient visits.

The relationship of medical and recreational cannabis laws with opioid misuse and opioid use disorder in the USA: Does it depend on prior history of cannabis use?

Martins, Silvia S · 2025

Overall, neither medical nor recreational cannabis laws were associated with changes in opioid misuse or use disorder at the population level.

The Impact of Medical Cannabis Laws on Cannabis and Opioid Use Disorder Treatment and Overdose-Related Health Care Utilization Among Adults With Chronic Noncancer Pain.

McGinty, Emma E · 2025

Medical cannabis laws had estimated effects of less than 0.005 percentage points on CUD or OUD treatment, less than 0.009 points on new treatment initiation, and less than 0.0005 points on overdose-related care (all p > 0.05).

Cannabis Use Among Older Adults.

Pravosud, Vira · 2025

Of 4,503 veterans aged 65-84, 58.2% had ever used cannabis.

Pain predicts past-month co-use of alcohol and cannabis among emerging adults: Results from the Population Assessment of Tobacco and Health (PATH) Study.

Williams, Callon M · 2025

Moderate/severe pain at baseline prospectively predicted engaging in co-use of alcohol and cannabis among emerging adults aged 18–24.

Pain Predicts Cannabis Initiation Among Emerging Adults: Results from the Population Assessment of Tobacco and Health (PATH) Study.

Williams, Callon M · 2025

Among 4,185 emerging adults who denied cannabis use at baseline, moderate/severe pain (reported by about 10%) prospectively predicted cannabis initiation across five annual waves.

Cannabis for chronic pain: cardiovascular safety in a nationwide Danish study.

Holt, Anders · 2024

Among 5,391 chronic pain patients who received prescribed medical cannabis, 0.8% developed new-onset arrhythmia within 180 days compared to 0.4% of matched controls, yielding a risk ratio of 2.07.

Charting the therapeutic landscape: a comprehensive evidence map on medical cannabis for health outcomes.

Montagner, Patrícia · 2024

Of 489 descriptions of treatment effects across 71 health outcomes, 278 (57%) reported positive or potentially positive effects.

Cannabis combined with oxycodone for pain relief in fibromyalgia pain: a randomized clinical self-titration trial with focus on adverse events.

van Dam, Cornelis Jan · 2024

The combination of cannabis and oxycodone reduced opioid tablet consumption by 35% (p=0.02) but did not reduce adverse effects or improve pain relief compared to either treatment alone.

Medical Marijuana Legalization and Opioid- and Pain-Related Outcomes Among Patients Newly Diagnosed With Cancer Receiving Anticancer Treatment.

Bao, Yuhua · 2023

In a difference-in-differences analysis of 58,195 cancer patients across 34 states, medical marijuana legalization was associated with a 5.6 percentage point reduction in opioid dispensing among breast cancer patients with recent opioid use and a 6.3 percentage point reduction in pain-related hospital events among lung cancer patients..

Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications.

Bilbao, Ainhoa · 2022

CBD showed high-grade evidence for epilepsy (SMD -0.5) and moderate-grade for Parkinsonism (SMD -0.41).

Association of a Positive Drug Screening for Cannabis With Mortality and Hospital Visits Among Veterans Affairs Enrollees Prescribed Opioids.

Keyhani, Salomeh · 2022

Cannabis use was not associated with all-cause mortality at 90 or 180 days in the overall population or among those on long-term opioid therapy.

Opioid-sparing effect of cannabinoids for analgesia: an updated systematic review and meta-analysis of preclinical and clinical studies.

Nielsen, Suzanne · 2022

Preclinical meta-analysis showed THC reduced the effective morphine dose by 3.5-fold (95% CI 2.04-6.03).

Efficacy and safety of therapeutic use of cannabis derivatives and their synthetic analogs: Overview of systematic reviews.

Riera, Rachel · 2022

Evidence certainty was not high for any cannabinoid outcome.

Cannabidiol treatment in hand osteoarthritis and psoriatic arthritis: a randomized, double-blind, placebo-controlled trial.

Vela, Jonathan · 2022

Between-group difference in pain intensity at 12 weeks was 0.23 mm on a 0-100 mm scale (95% CI -9.41 to 9.90, p=0.96).

Legal status of recreational cannabis and self-reported substitution of cannabis for opioids or prescription pain medication in Canada and the United States.

Wadsworth, Elle · 2022

Between 14-33% of cannabis consumers used it for pain.

Medical cannabis or cannabinoids for chronic pain: a clinical practice guideline.

Busse, Jason W · 2021

The guideline panel issued a weak recommendation to offer a trial of non-inhaled medical cannabis or cannabinoids as add-on therapy for chronic pain when standard care is insufficient.

Opioid use in medical cannabis authorization adult patients from 2013 to 2018: Alberta, Canada.

Lee, Cerina · 2021

Patients on high-dose opioids (OME > 100) who received medical cannabis authorization showed a significant decrease in opioid use of 435.5 mg OME over six months compared to matched controls..

Cannabis Significantly Reduces the Use of Prescription Opioids and Improves Quality of Life in Authorized Patients: Results of a Large Prospective Study.

Lucas, Philippe · 2021

Among participants who used opioids at baseline (28%), the proportion dropped to 11% at six months.

Opioid-sparing effects of medical cannabis or cannabinoids for chronic pain: a systematic review and meta-analysis of randomised and observational studies.

Noori, Atefeh · 2021

Randomized trials (all in cancer pain) found adding cannabis had little or no impact on opioid dose (weighted mean difference: -3.4 MME, 95% CI -12.7 to 5.8) or pain relief (-0.18 cm on 10 cm VAS).

Systematic review and meta-analysis of cannabinoids, cannabis-based medicines, and endocannabinoid system modulators tested for antinociceptive effects in animal models of injury-related or pathological persistent pain.

Soliman, Nadia · 2021

Across 374 studies testing 171 interventions, selective CB1, CB2, and nonselective cannabinoid agonists (including THC) plus PPAR-alpha agonists significantly reduced pain in both inflammatory and neuropathic models, while FAAH inhibitors, MAGL inhibitors, and CBD were effective in neuropathic but showed mixed results in inflammatory pain..

Medical cannabis or cannabinoids for chronic non-cancer and cancer related pain: a systematic review and meta-analysis of randomised clinical trials.

Wang, Li · 2021

Cannabis provides small to very small improvements in pain intensity (WMD -0.50 on 10cm VAS), physical functioning (WMD 1.67 on 100-point SF-36), and sleep (WMD -0.35 on 10cm VAS) compared to placebo, with moderate-to-high certainty evidence.

Therapeutic potential of opioid/cannabinoid combinations in humans: Review of the evidence.

Babalonis, Shanna · 2020

Preclinical studies show cannabinoids enhance opioid analgesia and reduce required opioid doses in animals.

Cannabinoids and the expanded endocannabinoid system in neurological disorders.

Cristino, Luigia · 2020

Beyond the classical CB1/CB2 system, an expanded "endocannabinoidome" includes biochemically related mediators with their own receptors and enzymes.

Cannabis and multiple sclerosis.

Fragoso, Yara Dadalti · 2020

Evidence-based data from 33 studies with over 7,500 patients supports nabiximols for MS-related spasticity, pain, and urinary symptoms.

Tetrahydrocannabinol and cannabidiol oromucosal spray in resistant multiple sclerosis spasticity: consistency of response across subgroups from the SAVANT randomized clinical trial.

Meuth, Sven G · 2020

In post hoc analysis of the SAVANT RCT, THC:CBD oromucosal spray halved mean spasticity and pain severity scores across all subgroups defined by disability level (EDSS), spasticity severity, and spasticity duration.

Recreational Cannabis Use and Risk of Prescription Opioid Overdose: Insights from Pediatric Inpatients.

Pankaj, Amaya · 2020

In 27,444,239 pediatric hospitalizations (NIS database), 10,562 (0.04%) involved prescription opioid overdose.

Frequent Cannabis Use and Cessation of Injection of Opioids, Vancouver, Canada, 2005-2018.

Reddon, Hudson · 2020

Among three prospective cohorts of people who inject drugs (PWID) in Vancouver from 2005-2018, at-least-daily cannabis use was associated with 16% faster injection cessation overall (AHR 1.16, CI 1.03-1.30).

Dark Classics in Chemical Neuroscience: Δ9-Tetrahydrocannabinol.

Banister, Samuel D · 2019

THC primarily acts as a partial agonist at CB1 receptors, producing its distinctive intoxication.

Gastrointestinal Adverse Events of Cannabinoid 1 Receptor Inverse Agonists suggest their Potential Use in Irritable Bowel Syndrome with Constipation: A Systematic Review and Meta-Analysis.

Fabisiak, Adam · 2019

Rimonabant 20mg produced significantly more GI adverse events than placebo (OR 2.05) and overall adverse events (OR 1.35).

Safety, efficacy, and mechanisms of action of cannabinoids in neurological disorders.

Friedman, Daniel · 2019

Randomized controlled trials provide evidence of CBD's anti-seizure effects for Lennox-Gastaut and Dravet syndromes.

Newest evidence for tetrahydrocannabinol:cannabidiol oromucosal spray from randomized clinical trials.

Marková, Jolana · 2019

A Phase IV trial found no effect of THC:CBD spray on cognition and mood after 50 weeks of treatment.

Sativex® as add-on therapy vs. further optimized first-line ANTispastics (SAVANT) in resistant multiple sclerosis spasticity: a double-blind, placebo-controlled randomised clinical trial.

Markovà, Jolana · 2019

77.4% of patients receiving add-on THC:CBD spray achieved clinically relevant (30%+) spasticity NRS improvement versus 32.1% on placebo (p<0.0001).

Association between medical cannabis laws and opioid overdose mortality has reversed over time.

Shover, Chelsea L · 2019

Extending the Bachhuber et al.

The therapeutic effects of Cannabis and cannabinoids: An update from the National Academies of Sciences, Engineering and Medicine report.

Abrams, Donald I · 2018

The National Academies of Sciences, Engineering and Medicine conducted a comprehensive review of the health effects of cannabis, with a 16-member committee analyzing 10,000 recent abstracts across 11 health categories. For therapeutic effects, the committee found conclusive or substantial evidence that cannabis or cannabinoids effectively treat three conditions: chronic pain in adults, chemotherapy-induced nausea and vomiting, and spasticity associated with multiple sclerosis. Moderate evidence supported cannabis for improving secondary sleep disturbances.

Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study.

Campbell, Gabrielle · 2018

This prospective national cohort followed 1,514 Australians with chronic non-cancer pain who were prescribed opioids over four years.

The Endogenous Cannabinoid System: A Budding Source of Targets for Treating Inflammatory and Neuropathic Pain.

Donvito, Giulia · 2018

This comprehensive review examined the entire endocannabinoid system as a source of pain treatment targets, covering CB1 and CB2 receptors plus the enzymes that make and break down endocannabinoids (FAAH and MAGL). In preclinical models, cannabinoid receptor agonists and inhibitors of endocannabinoid-regulating enzymes (FAAH and MAGL) produced reliable antinociceptive (pain-reducing) effects across multiple inflammatory and neuropathic pain models. A particularly notable finding: these compounds offered opioid-sparing effects, meaning they could reduce the amount of opioid medication needed for pain control. Clinical studies showed that medicinal cannabis or cannabinoid-based medications relieve pain in cancer, multiple sclerosis, and fibromyalgia.

Medical Use of Cannabinoids.

Fraguas-Sánchez, Ana Isabel · 2018

This extensive review covered the therapeutic landscape of cannabinoids across dozens of medical conditions. Six cannabinoid medications had already received regulatory approval: nabilone and dronabinol capsules for chemotherapy nausea and vomiting, dronabinol capsules and oral solution for anorexia, THC:CBD oromucosal spray (Sativex) for MS-related spasticity and cancer pain, and CBD oral solution (Epidiolex) for Dravet and Lennox-Gastaut epilepsy syndromes. Beyond approved uses, the review found evidence supporting potential applications in inflammatory and neuropathic pain, various cancer types (brain, breast, prostate), neurodegenerative diseases (Parkinson's, Huntington's, Alzheimer's), PTSD and anxiety disorders, irritable bowel syndrome, eye diseases, and substance abuse disorders (particularly alcohol and opioid). The endocannabinoid system's involvement in energy balance, appetite, blood pressure, pain modulation, nausea, memory, learning, and immune response explains the breadth of potential therapeutic applications..

Cannabis-based medicines for chronic neuropathic pain in adults.

Mücke, Martin · 2018

The Cochrane Collaboration reviewed 16 randomized, double-blind controlled trials (1,750 patients, 2-26 weeks) of cannabis-based medicines for chronic neuropathic pain. Formulations included: THC/CBD oromucosal spray (10 studies), nabilone (2), inhaled herbal cannabis (2), and dronabinol (2). Efficacy was modest: 21% of cannabis patients achieved 50% or greater pain relief vs 17% with placebo (NNT 20, low-quality evidence).

The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: a Systematic Review of Reviews.

Nielsen, Suzanne · 2018

Researchers conducted a "review of reviews" to synthesize high-quality systematic reviews on cannabinoids for multiple sclerosis symptoms. Eleven eligible systematic reviews were identified, providing data from 32 studies including 10 moderate-to-high quality RCTs. Five reviews concluded there was sufficient evidence that cannabinoids may be effective for MS-related pain and/or spasticity. Few reviews reported conclusions for other MS symptoms including disability/progression, bladder function, tremor/ataxia, or quality of life. The authors noted that cannabinoid effects on pain and spasticity were "modest" rather than large, and identified a critical evidence gap: no studies compared cannabinoids to non-cannabinoid treatments, only to placebo..

Cannabinoids for Treatment of MS Symptoms: State of the Evidence.

Rice, Jessica · 2018

Nabiximols (Sativex), oral cannabis extract (OCE), and synthetic THC are probably effective for patient-reported spasticity and central pain in MS.

Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies.

Stockings, Emily · 2018

For 30% pain reduction: 29% on cannabinoids vs 25.9% on placebo (NNT=24).

Cannabinoids in Pain Management and Palliative Medicine.

Häuser, Winfried · 2017

This systematic review of systematic reviews examined the highest-quality evidence available on cannabinoids for pain management and palliative medicine. Of 750 publications identified, 11 systematic reviews met inclusion criteria.

Selective Cannabinoids for Chronic Neuropathic Pain: A Systematic Review and Meta-analysis.

Meng, Howard · 2017

This systematic review and meta-analysis addressed the conflicting recommendations from pain societies about cannabinoids for neuropathic pain. Across 11 RCTs including 1,219 patients, selective cannabinoids (dronabinol, nabilone, nabiximols) produced a statistically significant reduction in pain scores compared to placebo or conventional treatment: -0.65 points on a 0-10 scale.

Cannabis Pharmacology: The Usual Suspects and a Few Promising Leads.

Russo, Ethan B · 2017

This major review, authored by leading cannabis researchers, argued that the pharmacology of cannabis cannot be reduced to THC and CBD alone.

Use of Cannabinoids for Spasticity and Pain Management in MS.

Chohan, Hardeep · 2016

This review synthesized evidence from randomized trials on cannabinoid use for two of the most troubling MS symptoms: spasticity and pain. Several randomized trials provided Class 1 and 2 evidence (the highest levels) supporting cannabinoid products for these indications.

Systematic review: efficacy and safety of medical marijuana in selected neurologic disorders [RETIRED]: report of the Guideline Development Subcommittee of the American Academy of Neurology.

Koppel, Barbara S · 2014

This systematic review by the American Academy of Neurology evaluated 34 studies (8 Class I) on medical marijuana for neurological conditions.

A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatment.

Serpell, M · 2014

At the 30% pain reduction threshold (considered clinically meaningful), significantly more patients on THC/CBD spray achieved this target compared to placebo (p=0.034).

Delta-9-tetrahydrocannabinol/cannabidiol (Sativex®): a review of its use in patients with moderate to severe spasticity due to multiple sclerosis.

Syed, Yahiya Y · 2014

In the largest multinational clinical trial using the approved treatment protocol, Sativex significantly reduced spasticity severity compared to placebo after 12 weeks in patients who had demonstrated initial response during a 4-week trial period.

Complementary and alternative medical therapies in multiple sclerosis--the American Academy of Neurology guidelines: a commentary.

Yadav, Vijayshree · 2014

The AAN's comprehensive evidence-based guidelines issued Level A recommendations (strongest) that oral cannabis extract is effective short-term for spasticity-related symptoms and pain (excluding central neuropathic pain), and that ginkgo biloba is ineffective for cognitive improvement in MS. Level B recommendations (probable) included: THC is probably effective for spasticity symptoms and pain but probably ineffective for objective spasticity or tremor.

Summary of evidence-based guideline: complementary and alternative medicine in multiple sclerosis: report of the guideline development subcommittee of the American Academy of Neurology.

Yadav, Vijayshree · 2014

This is the full guideline publication (not the commentary).

Chemical probes of endocannabinoid metabolism.

Blankman, Jacqueline L · 2013

The review described the development and application of chemical tools that selectively block the enzymes degrading each major endocannabinoid.

Multiple sclerosis and extract of cannabis: results of the MUSEC trial.

Zajicek, John Peter · 2012

The MUSEC trial randomized 279 MS patients across 22 UK centers to oral cannabis extract or placebo.

Cannabinoids for treatment of chronic non-cancer pain; a systematic review of randomized trials.

Lynch, Mary E · 2011

Researchers systematically reviewed randomized controlled trials of cannabinoids for chronic non-cancer pain.

Cannabinoids in the management of difficult to treat pain.

Russo, Ethan B · 2008

This review by Ethan Russo comprehensively covered the evidence for cannabinoid use in pain management as of 2008. Sativex (THC:CBD oromucosal spray) had been approved in Canada for MS central neuropathic pain (2005) and intractable cancer pain (2007).

Sativex successfully treats neuropathic pain characterised by allodynia: a randomised, double-blind, placebo-controlled clinical trial.

Nurmikko, Turo J · 2007

In a five-week randomized trial, 125 patients with peripheral neuropathic pain received either Sativex (THC:CBD mouth spray) or placebo while continuing their existing pain medications. Patients on Sativex experienced significantly greater pain reduction: -1.48 points vs.

Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis.

Rog, David J · 2005

Sixty-six MS patients with central pain (59 with dysesthetic pain, 7 with painful spasms) participated in a 5-week randomized, double-blind, placebo-controlled trial of a THC:CBD oromucosal spray.

Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up.

Zajicek, J P · 2005

This was the 12-month follow-up to the main Cannabinoids in Multiple Sclerosis (CAMS) study, the largest RCT of cannabinoids for MS at the time.

Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial.

Zajicek, John · 2003

In this landmark trial of 667 MS patients across 33 UK centers, neither oral cannabis extract nor THC improved spasticity as measured by the Ashworth scale (primary outcome, p=0.40).

Cannabinoid CB1 receptor and mu-opioid receptor interaction: new insights from conditional knockout mice.

Alton, Hannah · 2026

CB1 and mu-opioid receptors showed limited colocalization in pain and reward brain regions (5-25%); conditional knockout of MOR didn't alter THC effects (analgesia, hypothermia, catalepsy) and CB1R knockout didn't alter oxycodone effects, challenging direct receptor interaction theory..

Cannabis-based medicines for chronic neuropathic pain in adults.

Ateş, Gülay · 2026

This is the definitive evidence synthesis on cannabis for neuropathic pain—an updated Cochrane Review (originally published 2018) that applied the most rigorous inclusion criteria available: only randomized, double-blind trials lasting at least two weeks. The critical outcome was the proportion of patients achieving at least 50% pain relief—the threshold considered clinically meaningful.

Self-reported use of cannabidiol as a substitute or adjunct for approved medications.

Austin, Emily A C · 2026

35.2% of US adults (~90.8 million) have tried CBD; among users, 32% used it as a substitute or adjunct for medications, with adjunct use (24.2%) more common than substitution (11.0%); most commonly for pain, psychiatric conditions, and replacing ibuprofen/Tylenol..

Demographics, methods of use, and perceived benefits among patients with cancer who use cannabis.

Behl, Deepti · 2026

24.7% of cancer patients used cannabis; primary reason was sleep (56.7%); associated with younger age, Stage 4 cancer (OR=3.28), and concurrent chemotherapy (OR=2.45); 68% smoked/vaped, 60% used edibles, 65%+ used multiple methods..

Clinical pain intensity is associated with greater cannabis demand among people who regularly use cannabis.

Bush, Nicholas J · 2026

Greater pain intensity predicted higher Omax (maximum spending), Pmax (maximum price), Intensity (consumption at zero cost), Breakpoint (price that stops use), and lower Elasticity (price sensitivity) for cannabis, with sex-moderated effects for women under responsibility conditions..

Cannabis-Based Products for Chronic Pain : An Updated Systematic Review.

Chou, Roger · 2026

This updated systematic review pooled data from 25 randomized controlled trials involving 2,303 patients, most with neuropathic pain.

Impact of Medical Cannabis on the Quality of Life of Cancer Patients: A Critical Review.

Correa, Larissa Gonçalves · 2026

Medical cannabis use in cancer patients was associated with improvements in mental health, sleep, appetite, and pain management.

Overlapping pathways of migraine and the endocannabinoid system: Potential therapeutic targets.

Della Pietra, Adriana · 2026

The endocannabinoid system overlaps extensively with migraine pathways.

Pharmacoepidemiologic characterization of cannabis use and symptomatology in rheumatology using natural language processing of electronic health record clinic notes.

Falasinnu, Titilola · 2026

Cannabis use documentation rose from 0.1% to 1.1% (900% increase) over 2004-2024.

Delta-9-tetrahydrocannabinol and Cannabidiol for Pain: Preclinical and Clinical Models.

Harris, H M · 2026

While preclinical models consistently show cannabinoid analgesic effects, human studies produce largely mixed results that depend on the specific cannabinoid, route of administration, and pain modality tested — with the current evidence insufficient to make definitive clinical recommendations..

Therapeutic Use of Cannabis and Cannabinoids: A Review.

Hsu, Michael · 2026

Published in JAMA — the most widely read medical journal in the world — this review synthesized the therapeutic evidence for cannabis and cannabinoids across all conditions studied in randomized trials and meta-analyses. The strongest evidence supports three FDA-approved indications: HIV/AIDS-related anorexia (cannabinoids moderately increased body weight; SMD 0.57), chemotherapy-induced nausea and vomiting (small but significant reduction; SMD −0.29), and certain pediatric seizure disorders (CBD as Epidiolex). For chronic pain — the most common reason people report using medical cannabis — the review found that approximately 27% of US and Canadian adults have used cannabis medicinally, with 10.5% of the US population reporting CBD use for therapeutic purposes.

Daily Temporal Associations Between Use of Psychoactive Substances and Fatigue, Pain, Stress, and Depressive Symptoms in People with Multiple Sclerosis.

Kim, Jeeyeon · 2026

Cannabis use was associated with greater subsequent fatigue and higher momentary pain in MS patients, while alcohol and nicotine also predicted greater fatigue.

Preoperative cannabinoid exposure and postoperative pain: A narrative review.

King, Daniel D · 2026

Of 42 studies, 33.3% found cannabis users reported higher postoperative pain, 23.8% found no difference, and 42.9% indicated greater postoperative opioid requirements.

The psychoactive cannabinoid THC inhibits peripheral nociceptors by targeting NaV1.7 and NaV1.8 nociceptive sodium channels.

Maatuf, Yossef · 2026

THC directly targets nociceptive voltage-gated sodium channels NaV1.7 and NaV1.8 through the conserved local anesthetic binding site, reducing sodium currents and suppressing action potential generation in peripheral sensory neurons — a mechanism entirely independent of cannabinoid receptor signaling..

Investigating the effectiveness and adverse events of medicinal cannabis for patients with muscle spasticity or spasms.

Nastatos, Xenia L · 2026

No physical functioning improvements for any group or product type.

Medical Cannabis for Best Supportive Care of Patients Affected by Cancers of the Head and Neck: A Narrative Review.

Perri, Francesco · 2026

Medical cannabis can be effective in managing chronic pain, nausea, vomiting, and anxiety in cancer patients through interaction with the endocannabinoid system.

Rates and predictors of postdischarge opioid-free analgesia after elective colorectal surgery: A prospective cohort study.

Pook, Makena · 2026

Among 344 colorectal surgery patients, 51% used no opioids after discharge.

Unveiling Neurological Benefits: A Review of Hemp Leaf, Flower, Seed Oil Extract, and Their Phytochemical Properties in Neurological Disorders.

Purushothaman, Atchuthan · 2026

This review synthesized evidence on how different parts of the hemp plant — seeds, leaves, and flowers — contain distinct bioactive compound profiles with relevance to neurological disorders. Flowers are richest in cannabinoids (particularly CBD) and terpenes, which interact with the endocannabinoid system, neurotransmitter receptors, and inflammatory pathways.

Effect of Δ9-tetrahydrocannabinol and cannabidiol on myofascial pain modulation in patients with temporomandibular disorder: a prospective crossover study.

Schinko, Francisco Gomes Bonetto · 2026

THC/CBD improved all outcomes versus both baseline and post-placebo (p < 0.05).

Cannabis use among Canadian veterans: associations with the use of other substances, chronic pain conditions, mental disorders, suicide behaviours, and help-seeking.

Taillieu, Tamara L · 2026

Regular cannabis use was associated with increased odds of tobacco smoking, arthritis, any chronic pain, several mental disorders, and suicidal ideation (AOR 1.61-3.99).

The development of a cannabis risk assessment tool for patients with rheumatologic conditions: a Delphi study.

Turk, Tarek · 2026

Consensus (75%+ agreement) was achieved on 40 of 45 items (88.9%) after two rounds, confirmed in a third validation round.

UK Medical Cannabis Registry: a case series analysing clinical outcomes of medicinal cannabis therapy for fibromyalgia.

Varadpande, Madhur · 2026

All patient-reported outcome measures improved significantly from baseline through 18 months of follow-up.

Endocannabinoid Modulation in Headache: Mechanisms, Models, and Translational Therapies.

Wen, Jie · 2026

The endocannabinoid system modulates trigeminovascular firing, CGRP release, neurogenic inflammation, cortical spreading depression, and glial activation after brain injury.

Canadian real-world evidence: observational 24-week outcomes for health care practitioner authorized cannabis.

Yang, Brian · 2026

Over 24 weeks, patients showed improvements in pain interference (-4.6 points), numeric pain rating (-1.19), anxiety (-2.24), depression (-2.79), and quality of life (-0.56).

Are Cannabis-Based Medicines a Useful Treatment for Neuropathic Pain? A Systematic Review.

Almuntashiri, Nawaf · 2025

Among 22 RCTs of cannabis-based medicines for neuropathic pain, 15 reported significant pain reductions for conditions including multiple sclerosis, spinal cord injuries, diabetic neuropathy, postherpetic neuralgia, HIV-associated neuropathy, and peripheral neuropathic pain.

Regarding the pain of men: characteristics of fibromyalgia in male patients.

Bannon, Lian · 2025

Among 3,044 fibromyalgia patients, 48% of males received medical cannabis treatment compared to 34.6% of females.

Interactions between cannabis use and chronic pain on sleep architecture: Findings from in-home EEG recordings.

Brown, Tracy W · 2025

Cannabis use showed significant main effects on slow-wave sleep (deep sleep), total sleep time, sleep onset latency, and REM sleep.

Investigating the Relationship Between Cannabis Expectancies and Anxiety, Depression, and Pain Responses After Acute Flower and Edible Cannabis Use.

Chen, Margy Y · 2025

More positive health expectancies correlated with greater tension reduction in both flower and edible users; edible users with stronger expectancies also showed greater elation increases and pain reductions; domain-specific expectancies predicted corresponding outcomes..

UGT2B7-mediated drug-drug interaction between cannabinoids and hydromorphone.

Coates, Shelby · 2025

Multiple cannabinoids inhibited UGT2B7-mediated hydromorphone glucuronidation with Ki values 0.068-1.01 uM; static modeling predicted >1.25-fold increase in hydromorphone exposure; PBPK models predicted 20-30% CBD-hydromorphone interaction in healthy and cirrhotic individuals..

Corticosterone stimulates synthesis of 2-arachidonoylglycerol via putative membrane-bound glucocorticoid receptors and inhibits GABA release via CB1 cannabinoid receptors in the ventrolateral periaqueductal gray.

Coutens, Basile · 2025

In the ventrolateral periaqueductal gray (vlPAG), corticosterone activates putative membrane-bound glucocorticoid receptors, which stimulate 2-AG synthesis.

UK medical cannabis registry: A clinical outcome analysis of medical cannabis therapy in chronic pain patients with and without co-morbid sleep impairment.

Datta, Ishita · 2025

Sleep-impaired patients showed improvements across all patient-reported outcomes at every follow-up.

Recreational marijuana legalization's impact and opioid death rates: A synthetic control approach.

Denkyirah, Elisha Kwaku · 2025

The average treatment effect was approximately -6.49 opioid deaths per capita for Colorado, -2.89 for Washington, and -4.8 for Oregon after recreational dispensaries opened.

Cannabis Use and Analgesic Prescribing in UK Primary Care: A Retrospective Cohort Study of Patients with Osteoarthritis.

Erridge, Simon · 2025

Cannabis-exposed osteoarthritis patients had a 2.06x higher hazard of being prescribed opioids compared to matched unexposed patients.

The contribution of baseline circulating endocannabinoids to individual differences in human pain sensitivity: a quantitative sensory testing study.

Fatemi, S A · 2025

Serum eCB/NAE concentrations were not affected by sex, FAAH genotype, or cannabis use.

Opioid reduction in patients with chronic non-cancer pain undergoing treatment with medicinal cannabis.

Finch, Philip M · 2025

Among 102 chronic pain patients co-prescribed cannabinoids alongside opioids, median opioid consumption dropped from 40 mg/day to 2.7 mg/day at one year, significantly lower than the 42.3 mg/day maintained by 53 opioid-only controls.

Opioid Initiation in Older Patients with Chronic Pain Who Received Authorized Cannabis Prescription.

Fontaine, Emilie · 2025

Among 3,427 opioid-naive patients 66+ with cannabis prescriptions, 1.84/100 person-years initiated 90+ day opioids vs 1.19/100 in 12,006 controls.

Comparative Effects of THC and CBD on Chemotherapy-Induced Peripheral Neuropathy: Insights from a Large Real-World Self-Reported Dataset.

Geva, Ravit · 2025

Both THC-high and CBD-high groups improved, but the THC-high group showed significantly greater improvement in burning sensation (p=0.024), cold sensation (p=0.008), activities of daily living (p=0.029), and quality of life (p=0.006).

Medicinal cannabis for symptom control in advanced cancer: a double-blind, placebo-controlled, randomised clinical trial of 1:1 tetrahydrocannabinol and cannabidiol.

Hardy, Janet R · 2025

This is one of the most rigorous tests of medicinal cannabis for cancer symptoms conducted to date.

Medical marijuana policies, opioid prescriptions, and adverse events among patients undergoing cancer resection surgery.

Hu, Ju-Chen · 2025

Using insurance claims data from over 34,000 cancer surgery patients across 27 states, this study examined whether medical marijuana legalization (MML) affected opioid prescribing patterns in the six months after diagnosis. The researchers distinguished between two phases of legalization: the law passing (MML without dispensaries) and dispensaries actually opening (MML with dispensaries).

Cannabis-Related Disorders Are Associated With Increased Early Postoperative Opioid Prescriptions and Delayed Emergency Department Visits Following Open Carpal Tunnel Release.

Humble, Kirstin A · 2025

Among 1,850 propensity-matched patients undergoing open carpal tunnel release, those with cannabis-related disorders (CRD) had higher rates of opioid prescriptions within 2 weeks (30.9% vs 25.6%, p=0.011), lower rates of outpatient follow-up within 6 weeks, and higher ER visits between 6-12 weeks (11.0% vs 8.0%, p=0.027)..

Medical Marijuana and Opioid Usage: An Analysis of Patient Perceptions in Louisiana.

Hummel, Daniel · 2025

Respondents reported lower pain levels with medical marijuana use by an average of 3.4 points on a 10-point scale.

Co-use of opioids and cannabis versus single-substance use: a national analysis of US adults.

Kang, Hyojung · 2025

Among adults using prescription opioids and/or cannabis medically, 49.5% used opioids only, 35.3% cannabis only, and 15.2% co-used both.

Beyond the hype - who uses cannabidiol for self-medication - and why: a cross-sectional study in Germany.

Krowartz, Eva-Maria · 2025

37.9% used CBD for self-medication.

Interspecies differences in the expression of cannabinoid receptors at the tissue and cellular levels.

Lawley, Sydney · 2025

CB1 and CB2 receptor expression differs substantially between species in terms of tissue distribution, cellular localization, and co-expressed markers.

Efficacy of a 20:1 CBD:THC cannabis herbal extract for pain and inflammation in dogs following tibial plateau leveling osteotomy.

Lyons, Chloe · 2025

There were no significant differences in pain scores, range of motion, thigh circumference, or gait symmetry between dogs receiving CBD:THC extract and those receiving placebo, when both groups also received standard analgesics.

Alcohol, Tobacco, and Marijuana Use Among Individuals Receiving Prescription Opioids for Pain Management.

Miller-Matero, Lisa R · 2025

Tobacco users had greater pain severity, more pain sites, and higher opioid misuse concern, plus higher rates of depression, anxiety, and PTSD.

Effects and safety of a CBD-rich Cannabis sativa oil in knee osteoarthritis: a double-blind, randomized, placebo-controlled trial - CANOA - cannabis for osteoarthritis.

Mojoli, Andrés · 2025

This Brazilian trial is one of the most rigorous tests of CBD for osteoarthritis pain.

Correlates of Recreational and Medicinal Cannabis Use Among Non-Hispanic Black and Hispanic Men with Chronic Conditions.

Montemayor, Benjamin N · 2025

Of 1,982 non-Hispanic Black and Hispanic men with chronic conditions, 21.3% reported past 30-day cannabis use.

Cannabis-based products for medicinal use in dogs and cats: a systematic review.

Moreno-López, N · 2025

Across 22 studies, CBD-based formulations showed benefits for osteoarthritis pain, epilepsy, atopic dermatitis, postsurgical pain, and behavioral issues in dogs, with no serious adverse events reported.

A randomized trial on efficacy of purified cannabidiol on spasticity in multiple sclerosis patients with gait problems: first report in Iran.

Mousavi, Pegah · 2025

CBD treatment (escalating from 5 to 80 mg/day over 4 weeks) significantly improved walking speed on the T25-FW test (p=0.031) and reduced maximum pain (p=0.033) compared to placebo, but did not significantly reduce spasticity severity at 4 or 8 weeks..

Looking beyond traditional pain outcomes to better evaluate cannabis's true potential and limitations in chronic pain management.

Mun, Chung Jung · 2025

While clinical trials show inconsistent evidence for cannabis reducing pain severity, qualitative research reveals patients value cannabis because it changes their psychological response to pain and improves sleep, social functioning, and ability to reduce opioid use.

Risk of Cannabis Use Disorder in Chronic Pain: Longitudinal Links to Pain Outcomes.

Mun, Chung Jung · 2025

Among 1,453 chronic pain patients followed for 2 years, 36.3% used cannabis and 39.8% of users showed high CUD risk.

Gender Differences in Cannabis as a Mediator Between Distress Factors and Non-Fatal Suicidal Behaviors.

Nayeem, Nawar · 2025

Cannabis use mediated 2.3% of the effect of depression on suicidal ideation in women versus 1.2% in men, and 1.7% versus 1.0% for suicide attempts.

Chronic Disease Symptoms Self-Managed by Cannabis During the COVID-19 Pandemic: Results from the COVID-19 Cannabis Health Study.

O'Dell, Nicole · 2025

Of 1,466 cannabis users with chronic conditions, 90.9% reported using cannabis medicinally.

Relationship between pain and nonopioid substance use in two national samples of cancer survivors.

Powers, Jessica M · 2025

This study used two large national datasets to examine how pain relates to substance use among cancer survivors—a population with high rates of both pain and substance use but surprisingly little research on the connection. The pattern was consistent across both samples: cancer survivors with more pain were significantly more likely to use cannabis and cigarettes, but less likely to drink alcohol.

Dual Role of the Spinal Endocannabinoid System in Response to Noxious Stimuli: Antinociceptive Pathways and Neuropathic Pain Mechanisms.

Saldaña, Raquel · 2025

This review reveals that the spinal endocannabinoid system's role in pain is context-dependent.

'In the weeds': navigating the complex concerns, challenges and choices associated with medicinal cannabis consumption for endometriosis.

Sinclair, Justin · 2025

Illicit cannabis (56.7%) was the most common access pathway.

Recreational Cannabis Laws and Fills of Pain Prescriptions in the Privately Insured.

Steuart, Shelby R · 2025

Using nationally representative commercial insurance data, the study examined how two sequential recreational cannabis policies affected prescribing of opioids and other pain medications, providing evidence on whether cannabis substitutes for or complements prescription pain treatments..

Entourage effects of nonpsychotropic cannabinoids on visceral sensitivity in experimental colitis.

Svendsen, Kristofer · 2025

Single injections of CBD or CBG (10 mg/kg) each reduced visceral hypersensitivity and spinal cord c-Fos activation in colitis mice.

Novel approaches for drug development against chronic primary pain: A systematic review.

Tékus, Valéria · 2025

Among novel drug development approaches for fibromyalgia, CRPS, and chronic low back pain (2014-2024), only CBD and esketamine have been tested across all three conditions.

Cannabis expectancies and associations with cannabis use and health functioning among adults with chronic pain.

Tomlinson, Devin C · 2025

Positive cannabis expectancies (believing cannabis will help with pain, sleep, mood) were significantly associated with higher use frequency and cannabis use disorder symptoms, even after controlling for pain severity, anxiety, and depression.

The role of the endocannabinoid system in the mechanism of action of nonopioid analgesics.

Unterspann, Marcela · 2025

These analgesics interact with the ECS: enhancing endocannabinoid levels, influencing CB1/CB2 signaling, and modulating FAAH and MAGL enzymes, providing synergistic analgesic effects..

Cannabidiol for Orofacial and Upper-Quarter Pain: A Systematic Evaluation of Therapeutic Potential.

Walczyńska-Dragon, Karolina · 2025

CBD showed consistent benefits for chronic myofascial TMD and bruxism pain across clinical trials and preclinical models, particularly with topical or intraoral application.

Ultra-Weak Photon Emission Demonstrates Specificity for Anxiety over Pain in Cannabis-Treated Chronic Neuropathic Pain: A Biomarker Validation Study.

Yassin, Mustafa · 2025

This study has two distinct contributions.

Cannabis and opioid perceptions, co-use, and substitution among patients across 4 NCI-Designated Cancer Centers.

Ashare, Rebecca L · 2024

Black patients were less likely to use opioids for pain (OR 0.66, p=0.035) and more likely to report cannabis was more effective than opioids (OR 2.46, p=0.03) compared to White patients.

Cannabis Co-Use Among Black Individuals with Chronic Pain Who Use Opioids: Associations with Other Substance Use and Pain Related Outcomes.

Bakhshaie, Jafar · 2024

Compared to opioid use alone, cannabis-opioid co-use was associated with elevated anxiety and depression symptoms, greater opioid dependence, and riskier use of other substances, but was not associated with differences in pain intensity or interference..

Clinical Practice Guidelines for Cannabis and Cannabinoid-Based Medicines in the Management of Chronic Pain and Co-Occurring Conditions.

Bell, Alan D · 2024

From 70 articles (19 systematic reviews, 51 original studies), research demonstrates moderate benefit of cannabinoid-based medicines for chronic pain.

The endocannabinoid system's genetic polymorphisms in sickle cell anemia patients.

Berti, Amanda Cristina Meneguetti · 2024

Sickle cell anemia (SCA) is a genetic blood disorder that causes a range of severe complications, including priapism — prolonged, painful erections caused by sickled red blood cells blocking penile blood vessels.

Evaluation of pre-hospital cannabis exposure and hospital opioid utilization in a trauma population: A retrospective cohort.

Chang, Alexander J · 2024

THC-positive trauma patients had significantly higher median opioid use during hospitalization (155 MME vs.

Marijuana use among community-dwelling older adults: A population-based study.

De Genna, Natacha M · 2024

Cannabis research in older adults has mostly relied on convenience samples — people recruited from dispensaries or cannabis clinics who are already enthusiastic users.

Cannabis Use Disorder Trends and Health Care Utilization After Cervical and Lumbar Spine Fusions.

Dietz, Nicholas · 2024

Among 72,024 cervical and 105,612 lumbar fusion patients, those with CUD (2% and 1.5% respectively) had higher complication rates including neurological complications, wound complications, and cardiac events at various time points.

Is a Low Dosage of Medical Cannabis Effective for Treating Pain Related to Fibromyalgia? A Pilot Study and Systematic Review.

Giardina, Antonio · 2024

Pain intensity (NRS) decreased from a median of 8 (95% CI 7.66-8.54) at baseline to 4 (95% CI 3.28-4.79) after 6 months.

Use and perceptions of Cannabidiol among individuals in treatment for opioid use disorder.

Kudrich, Christopher · 2024

CBD has become wildly popular, with claims ranging from anxiety relief to pain management.

The State of Synthetic Cannabinoid Medications for the Treatment of Pain.

Maglaviceanu, Anca · 2024

Dronabinol and nabilone, both THC-mimicking synthetics approved for nausea, are being investigated for neuropathic pain, spasticity-related pain, fibromyalgia, osteoarthritis, and postoperative pain.

Clinical Benefits and Safety of Medical Cannabis Products: A Narrative Review on Natural Extracts.

Mick, Gérard · 2024

THC-predominant and balanced THC/CBD products showed the strongest evidence for chronic neuropathic pain.

Cannabis Use Is Associated With Increased Use of Prescription Opioids Following Posterior Lumbar Spinal Fusion Surgery.

Moon, Andrew S · 2024

Among 220 opioid-naive patients, 29 cannabis users consumed significantly more postoperative prescription opioids (2,545 vs 1,380 morphine equivalent doses, p=.019) than 191 non-users.

Distinct antinociceptive and conditioned behavioral effects are produced by individual cannabinoids and a cannabis-derived mixture.

Morris, Tamara · 2024

NEPE14 significantly reduced mechanical and thermal hyperalgesia via both injection and oral routes without decreasing operant response rates.

Clinical outcome analysis of patients with multiple sclerosis - Analysis from the UK Medical Cannabis Registry.

Murphy, Matthew · 2024

At 6 months, significant improvements in MSQoL-54 subscales: cognitive function, mental health composite, physical health, role limitations, social and sexual function.

Recreational and Medical Cannabis Legalization and Opioid Prescriptions and Mortality.

Nguyen, Hai V · 2024

Using a generalized difference-in-differences approach, neither type of legalization was significantly associated with opioid outcomes.

Relationship Between Nociplastic Pain Involvement and Medication Use, Symptom Relief, and Adverse Effects Among People Using Medical Cannabis for Chronic Pain.

Scott, J Ryan · 2024

Higher nociplastic pain (NPP) scores were associated with less self-reported improvement in pain and overall health from medical cannabis, more cannabis side effects, and paradoxically, greater use of other medications including opioids and benzodiazepines, but also greater substitution of cannabis for those same medication classes..

A Cross-Sectional Survey Study of Cannabis Use for Fibromyalgia Symptom Management.

Singla, Abhinav · 2024

Of 1,336 fibromyalgia patients, 49.5% (661) reported cannabis use since diagnosis.

Non-Intoxicating Cannabinoids in Visceral Pain.

Svendsen, Kristofer · 2024

Non-intoxicating cannabinoids (niCBs) show potential to normalize intestinal motility, reduce inflammation, and produce analgesic effects in preclinical models of visceral pain.

Recreational marijuana laws and the misuse of prescription opioids: Evidence from National Survey on Drug Use and Health microdata.

Ali, Mir M · 2023

Standard difference-in-differences analysis suggested RML adoption reduced frequent opioid misuse.

Cannabis use among adults undergoing cancer treatment.

Azizoddin, Desiree R · 2023

Cannabis users most commonly used edibles (65%) or smoked (51%).

Cannabis use disorder in patients with chronic pain: overestimation and underestimation in a cross-sectional observational study in 3 German pain management centres.

Bialas, Patric · 2023

Among 187 chronic pain patients prescribed medical cannabis, CUD prevalence was 29.9% using standard DSM-5 criteria, 13.9% when tolerance and withdrawal items were removed, and just 2.1% when positive items attributable to pain relief were excluded.

Impact of Recreational Cannabis Legalization on Opioid Prescribing and Opioid-Related Hospital Visits in Colorado: an Observational Study.

Buttorff, Christine · 2023

Using county-level variation in recreational dispensary allowances across Colorado, recreational cannabis exposure was associated with significantly fewer 30-day opioid fills (coefficient: -117.6, P<0.01) and inpatient visits (coefficient: -0.8, P=0.03), but not with reductions in total morphine milligram equivalents or ED visits.

Pain Medications Used by Persons Living With Fibromyalgia: A Comparison Between the Profile of a Quebec Sample and Clinical Practice Guidelines.

De Clifford-Faugère, Gwenaelle · 2023

Among 63 fibromyalgia patients, medical cannabis was used by 34.9% and pharmaceutical cannabinoids by 17.5%.

Multiple Sclerosis and Use of Medical Cannabis: A Retrospective Review of a Neurology Outpatient Population.

Rainka, Michelle M · 2023

Pain improvement was reported by 72% of patients, spasticity relief by 48%, and sleep improvement by 40%.

Predictors of Pain Reduction Among Fibromyalgia Patients Using Medical Cannabis: A Long-Term Prospective Cohort Study.

Sotoodeh, Romina · 2023

Reductions in pain intensity among fibromyalgia patients using medical cannabis were partially mediated by concurrent improvements in sleep quality and reductions in anxiety and depression symptoms..

Cannabis for the Treatment of Fibromyalgia: A Systematic Review.

Strand, Natalie H · 2023

Of four RCTs examining cannabis for fibromyalgia, three showed benefit over placebo for pain.

Cannabis-opioid interaction in the treatment of fibromyalgia pain: an open-label, proof of concept study with randomization between treatment groups: cannabis, oxycodone or cannabis/oxycodone combination-the SPIRAL study.

van Dam, Cornelis Jan · 2023

The SPIRAL study randomized fibromyalgia patients to three arms: cannabis alone, oxycodone alone, or cannabis+oxycodone combination.

Assessment of clinical outcomes in patients with fibromyalgia: Analysis from the UK Medical Cannabis Registry.

Wang, Claire · 2023

Patients prescribed cannabis-based medicinal products for fibromyalgia showed statistically significant improvements in patient-reported outcome measures (PROMs) for health-related quality of life after at least one month of treatment..

Multinational Association of Supportive Care in Cancer (MASCC) expert opinion/consensus guidance on the use of cannabinoids for gastrointestinal symptoms in patients with cancer.

Alderman, Bryony · 2022

Of 36 RCTs, 11 showed cannabis improved CINV vs.

Long-term observational studies with cannabis-based medicines for chronic non-cancer pain: A systematic review and meta-analysis of effectiveness and safety.

Bialas, Patric · 2022

Mean pain reduction was 1.75 points on a 0-10 scale (95% CI 0.72-2.78).

A mixed methods analysis of cannabis use routines for chronic pain management.

Boehnke, Kevin F · 2022

Of participants, 45% used both inhalation and non-inhalation routes, 36.2% used inhalation only, and 18.8% used non-inhalation only.

Cannabidiol Product Dosing and Decision-Making in a National Survey of Individuals with Fibromyalgia.

Boehnke, Kevin F · 2022

Average CBD dose per session was 16 mg, with 24-27 mg per day.

Cannabinoids and the endocannabinoid system in fibromyalgia: A review of preclinical and clinical research.

Bourke, Stephanie L · 2022

Clinical evidence shows endocannabinoid system alterations in fibromyalgia patients, including single nucleotide polymorphisms and increased circulating endocannabinoids.

Healthcare professionals' perspectives on the use of medicinal cannabis to manage chronic pain: A systematic search and narrative review.

Cheng, Katherine Y C · 2022

Seven key themes emerged: MC as a treatment option for chronic pain; willingness to prescribe; legal issues; low perceived knowledge and need for education; comparative safety vs.

Symptoms and Extraintestinal Manifestations in Active Cannabis Users with Inflammatory Bowel Disease.

Coates, Matthew D · 2022

Cannabis users (7.8% of the cohort, average 2.7 times/week) were more likely to report abdominal pain (83.3% vs.

Cannabis and cannabinoids for symptomatic treatment for people with multiple sclerosis.

Filippini, Graziella · 2022

Nabiximols probably increases the number of people reporting significant spasticity reduction (OR 2.51, moderate certainty).

Systematic Review and Meta-analysis Seem to Indicate that Cannabinoids for Chronic Primary Pain Treatment Have Limited Benefit.

Giossi, Riccardo · 2022

Across 8 RCTs with 240 patients, VAS pain reduction was not significant for cannabinoids vs placebo (MD -0.64, CI -1.30 to 0.02).

Association of medical cannabis licensure with prescription opioid receipt: A population-based, individual-level retrospective cohort study.

Goedel, William C · 2022

Among 5,296 medical cannabis license holders in Rhode Island, licensure was not associated with changes in odds of filling any opioid prescription (OR 0.99), filling prescriptions at 50+ morphine equivalent dose (OR 0.93), or at 90+ MED (OR 0.99).

The Efficacy of Cannabis on Multiple Sclerosis-Related Symptoms.

Haddad, Fatma · 2022

Nabiximols (oromucosal spray) demonstrated improvement in MS spasticity, pain, and quality of life with tolerable adverse effects.

Sex-specific mechanisms of tolerance for the cannabinoid agonists CP55,940 and delta-9-tetrahydrocannabinol (Δ9-THC).

Henderson-Redmond, Angela N · 2022

The S426A/S430A mutation, which blocks CB1 receptor desensitization via the GRK/beta-arrestin2 pathway, conferred partial resistance to THC tolerance in male mice but did not alter tolerance in female mice.

Cannabinoids in rheumatology: Friend, foe or a bystander?

Jain, Nibha · 2022

Cannabinoids act through CB1 and CB2 receptors with potential analgesic effects.

Cannabidiol enhances the antinociceptive effects of morphine and attenuates opioid-induced tolerance in the chronic constriction injury model.

Jesus, Carlos Henrique Alves · 2022

CBD (30 mg/kg) combined with a sub-effective dose of morphine (1 mg/kg) produced enhanced pain relief for both evoked and ongoing pain that neither drug achieved alone.

The Role of Cannabis, Cannabidiol and Other Cannabinoids in Chronic Pain. The Perspective of Physicians.

Köstenberger, Markus · 2022

Most reviews concluded cannabis plays a significant role in pain management.

Plasma and interstitial levels of endocannabinoids and N-acylethanolamines in patients with chronic widespread pain and fibromyalgia: a systematic review and meta-analysis.

Kurlyandchik, Inna · 2022

Plasma levels of oleoylethanolamide and stearoylethanolamide were significantly increased in fibromyalgia patients compared to controls.

Medical Cannabis for Gynecologic Pain Conditions: A Systematic Review.

Liang, Angela L · 2022

Among 16 included studies, 13-27% of women used cannabis for gynecologic pain.

A peripheral CB2 cannabinoid receptor mechanism suppresses chemotherapy-induced peripheral neuropathy: evidence from a CB2 reporter mouse.

Lin, Xiaoyan · 2022

CB2 agonists (AM1710 and LY2828360) suppressed paclitaxel-induced mechanical and cold allodynia in mice.

TRPV1: A Common Denominator Mediating Antinociceptive and Antiemetic Effects of Cannabinoids.

Louis-Gray, Kathleen · 2022

TRPV1 activation in the central descending pain pathway (RVM and PAG) mediates antinociception, while peripheral TRPV1 activation mediates nociception.

Cannabinoid Effect and Safety in Spasticity Following Stroke: A Double-Blind Randomized Placebo-Controlled Study.

Marinelli, Lucio · 2022

Among 34 stroke patients, nabiximols did not improve spasticity on the primary or secondary endpoints compared to placebo.

Anti-Inflammatory and Analgesic Properties of the Cannabis Terpene Myrcene in Rat Adjuvant Monoarthritis.

McDougall, Jason J · 2022

Local application of myrcene (1 and 5 mg/kg) reduced joint pain and inflammation in rats with chronic arthritis via a cannabinoid receptor mechanism.

Cannabidiol for the Management of Endometriosis and Chronic Pelvic Pain.

Mistry, Megha · 2022

Of 264 articles screened, 41 were included.

Mood, sleep and pain comorbidity outcomes in cannabis dependent patients: Findings from a nabiximols versus placebo randomised controlled trial.

Montebello, Mark · 2022

Among participants with moderate-to-severe baseline scores, depression, anxiety, stress, and insomnia symptoms gradually decreased over 12 weeks of treatment.

The prevalence, distribution and impact of peripheral neuropathy among Danish patients with cancer - a population-based cross-sectional study.

Nielsen, Sebastian Werngreen · 2022

Overall neuropathy prevalence was 17%, ranging from 6% to 33% across cancer types.

Cannabis for Rheumatic Disease Pain: a Review of Current Literature.

Nowell, William Benjamin · 2022

Publications on cannabis and rheumatic disease have increased, but recent literature skews heavily toward reviews over primary research.

Long-term Cannabis-based oil therapy and pain medications prescribing patterns: an Italian observational study.

Nunnari, P · 2022

After long-term cannabis-based oil therapy, opioid non-users increased significantly from 32.1% to 55.4% (p=0.0023).

Survival rate of patients with combined hepatocellular cholangiocarcinoma receiving medical cannabis treatment: A retrospective, cohort comparative study.

Phansila, Narisara · 2022

Cholangiocarcinoma (bile duct cancer) is devastating in Northeast Thailand, where incidence is among the highest in the world due to endemic liver fluke infections.

Chronic health conditions, acute health events, and healthcare utilization among adults over age 50 in Hawai'i who use cannabis: A matched cohort study.

Phillips, Kristina T · 2022

Cannabis-diagnosed patients had significantly greater risk of coronary heart disease, chronic non-cancer pain, stroke, myocardial infarction, cyclic vomiting, and injuries compared to age- and sex-matched controls.

Medical Cannabis Patients Report Improvements in Health Functioning and Reductions in Opiate Use.

Pritchett, Carolyn E · 2022

61% of patients used pain medications before cannabis.

Developing a real-world evidence base for prescribed cannabis in the United Kingdom: preliminary findings from Project Twenty21.

Sakal, C · 2022

678 patients enrolled in 7 months.

Medical cannabis use in Canadians with multiple sclerosis.

Santarossa, Talia M · 2022

64.5% had tried medical cannabis, 52.3% were currently using it.

Cannabis Use for Endometriosis: Clinical and Legal Challenges in Australia and New Zealand.

Sinclair, Justin · 2022

72% of Australian and 88.2% of NZ endometriosis patients using cannabis obtained it illicitly rather than through legal medical channels.

A large Australian longitudinal cohort registry demonstrates sustained safety and efficacy of oral medicinal cannabis for at least two years.

Vickery, Alistair W · 2022

Statistically significant improvements sustained over 2+ years across all outcomes: clinical impression (+39-52%), pain interference and severity (22-26%), depression/anxiety/stress (24-28%), insomnia (35%), and physical/emotional functioning (34-37%).

Routes of administration, reasons for use, and approved indications of medical cannabis in oncology: a scoping review.

Vinette, Billy · 2022

Two main reasons for medical cannabis use in cancer: limiting cancer impacts and side effects, and staying connected to others.

Long-term and serious harms of medical cannabis and cannabinoids for chronic pain: a systematic review of non-randomised studies.

Zeraatkar, Dena · 2022

Overall adverse event prevalence was 26.0% (95% CI: 13.2-41.2%).

Interests and concerns regarding medical marijuana among chronic pain patients in Ohio: an online survey.

Adams, Daniel · 2021

84.3% were willing to consider medical marijuana.

Medical Marijuana Laws, Marijuana Use, and Opioid-Related Outcomes among Women in the United States.

Ali, Mir M · 2021

Medical marijuana laws were not associated with opioid misuse, initiation, or OUD among all women, pregnant women, or parenting women.

Targeting the endocannabinoid system for management of HIV-associated neuropathic pain: A systematic review.

Aly, Esraa · 2021

10 preclinical studies found that endocannabinoids, CB2-selective agonists, and FAAH inhibitors prevented or reversed HIV-associated neuropathic pain.

Attitudes towards and use of cannabis in New Zealand patients with inflammatory bowel disease: an exploratory study.

Appleton, Kerry · 2021

51% reported ever using cannabis.

Safety of Medical Cannabis in Neuropathic Chronic Pain Management.

Bennici, Alessandra · 2021

Only nabiximols (a balanced CBD/THC product) is approved by regulatory authorities for neuropathic pain and included in pharmacovigilance systems.

Differences between cancer patients and others who use medicinal Cannabis.

Cousins, Matthew M · 2021

Among 1,485 adults pursuing medical cannabis certification in Michigan, 72 cancer patients used less cannabis and used it less often than the 1,413 non-cancer patients.

Preadmission Cannabis Use Is Positively Correlated With Inpatient Opioid Dose Exposure in Hospitalized Patients With Inflammatory Bowel Diseases.

Dalal, Rahul S · 2021

Preadmission cannabis use was significantly correlated with higher inpatient opioid exposure (coefficient = 12.1 IV morphine mg equivalents/day; 95% CI: 2.6-21.5) after adjusting for IBD severity, pain scores, and preadmission opioid use..

Prevalence of Cannabinoid Use in Patients With Hip and Knee Osteoarthritis.

Deckey, David G · 2021

24% of 200 patients presenting with hip or knee osteoarthritis had used CBD products.

Recreational cannabis laws and opioid-related emergency department visit rates.

Drake, Coleman · 2021

Event study models using ED data from 29 states (2011-2017) found recreational cannabis laws reduced opioid-related ED visit rates by approximately 7.6% for two quarters after implementation.

Cost-Effectiveness of Medicinal Cannabis for Management of Refractory Symptoms Associated With Chronic Conditions: A Systematic Review of Economic Evaluations.

Erku, Daniel · 2021

Twelve cost-utility analyses were identified across MS (n=8), pediatric epilepsies (n=2), and chronic pain (n=2).

Cannabidiol (CBD) and other drug use among young adults who use cannabis in Los Angeles.

Fedorova, Ekaterina V · 2021

CBD-dominant users were more likely female, used cannabis at lower frequency and amount (except edibles), cited medical motivations, used cannabis for pain, and reported more health problems.

Use of medical cannabis by patients with fibromyalgia in Canada after cannabis legalisation: a cross-sectional study.

Fitzcharles, Mary-Ann · 2021

23.9% of FM patients reported ever using medical cannabis, compared to 11.1% of non-FM rheumatology patients.

Recreational Cannabis Use Before and After Legalization in Women With Pelvic Pain.

Geoffrion, Roxana · 2021

14.9% of all patients were current cannabis users.

Is Cannabis being used as a substitute for non-medical opioids by adults with problem substance use in the United States? A within-person analysis.

Gorfinkel, Lauren R · 2021

On days when cannabis was used, the adjusted odds of non-medical opioid use were 1.86 times higher (95% CI: 1.44-2.41).

Cannabis use assessment and its impact on pain in rheumatologic diseases: a systematic review and meta-analysis.

Guillouard, M · 2021

40.4% of rheumatology patients reported ever using cannabis and 15.3% reported current use.

The Effect of Medical Cannabis on Pain Level and Quality of Sleep among Rheumatology Clinic Outpatients.

Habib, George · 2021

Patients with neuropathic problems reported the largest pain reduction (83%) and sleep improvement (87%), while those with inflammatory conditions saw the smallest pain reduction (57%).

A Systematic Review of Fibromyalgia and Recent Advancements in Treatment: Is Medicinal Cannabis a New Hope?

Khurshid, Hajra · 2021

Across 22 studies, medical cannabis (including nabilone, dronabinol, and various THC/CBD ratios) showed analgesic and anti-inflammatory effects in fibromyalgia patients.

Cannabinoids and bladder symptoms in multiple sclerosis.

Kim-Fine, Shunaha · 2021

Of 734 respondents reporting cannabis use status, 275 (37.5%) used cannabis in the past 3 months, with 73.8% using at least weekly.

Safety and Efficacy of Medicinal Cannabis in the Treatment of Fibromyalgia: A Systematic Review.

Kurlyandchik, Inna · 2021

Across 3 RCTs and 6 observational studies, cannabis showed potential benefit for fibromyalgia symptoms with side effects limited to feeling "high," dizziness, dry mouth, cough, red eyes, and drowsiness.

Exploring the use of cannabis as a substitute for prescription drugs in a convenience sample.

Kvamme, Sinikka L · 2021

Of 2,841 respondents using cannabis medically (91% non-prescribed), 54.6% used it to replace a prescription drug.

Perioperative Pain and Addiction Interdisciplinary Network (PAIN): consensus recommendations for perioperative management of cannabis and cannabinoid-based medicine users by a modified Delphi process.

Ladha, Karim S · 2021

Major consensus recommendations included: elicit and quantify cannabis use history, contact the cannabis authorizer if one exists, consider perioperative cannabis weaning, provide additional postoperative nausea/vomiting prophylaxis, pay extra attention to anesthetic depth monitoring, anticipate increased postoperative analgesic requirements, and watch for cannabis withdrawal syndrome..

Cannabis sativa terpenes are cannabimimetic and selectively enhance cannabinoid activity.

LaVigne, Justin E · 2021

All four terpenes activated CB1 receptors in vitro and produced cannabinoid tetrad behaviors in mice (pain relief, immobility, hypothermia, reduced movement).

Measuring the Change in Health-Related Quality of Life in Patients Using Marijuana for Pain Relief.

Peterson, Andrew M · 2021

Health-related quality of life (EQ-5D Index Score) improved significantly from 0.722 to 0.747 (p=0.011) over 6 weeks.

Cannabidiol use and effectiveness: real-world evidence from a Canadian medical cannabis clinic.

Rapin, Lucile · 2021

All ESAS-r symptom scores improved significantly from baseline to 3 months (all p<0.003).

A cross-sectional survey of cannabis use by people with MS in Oregon and Southwest Washington.

Rice, Jessica · 2021

30% currently used cannabis, 21% had used in the past, and 49% never used.

A Survey of Cannabis Use in a Large US-Based Cohort of People with Multiple Sclerosis.

Salter, Amber · 2021

Among 3,249 respondents from the NARCOMS Registry, 31% had ever used cannabis for MS symptoms and 20% were current users, while 69% who had never tried it cited insufficient efficacy data (40%), safety concerns (27%), and legality (25%) as barriers..

Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms.

Sinclair, Justin · 2021

Across 16,193 tracked cannabis sessions, pain was the most common symptom treated (57.3%) with inhalation as the preferred method (67.4%).

The state of the evidence on the association between state cannabis laws and opioid-related outcomes: A review.

Tormohlen, Kayla N · 2021

Across 21 U.S.

Cannabis: An Emerging Treatment for Common Symptoms in Older Adults.

Yang, Kevin H · 2021

15% of geriatric clinic patients used cannabis.

Medication overuse headache in patients with chronic migraine using cannabis: A case-referent study.

Zhang, Niushen · 2021

Medication overuse headache was present in 81% of cannabis-using chronic migraine patients vs.

Cannabis and cannabidiol (CBD) for the treatment of fibromyalgia.

Berger, Amnon A · 2020

Fibromyalgia affects up to 10% of the population.

Do-It-Yourself medicine? The impact of light cannabis liberalization on prescription drugs.

Carrieri, Vincenzo · 2020

Using the staggered rollout of light cannabis shops across Italian provinces, the study documented significant substitution effects between CBD products and five prescription drug categories: anxiolytics, sedatives, opioids, antidepressants, and antipsychotics..

Diversity of molecular targets and signaling pathways for CBD.

de Almeida, Douglas L · 2020

CBD's effects are mediated through multiple molecular mechanisms rather than a single target.

Adding medical cannabis to standard analgesic treatment for fibromyalgia: a prospective observational study.

Giorgi, Valeria · 2020

Medical cannabis most consistently improved sleep quality (44% of patients) and overall fibromyalgia impact (33%).

Cannabis use for symptom relief in multiple sclerosis: A cross-sectional survey of webinar attendees in the US and Canada.

Hildebrand, Andrea · 2020

Cannabis use for MS symptoms was significantly associated with recreational legality (OR 4.55), disease severity (severe vs.

The cannabinoid CB2 receptor agonist LY2828360 synergizes with morphine to suppress neuropathic nociception and attenuates morphine reward and physical dependence.

Iyer, Vishakh · 2020

LY2828360 and morphine produced synergistic pain relief for chemotherapy-induced neuropathy.

A Critical Review of the Role of the Cannabinoid Compounds Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) and their Combination in Multiple Sclerosis Treatment.

Jones, Éamon · 2020

The review found the strongest evidence for nabiximols (Sativex, a 1:1 THC:CBD oromucosal spray) in reducing spasticity and neuropathic pain in MS patients.

Cannabis, e-cigarettes and anesthesia.

Lynn, Rachael S Rzasa · 2020

Cannabis use may reduce the efficacy of propofol and postoperative opioid pain management, potentially requiring higher doses.

Medical cannabis for the reduction of opioid dosage in the treatment of non-cancer chronic pain: a systematic review.

Okusanya, Babasola O · 2020

Across 9 studies involving 7,222 participants, combining medical cannabis with opioids was associated with 64-75% reduction in opioid dosage for non-cancer chronic pain.

Is there a relationship between cannabis use problems, emotion dysregulation, and mental health problems among adults with chronic pain?

Orr, Michael F · 2020

In 431 opioid-using adults with moderate to severe chronic pain (176 current cannabis users, 30% with cannabis use problems), emotion dysregulation significantly mediated the relationship between cannabis use problems and anxiety, depression, and suicidal ideation.

Medical Cannabis for the Management of Pain and Quality of Life in Chronic Pain Patients: A Prospective Observational Study.

Safakish, Ramin · 2020

Among 751 chronic pain patients initiating medical cannabis treatment, pain severity and interference improved significantly at 1 month and remained improved through 12 months (p<0.001).

A Survey on the Effect That Medical Cannabis Has on Prescription Opioid Medication Usage for the Treatment of Chronic Pain at Three Medical Cannabis Practice Sites.

Takakuwa, Kevin M · 2020

Of 525 chronic pain patients who used both medical cannabis and prescribed opioids, 40.4% stopped all opioids, 45.2% decreased use, 13.3% had no change, and only 1.1% increased opioid use.

Should Oncologists Recommend Cannabis?

Abrams, Donald I · 2019

Cannabis analgesic effects are supported by the best clinical evidence.

Persistence of use of prescribed cannabinoid medicines in Manitoba, Canada: a population-based cohort study.

Alkabbani, Wajd · 2019

Among 5,452 new prescribed cannabinoid users, 18.1% continued use at 1 year.

Impact of Medical Cannabis on Patient-Reported Symptoms for Patients With Cancer Enrolled in Minnesota's Medical Cannabis Program.

Anderson, Susan P · 2019

Significant reductions were found across all 8 symptoms (anxiety, appetite loss, depression, sleep disturbance, fatigue, nausea, pain, and vomiting) within 4 months of starting medical cannabis.

Self-management strategies amongst Australian women with endometriosis: a national online survey.

Armour, Mike · 2019

Self-management was used by 76% of women with endometriosis.

Use of Cannabis to Relieve Pain and Promote Sleep by Customers at an Adult Use Dispensary.

Bachhuber, Marcus · 2019

65% of adult-use customers used cannabis for pain relief, and 74% used it for sleep.

Qualitative Analysis of Cannabis Use Among Older Adults in Colorado.

Bobitt, Julie · 2019

Five themes emerged from 17 focus groups: (1) older adults want more education and research about cannabis, (2) healthcare providers are not communicating about cannabis, (3) accessing medical cannabis is difficult, (4) medical cannabis users report positive outcomes, and (5) stigma continues to prevent open discussion.

Pills to Pot: Observational Analyses of Cannabis Substitution Among Medical Cannabis Users With Chronic Pain.

Boehnke, Kevin F · 2019

80% of 1,321 medical cannabis users with chronic pain reported substituting cannabis for traditional pain medications: 53% for opioids, 22% for benzodiazepines.

Cannabis Use Preferences and Decision-making Among a Cross-sectional Cohort of Medical Cannabis Patients with Chronic Pain.

Boehnke, Kevin F · 2019

76.5% used cannabis daily, 93.4% used 2+ administration routes, and 72.5% used 3+ routes.

Cannabis and Neuropsychiatric Disorders: An Updated Review.

Chayasirisobhon, Sirichai · 2019

CBD has demonstrated therapeutic benefit across multiple neuropsychiatric conditions including autism spectrum disorder, anxiety, psychosis, neuropathic pain, cancer pain, migraine, MS, Alzheimer disease, Parkinson disease, Huntington disease, hypoxic-ischemic injury, and epilepsy.

What cancer patients actually know regarding medical cannabis? A cross-sectional survey with a critical analysis of the current attitudes.

Cortellini, Alessio · 2019

81% of patients had heard about medical cannabis, but only 2% from healthcare professionals.

Adverse Consequences of Co-Occurring Opioid Use Disorder and Cannabis Use Disorder Compared to Opioid Use Disorder Only.

De Aquino, Joao P · 2019

Veterans with co-occurring OUD and CUD received fewer opioid prescriptions (mean 3.79 vs 4.8) compared to the OUD-only group, but had a higher likelihood of inpatient psychiatric admission (RR = 1.95) and homelessness (RR = 1.52)..

Position Statement: A Pragmatic Approach for Medical Cannabis and Patients with Rheumatic Diseases.

Fitzcharles, Mary-Ann · 2019

No clinical trials of medical cannabis in rheumatology patients existed at the time of review.

Illegal cannabis use is common among Danes with multiple sclerosis.

Gustavsen, S · 2019

49% had tried cannabis, 21% were current users, and only 21% of current users had prescribed cannabis.

Cannabis and multiple sclerosis.

Ingram, Gillian · 2019

About half of MS patients report previous or current medicinal cannabis use.

Perspectives on cannabis as a substitute for opioid analgesics.

Khan, Sara P · 2019

The review found evidence from preclinical, clinical, and epidemiological studies suggesting cannabis can complement or partially substitute for opioids in pain management, with some studies showing reduced opioid prescriptions in states with medical cannabis laws..

Opportunities for cannabis in supportive care in cancer.

Kleckner, Amber S · 2019

The review found reasonable evidence to consider cannabis for nausea/vomiting, appetite loss, and pain as supplemental treatment.

The Impact of Perioperative Cannabis Use: A Narrative Scoping Review.

Ladha, Karim S · 2019

The review identified several perioperative concerns for cannabis users: potential increased anesthetic requirements, altered post-operative pain processing, cannabis withdrawal syndrome risk, and cardiovascular effects.

Frequency of cannabis and illicit opioid use among people who use drugs and report chronic pain: A longitudinal analysis.

Lake, Stephanie · 2019

After adjusting for demographics, substance use, and health factors, daily cannabis use was associated with significantly lower odds of daily illicit opioid use (adjusted OR 0.50, 95% CI 0.34-0.74, p < 0.001).

Medical cannabis patterns of use and substitution for opioids & other pharmaceutical drugs, alcohol, tobacco, and illicit substances; results from a cross-sectional survey of authorized patients.

Lucas, Philippe · 2019

69.1% reported substituting cannabis for prescription drugs (35.3% of those for opioids), 44.5% for alcohol, 31.1% for tobacco, and 26.6% for illicit substances.

Benefits and harms of medical cannabis: a scoping review of systematic reviews.

Pratt, Misty · 2019

Pain management was the most commonly studied condition.

Association between cannabis laws and opioid prescriptions among privately insured adults in the US.

Raji, Mukaila A · 2019

In states with medical cannabis laws, opioid prescription rates (>30-day and >90-day) were significantly lower for adults aged 18-54 (aORs ranging from 0.56 to 0.77).

Safety and Efficacy of Medical Cannabis in Fibromyalgia.

Sagy, Iftach · 2019

Pain intensity decreased from median 9.0 to 5.0 (p < .001).

Cannabinoids in the treatment of rheumatic diseases: Pros and cons.

Sarzi-Puttini, Piercarlo · 2019

Cannabinoids may help rheumatic diseases through anti-inflammatory/immunomodulatory activity and pain management.

An Update of Current Cannabis-Based Pharmaceuticals in Pain Medicine.

Urits, Ivan · 2019

Nabiximols, a specific cannabis extract, has demonstrated benefit for pain related to spasticity in multiple sclerosis, cancer pain, and chronic pain conditions.

An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia.

van de Donk, Tine · 2019

None of the four treatments (high-THC, THC+CBD, high-CBD, placebo) had greater effect than placebo on spontaneous or electrical pain.

Is There Less Opioid Abuse in States Where Marijuana Has Been Decriminalized, Either for Medicinal or Recreational Use? A Clin-IQ.

Wendelboe, Aaron M · 2019

Of 10 studies meeting inclusion criteria (3 cross-sectional, 6 ecological, 1 retrospective cohort), 8 found associations between marijuana decriminalization policies and reduced prescription opioid use.

Medicinal cannabinoids in palliative care.

Agar, Meera · 2018

The author examined the evidence base for using medicinal cannabinoids in people with palliative diagnoses, where treatments increasingly focus on symptom management earlier in the disease trajectory.

Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort.

Baron, Eric P · 2018

Researchers surveyed 2,032 medical cannabis patients and found that pain syndromes accounted for 42% of cannabis use, with chronic pain being the most common reason.

Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science.

Baron, Eric P · 2018

This comprehensive review examined the medicinal properties of individual components in cannabis well beyond the usual focus on THC and CBD.

Potential of Endocannabinoids to Control Bladder Pain.

Bjorling, Dale E · 2018

Bladder-related pain is one of the most common forms of visceral pain, and opioids remain a primary treatment despite their well-known side effects.

Therapeutic Benefit of Smoked Cannabis in Randomized Placebo-Controlled Studies.

Bowen, Lynneice L · 2018

Despite 90% of marijuana users in 2014 using the smoked form, researchers could find only seven randomized placebo-controlled trials that specifically tested smoked cannabis for medical purposes. The results were mixed.

Therapeutic Cannabis and Endocannabinoid Signaling System Modulator Use in Otolaryngology Patients.

Bryant, Lucas M · 2018

Researchers reviewed the endocannabinoid signaling system in the context of ear, nose, and throat medicine.

Systematic Review of the Costs and Benefits of Prescribed Cannabis-Based Medicines for the Management of Chronic Illness: Lessons from Multiple Sclerosis.

Herzog, Samuel · 2018

Researchers systematically reviewed the economic costs and benefits of prescribed cannabis-based medicines across all chronic illnesses. Of 2,514 records identified, only 10 studies met criteria, all focused on multiple sclerosis (MS).

Cannabis Use, Lung Cancer, and Related Issues.

Jett, James · 2018

Researchers reviewed the evidence on cannabis, lung cancer risk, and therapeutic applications in oncology. On lung cancer risk: smoking cannabis has not been proven to be a risk factor for lung cancer development.

Cannabinoids for the treatment of rheumatic diseases - where do we stand?

Katz-Talmor, Daphna · 2018

Researchers reviewed the available evidence on cannabinoids for rheumatic diseases. Preliminary clinical trials have explored cannabis effects on rheumatoid arthritis, osteoarthritis, and fibromyalgia.

Availability and approval of cannabis-based medicines for chronic pain management and palliative/supportive care in Europe: A survey of the status in the chapters of the European Pain Federation.

Krcevski-Skvarc, N · 2018

The European Pain Federation (EFIC) surveyed its national chapters on the status of cannabis-based medicines for chronic pain and palliative care. 31 of 37 chapters responded, revealing large disparities: THC/CBD oromucosal spray (Sativex) was approved for MS spasticity in 21 chapters.

Slowly Signaling G Protein-Biased CB2 Cannabinoid Receptor Agonist LY2828360 Suppresses Neuropathic Pain with Sustained Efficacy and Attenuates Morphine Tolerance and Dependence.

Lin, Xiaoyan · 2018

Researchers characterized LY2828360, a CB2 cannabinoid receptor agonist that had previously failed in a clinical trial for osteoarthritis due to lack of efficacy. In vitro, LY2828360 was identified as a "G protein-biased" agonist: it activated G protein signaling but did not recruit arrestin, a pattern that may explain its sustained efficacy. In mice with chemotherapy-induced neuropathic pain (from paclitaxel), LY2828360 at 3 mg/kg/day for 12 days suppressed pain without developing tolerance.

Rates of cannabis use in patients with cancer.

Martell, K · 2018

Researchers distributed surveys to 3,138 cancer patients across two comprehensive and two community cancer centers in a Canadian province, with 1,987 usable responses (63% response rate). Lifetime cannabis use was reported by 43%, independent of age, sex, education level, or cancer type. Cannabis was acquired primarily through friends (80%), with only 10% from regulated medical dispensaries. Of 356 patients (18%) who used cannabis in the past 6 months, 36% were new users who started after their cancer diagnosis. Reasons for recent use included cancer-related pain (46%), nausea (34%), other cancer symptoms (31%), and non-cancer-related reasons (56%, which could overlap with other categories). Most users (81% of those with any use) had used dried leaves..

Effects of Legal Access to Cannabis on Scheduled II-V Drug Prescriptions.

Stith, Sarah S · 2018

28 of 83 MCP patients (34%) ceased all scheduled prescription medications by the end of the observation period, versus only 1 of 42 comparison patients (2%).

The use of cannabis in response to the opioid crisis: A review of the literature.

Vyas, Marianne Beare · 2018

The 10 included studies collectively suggest medical cannabis laws could be associated with decreased prescription opioid use, fewer POM-related hospitalizations, lower rates of opioid overdose, and reduced national healthcare expenditures related to opioid overdose and misuse.

Pharmacokinetics, Safety, and Clinical Efficacy of Cannabidiol Treatment in Osteoarthritic Dogs

Gamble, Lauri-Jo · 2018

CBD oil at 2 mg/kg twice daily significantly reduced pain (CBPI score 21→14, p<0.01) and increased activity (Hudson score 54→67, p<0.01) in dogs with osteoarthritis.

A selective review of medical cannabis in cancer pain management.

Blake, Alexia · 2017

The review identified five clinical studies evaluating THC or CBD for cancer pain.

Cannabis as a substitute for prescription drugs - a cross-sectional study.

Corroon, James M · 2017

Of 2,774 cannabis users surveyed, 1,248 (46%) reported using cannabis as a substitute for prescription drugs.

Cannabis and intractable chronic pain: an explorative retrospective analysis of Italian cohort of 614 patients.

Fanelli, Guido · 2017

Following Italy's 2015 authorization of medical cannabis, researchers analyzed the first year of clinical use for chronic pain across six treatment centers.

Cannabinoids for treating inflammatory bowel diseases: where are we and where do we go?

Hasenoehrl, Carina · 2017

Fifty years after THC was identified, this expert review assessed the clinical translation of cannabinoids for inflammatory bowel diseases (IBD) including Crohn's disease and ulcerative colitis. Surveys and small clinical studies confirmed that IBD patients frequently use cannabis to manage diarrhea, abdominal pain, and appetite loss.

Medical cannabis for the treatment of chronic pain and other disorders: misconceptions and facts.

Hill, Kevin P · 2017

As cannabis policy changes accelerated worldwide, this review addressed the gap between patient expectations and clinical evidence for medical cannabis. The authors found that the best current evidence supports medical cannabis for three specific conditions: chronic pain, neuropathic pain, and spasticity from multiple sclerosis.

The Increasing Use of Cannabis Among Older Americans: A Public Health Crisis or Viable Policy Alternative?

Kaskie, Brian · 2017

This essay examined the intersection of cannabis and aging in America, identifying multiple pathways through which older adults are increasingly using cannabis. Some older adults are responding to changing social and legal environments and using cannabis recreationally.

Medical cannabis: Another piece in the mosaic of autoimmunity?

Katz, D · 2017

This review examined cannabis and its active compounds as potential treatments for autoimmune diseases, conditions where the immune system mistakenly attacks the body's own tissues. The evidence supports cannabinoids as immune-modulating agents that affect T-cells, B-cells, monocytes, and microglia cells.

Medical use of cannabis in Switzerland: analysis of approved exceptional licences.

Kilcher, Gablu · 2017

This study analyzed all 1,193 patients approved for medical cannabis through Switzerland's exceptional licensing program in 2013 and 2014. The program grew rapidly: 542 patients were treated in 2013 compared to 825 in 2014, a 52% increase.

Cannabis for Pain and Headaches: Primer.

Kim, Philip S · 2017

This primer reviewed the landscape of cannabis-based pain treatment for physicians, covering three main categories of active compounds. Synthetic cannabinoids like dronabinol and nabilone have already received FDA approval for chemotherapy-related nausea and HIV wasting, providing a regulatory pathway for cannabinoid medicines.

The use of cannabis in supportive care and treatment of brain tumor.

Likar, Rudolf · 2017

This review examined the dual role of cannabinoids in brain tumor care: established palliative symptom management and emerging anti-tumor potential. For palliative care, cannabinoids have documented roles in managing nausea, vomiting, pain, anxiety, and sleep disturbances in cancer patients.

Cannabinoids therapeutic use: what is our current understanding following the introduction of THC, THC:CBD oromucosal spray and others?

Maccarrone, Mauro · 2017

This expert review assessed the state of cannabinoid therapeutics roughly five years after THC/CBD oromucosal spray (Sativex) entered clinical practice for multiple sclerosis spasticity. For MS spasticity, clinical trials confirmed the spray's efficacy and tolerability, establishing it as the most widely used prescription cannabinoid medicine internationally.

Evidence for the use of "medical marijuana" in psychiatric and neurologic disorders.

Noel, Christopher · 2017

This review took a deliberately narrow approach, examining only randomized clinical trials of phytocannabinoids (plant-derived cannabis) for psychiatric and neurologic conditions, excluding synthetic products like dronabinol and nabilone. The search identified trials in dementia, multiple sclerosis, Parkinson's disease, Huntington's disease, schizophrenia, social anxiety disorder, depression, tobacco use disorder, and neuropathic pain. The overall evidence base was thin.

Systematic review: interventions for abdominal pain management in inflammatory bowel disease.

Norton, C · 2017

This systematic review searched for interventions specifically targeting abdominal pain in inflammatory bowel disease, finding a surprisingly sparse evidence base. Only 15 papers met inclusion criteria.

Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep.

Piper, Brian J · 2017

Among 1,513 New England dispensary members surveyed, the rates of medication reduction after starting medical cannabis varied significantly by drug class.

Chronic pain patients' perspectives of medical cannabis.

Piper, Brian J · 2017

Among 984 dispensary members (two-thirds with chronic pain), the average self-rated effectiveness of medical cannabis was 74.6% on a scale from 0% (no relief) to 100% (complete relief).

Cannabis as a Substitute for Opioid-Based Pain Medication: Patient Self-Report.

Reiman, Amanda · 2017

Among 2,897 medical cannabis patients surveyed, 34% reported using opioid-based pain medication in the past six months.

Cannabis Use in Palliative Oncology: A Review of the Evidence for Popular Indications.

Turgeman, Ilit · 2017

The review assessed cannabis and cannabinoid use across the spectrum of palliative care needs in cancer patients. The best-established indications were chemotherapy-induced nausea and vomiting (CINV), where synthetic cannabinoids like nabilone and dronabinol have been approved for decades, and cancer-related pain, where cannabis showed benefit particularly for pain not adequately controlled by opioids alone. Emerging evidence supported use for anorexia/cachexia (cancer-related weight loss), insomnia, and anxiety, though clinical trial data for these indications was limited.

Integrating cannabis into clinical cancer care.

Abrams, D I · 2016

This review examined the role of cannabis in cancer care across multiple domains.

Attitudes to cannabis and patterns of use among Canadians with multiple sclerosis.

Banwell, Emma · 2016

Researchers surveyed 225 people with multiple sclerosis (MS) attending neurology and neuropsychiatry clinics in Canada about their cannabis use and attitudes. Overall attitudes were favorable: 54.3% approved of cannabis and 43.7% endorsed full legalization, while another 43.7% supported legalization for medical use only.

Cannabinoids for Symptom Management and Cancer Therapy: The Evidence.

Davis, Mellar P · 2016

This review from the National Comprehensive Cancer Network examined cannabinoids across multiple cancer-related applications. For pain, multiple studies (mostly moderate to low quality) showed that THC and THC/CBD combinations modestly reduce cancer pain.

Efficacy, tolerability and safety of cannabinoids in chronic pain associated with rheumatic diseases (fibromyalgia syndrome, back pain, osteoarthritis, rheumatoid arthritis): A systematic review of randomized controlled trials.

Fitzcharles, M-A · 2016

The researchers systematically searched for randomized controlled trials of cannabinoid products in fibromyalgia, osteoarthritis, chronic spinal pain, and rheumatoid arthritis.

Efficacy, Tolerability, and Safety of Cannabinoid Treatments in the Rheumatic Diseases: A Systematic Review of Randomized Controlled Trials.

Fitzcharles, Mary-Ann · 2016

This review identified the same thin evidence base for cannabinoids in rheumatic diseases: four short studies totaling only 203 patients across rheumatoid arthritis, fibromyalgia, and osteoarthritis. Cannabinoids had a statistically significant effect on pain in two of the studies and on sleep in two studies.

Medical cannabis - the Canadian perspective.

Ko, Gordon D · 2016

This review addressed the rapidly evolving Canadian medical cannabis landscape from both clinical and practical perspectives.

Opioid withdrawal suppression efficacy of oral dronabinol in opioid dependent humans.

Lofwall, Michelle R · 2016

The cannabinoid system shares neural circuitry with the opioid system, making it a rational target for treating opioid dependence.

A user's guide to cannabinoid therapies in oncology.

Maida, V · 2016

This review provides a clinical roadmap for using cannabinoid therapies in cancer care.

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.

Parmar, Jayesh R · 2016

Researchers reviewed 68 studies comparing the three FDA-approved cannabis-based medications (dronabinol, nabiximols, nabilone) with smoked and orally ingested marijuana.

Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.

Russo, Ethan B · 2016

Dr.

Cannabinoids: Medical implications.

Schrot, Richard J · 2016

This review covered the medical evidence for cannabinoid therapeutics across multiple conditions.

THC:CBD Observational Study Data: Evolution of Resistant MS Spasticity and Associated Symptoms.

Trojano, Maria · 2016

The MOVE 2 Italy study tracked real-world outcomes of THC:CBD oromucosal spray (Sativex) for treatment-resistant MS spasticity across more than 30 Italian MS centers.

Cannabinoids for fibromyalgia.

Walitt, Brian · 2016

The Cochrane Collaboration, considered the gold standard for medical evidence review, found only two randomized controlled trials testing cannabinoids for fibromyalgia, with a combined total of just 72 participants.

The Selective Monoacylglycerol Lipase Inhibitor MJN110 Produces Opioid-Sparing Effects in a Mouse Neuropathic Pain Model.

Wilkerson, Jenny L · 2016

Researchers combined morphine with MJN110, a selective MAGL inhibitor that boosts 2-AG levels, in a mouse model of neuropathic pain (chronic constriction injury). When used alone, both drugs reduced pain in a dose-dependent manner.

Cannabis in cancer care.

Abrams, D I · 2015

The review covers established and emerging roles of cannabis in cancer care.

Cannabinoids and Tremor Induced by Motor-related Disorders: Friend or Foe?

Arjmand, Shokouh · 2015

This review examined the potential of cannabinoid-based compounds to treat tremor associated with Parkinson's disease, multiple sclerosis, Huntington's disease, and forms of ataxia.

Comprehensive Review of Medicinal Marijuana, Cannabinoids, and Therapeutic Implications in Medicine and Headache: What a Long Strange Trip It's Been ….

Baron, Eric P · 2015

This extensive review traced the history of medicinal cannabis from ancient use through its prominence in 19th-century medicine, when it was widely prescribed for headache, to its prohibition driven by political rather than scientific factors.

Narrative review of the safety and efficacy of marijuana for the treatment of commonly state-approved medical and psychiatric disorders.

Belendiuk, Katherine A · 2015

Researchers reviewed the scientific evidence for cannabis treatment across the conditions most commonly approved by state medical marijuana programs.

Clinical perspectives on medical marijuana (cannabis) for neurologic disorders.

Fife, Terry D · 2015

This commentary examined the clinical implications of the American Academy of Neurology's systematic review of cannabinoids for neurological disorders.

Concomitant cannabis abuse/dependence in patients treated with opioids for non-cancer pain.

Hefner, Kathryn · 2015

Researchers examined cannabis use disorder (CUD) rates among 1,316,464 VHA patients with non-cancer pain who received opioid medications.

A multicentre, open-label, follow-on study to assess the long-term maintenance of effect, tolerance and safety of THC/CBD oromucosal spray in the management of neuropathic pain.

Hoggart, B · 2015

This open-label extension study followed 380 patients with peripheral neuropathic pain (from diabetes or allodynia) who had participated in two prior randomized controlled trials of THC/CBD oromucosal spray.

The role of cannabinoids in regulation of nausea and vomiting, and visceral pain.

Malik, Zubair · 2015

This review mapped cannabinoid receptors (CB1, CB2, and potentially GPR55) throughout the gastrointestinal tract and examined their roles in food intake, nausea, gastric secretion, motility, visceral sensation, inflammation, and cell proliferation. The strongest evidence supported cannabinoid involvement in regulating nausea and vomiting, where the endocannabinoid system has provided new mechanistic insights.

Peripherally Restricted Cannabinoids for the Treatment of Pain.

Romero-Sandoval, E Alfonso · 2015

This review examined strategies to use cannabinoids for pain treatment while avoiding central nervous system effects.

Patterns of cannabis use in patients with Inflammatory Bowel Disease: A population based analysis.

Weiss, Alexandra · 2015

Using data from the NHANES national health survey, researchers compared cannabis use patterns between people with inflammatory bowel disease (IBD) and matched controls. People with IBD were more likely to have ever used cannabis (67.3% vs.

Cannabinoids for medical use: A systematic review and meta-analysis

Whiting, Penny F. · 2015

Across 79 RCTs, cannabinoids were linked to better symptom outcomes than placebo for several indications, but effects were often small and not consistently statistically significant across trials.

Is the clinical use of cannabis by oncology patients advisable?

Bar-Sela, Gil · 2014

This review assessed the evidence for cannabis use by oncology patients.

Medical marijuana in neurology.

Benbadis, Selim R · 2014

This expert review assessed the evidence for cannabinoids in neurological diseases.

The subjective psychoactive effects of oral dronabinol studied in a randomized, controlled crossover clinical trial for pain.

Issa, Mohammed A · 2014

In a randomized controlled trial with 30 chronic non-cancer pain patients on opioids, single doses of dronabinol (10 mg and 20 mg) produced significantly elevated scores on four of five psychoactivity subscales compared to placebo.

Care and feeding of the endocannabinoid system: a systematic review of potential clinical interventions that upregulate the endocannabinoid system.

McPartland, John M · 2014

The review identified multiple categories of clinical interventions that enhance the endocannabinoid system.

Cannabis for inflammatory bowel disease.

Naftali, Timna · 2014

The authors report on their own clinical research program alongside a broader literature review.

THC:CBD spray and MS spasticity symptoms: data from latest studies.

Rekand, Tiina · 2014

A randomized, placebo-controlled long-term trial demonstrated that THC:CBD spray (Sativex) was not associated with cognitive decline, depression, or significant mood changes after 12 months of treatment.

Therapeutic potential of cannabinoid medicines.

Robson, P J · 2014

The review covers the endocannabinoid system's role in immune response, appetite, cognition, emotion, perception, motor coordination, body temperature, sleep, and bone metabolism.

Cannabis use provides symptom relief in patients with inflammatory bowel disease but is associated with worse disease prognosis in patients with Crohn's disease.

Storr, Martin · 2014

Of 313 IBD patients surveyed, 17.6% had used cannabis specifically to treat their IBD symptoms, primarily through inhalation (96.4%).

The endocannabinoid system as a potential therapeutic target for pain modulation.

Ulugöl, Ahmet · 2014

The review outlines the shift in cannabinoid pain research from directly activating cannabinoid receptors to enhancing the body's own endocannabinoid system.

The pharmacologic and clinical effects of medical cannabis.

Borgelt, Laura M · 2013

The review covered three types of cannabinoid medicines available in North America: dronabinol (Schedule III), nabilone (Schedule II), and medical cannabis (Schedule I).

Targeting the cannabinoid system for pain relief?

Chiou, Lih-Chu · 2013

The review covered multiple cannabinoid pain-relief strategies: exogenous cannabinoids (THC acting mainly through CB1), CB2-selective agonists (which avoid psychoactive effects), and endocannabinoid enzyme inhibitors (FAAH and MAGL inhibitors).

An open-label extension study to investigate the long-term safety and tolerability of THC/CBD oromucosal spray and oromucosal THC spray in patients with terminal cancer-related pain refractory to strong opioid analgesics.

Johnson, Jeremy R · 2013

Forty-three patients with advanced cancer and pain inadequately managed by strong opioids entered an open-label extension study of THC/CBD spray (nabiximols/Sativex).

Repeated low-dose administration of the monoacylglycerol lipase inhibitor JZL184 retains cannabinoid receptor type 1-mediated antinociceptive and gastroprotective effects.

Kinsey, Steven G · 2013

The MAGL inhibitor JZL184 blocks the enzyme that breaks down the endocannabinoid 2-AG, boosting natural cannabinoid signaling.

A double-blind, randomized, placebo-controlled, parallel-group study of THC/CBD oromucosal spray in combination with the existing treatment regimen, in the relief of central neuropathic pain in patients with multiple sclerosis.

Langford, R M · 2013

This study had two phases.

Amygdala activity contributes to the dissociative effect of cannabis on pain perception.

Lee, Michael C · 2013

Healthy volunteers received either THC or placebo before a capsaicin-induced pain and hyperalgesia model with fMRI brain imaging.

Peripheral and spinal activation of cannabinoid receptors by joint mobilization alleviates postoperative pain in mice.

Martins, D F · 2013

Mice underwent plantar incision surgery and received ankle joint mobilization 24 hours later.

Advances in the management of multiple sclerosis spasticity: experiences from recent studies and everyday clinical practice.

Pozzilli, Carlo · 2013

The review summarized the clinical evidence for Sativex in MS spasticity.

Cannabinoid and opioid interactions: implications for opiate dependence and withdrawal.

Scavone, J L · 2013

The review detailed how cannabinoid and opioid receptors interact at the molecular level, particularly in the locus coeruleus-norepinephrine (LC-NE) system, a key circuit in the negative effects of opiate addiction.

Sativex long-term use: an open-label trial in patients with spasticity due to multiple sclerosis.

Serpell, Michael G · 2013

One hundred forty-six MS patients entered an open-label follow-up of Sativex for spasticity.

Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial.

Corey-Bloom, Jody · 2012

Thirty MS patients with treatment-resistant spasticity completed a placebo-controlled crossover trial.

Medical marijuana: clearing away the smoke.

Grant, Igor · 2012

This review summarized the growing clinical trial evidence for medical cannabis, focusing on recent trials of smoked and vaporized marijuana as well as botanical extracts.

Cannabis as an adjunct to or substitute for opiates in the treatment of chronic pain.

Lucas, Philippe · 2012

This review compiled evidence from preclinical and clinical sources on using cannabis as an adjunct to or substitute for opiates in chronic pain.

Clinical efficacy and effectiveness of Sativex, a combined cannabinoid medicine, in multiple sclerosis-related spasticity.

Oreja-Guevara, Celia · 2012

The review examined accumulating clinical evidence for Sativex, an oromucosal spray containing equal parts THC and cannabidiol.

Targeting the endocannabinoid system with cannabinoid receptor agonists: pharmacological strategies and therapeutic possibilities.

Pertwee, Roger G · 2012

Three cannabinoid medicines were already in clinical use at the time: Cesamet (nabilone), Marinol (dronabinol), and Sativex (THC with CBD).

Nabiximols in the treatment of spasticity, pain and urinary symptoms due to multiple sclerosis.

Podda, Giulio · 2012

The review analyzed clinical trials of nabiximols for three MS symptoms: spasticity, neuropathic pain, and bladder dysfunction.

Endocannabinoids in nervous system health and disease: the big picture in a nutshell.

Skaper, Stephen D · 2012

The review provided a broad overview of the endocannabinoid system (ECS), describing how its two main signaling molecules, anandamide and 2-AG, regulate brain function through cannabinoid receptors.

Cannabidiol in humans-the quest for therapeutic targets.

Zhornitsky, Simon · 2012

The review identified 34 studies: 16 in healthy subjects and 18 in clinical populations covering MS, schizophrenia, bipolar mania, social anxiety, pain, cancer, Huntington's disease, insomnia, and epilepsy. Key findings included: high inhaled/IV doses of CBD were needed to block THC effects.

Endocannabinoid pathways and their role in multiple sclerosis-related muscular dysfunction.

Di Marzo, Vincenzo · 2011

The review examined the role of endocannabinoids in MS-related muscular dysfunction and the therapeutic potential of Sativex (nabiximols), containing equal parts THC and CBD. Endocannabinoid levels were found to be altered in both animal models of MS and in cerebrospinal fluid samples from MS patients.

Effects of cannabis on cognitive function in patients with multiple sclerosis.

Honarmand, Kimia · 2011

Researchers compared 25 MS patients who used cannabis to 25 matched MS non-users using a comprehensive neuropsychological battery designed specifically for MS. Cannabis users performed significantly worse on information processing speed, working memory, executive functions, and visuospatial perception.

Cannabis and its derivatives: review of medical use.

Leung, Lawrence · 2011

The review provided a practical update for family physicians on medical cannabis, covering several key points. Clinical trials demonstrated benefits for alleviating chronic and neuropathic pain, though significant psychotropic and physical side effects accompanied use.

Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain.

Johnson, Jeremy R · 2010

One hundred seventy-seven cancer patients whose pain was inadequately controlled by opioids were randomized to THC/CBD extract spray (60 patients), THC-only extract spray (58 patients), or placebo (59 patients) for two weeks. The THC/CBD group showed statistically significant pain improvement compared to placebo (mean change -1.37 vs -0.69 on a numerical rating scale).

Cellular mechanisms underlying the interaction between cannabinoid and opioid system.

Parolaro, D · 2010

The review synthesized evidence for three main mechanisms through which the cannabinoid and opioid systems interact: 1.

New approaches in the management of spasticity in multiple sclerosis patients: role of cannabinoids.

Smith, Paul F · 2010

The review examined clinical trial evidence for cannabis-based medicinal extracts (CBMEs) in treating spasticity associated with multiple sclerosis (MS). Patients consistently reported subjective improvement in spasticity when using CBMEs.

The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial.

Ware, Mark A · 2010

Twenty-nine fibromyalgia patients with chronic insomnia completed a crossover trial comparing nabilone (0.5-1.0 mg at bedtime) to amitriptyline (10-20 mg at bedtime), each for two weeks with a two-week washout period. Nabilone was significantly superior to amitriptyline on the Insomnia Severity Index (difference = 3.2 points, 95% CI: 1.2-5.3).

Characteristics of patients with chronic pain accessing treatment with medical cannabis in Washington State.

Aggarwal, Sunil K · 2009

Researchers reviewed charts of 139 patients legally authorized for medical cannabis in Washington State, seen at a university pain clinic. The patient population was complex: 88% had more than one pain syndrome.

Cannabinoids, endocannabinoids, and related analogs in inflammation.

Burstein, Sumner H · 2009

This review examined five years of research on the anti-inflammatory properties of cannabinoids across several categories: plant-derived cannabinoids (THC, CBD), synthetic analogs (ajulemic acid, nabilone), endocannabinoids (anandamide and related compounds), and non-cannabinoid cannabis components. All classes demonstrated anti-inflammatory activity.

The analgesic potential of cannabinoids.

Elikkottil, Jaseena · 2009

This review examined the history, pharmacology, and clinical data on cannabinoids as pain treatments. Clinical and experimental studies showed that cannabis-derived compounds act as antiemetic, appetite-modulating, and analgesic agents.

Blockade of endocannabinoid-degrading enzymes attenuates neuropathic pain.

Kinsey, S G · 2009

Researchers tested whether blocking the enzymes that degrade endocannabinoids could reduce neuropathic pain in mice with sciatic nerve injury. FAAH inhibitors (URB597 and OL-135), which increase anandamide levels, reduced both mechanical and cold allodynia.

Selective blockade of 2-arachidonoylglycerol hydrolysis produces cannabinoid behavioral effects.

Long, Jonathan Z · 2009

Researchers developed JZL184, the first potent and selective inhibitor of MAGL, the enzyme that breaks down the endocannabinoid 2-AG. When administered to mice, JZL184 raised brain 2-AG levels eightfold without altering anandamide levels, confirming that MAGL is the primary enzyme responsible for 2-AG degradation in the brain. Mice treated with JZL184 exhibited analgesia, hypothermia, and reduced movement, all classic cannabinoid effects that were blocked by a CB1 receptor antagonist, confirming they were mediated through the cannabinoid system. These findings established that 2-AG endogenously modulates several behavioral processes traditionally associated with cannabis pharmacology..

Emerging strategies for exploiting cannabinoid receptor agonists as medicines.

Pertwee, Roger G · 2009

Five strategies for improving cannabinoid therapeutics while reducing psychoactive side effects: (1) peripheral restriction — drugs that cannot cross the blood-brain barrier; (2) tissue-specific delivery — intrathecal, transdermal, topical routes; (3) receptor upregulation — exploiting disease-induced increases in receptor density; (4) CB2 selectivity — targeting immune receptors that don't cause intoxication; (5) multi-targeting — synergistic combinations, especially cannabinoid-opioid at sub-effective doses..

Plant-derived cannabinoids modulate the activity of transient receptor potential channels of ankyrin type-1 and melastatin type-8.

De Petrocellis, Luciano · 2008

Researchers tested six plant cannabinoids (CBD, THC, CBD acid, THC acid, cannabichromene/CBC, and cannabigerol/CBG) on two ion channels involved in pain sensing: TRPA1 and TRPM8. All six cannabinoids activated TRPA1 channels (which detect chemical irritants and contribute to inflammatory pain).

Cannabinoids:their role in pain and palliation.

McCarberg, Bill H · 2007

This review examined the evidence for cannabinoid use in pain management and palliative care across several conditions. The author described how the endocannabinoid system works alongside the opioid system as a retrograde neuromodulatory network.

Oromucosal delta9-tetrahydrocannabinol/cannabidiol for neuropathic pain associated with multiple sclerosis: an uncontrolled, open-label, 2-year extension trial.

Rog, David J · 2007

This open-label extension followed 63 MS patients with central neuropathic pain for up to 917 days (over 2.5 years) of Sativex (THC/CBD mouth spray) treatment. Of the 63 patients who entered the extension, 34 (54%) completed more than one year, and 28 (44%) completed the full follow-up.

Sativex: clinical efficacy and tolerability in the treatment of symptoms of multiple sclerosis and neuropathic pain.

Barnes, Michael Philip · 2006

This review covered the clinical development of Sativex, one of the first cannabis-based medicines approved through conventional pharmaceutical pathways.

A multicenter dose-escalation study of the analgesic and adverse effects of an oral cannabis extract (Cannador) for postoperative pain management.

Holdcroft, Anita · 2006

Patients were given a single dose of 5, 10, or 15 mg of oral cannabis extract (Cannador) for post-operative pain after stopping patient-controlled analgesia.

Combined cannabinoid therapy via an oromucosal spray.

Perez, Jordi · 2006

This review covered the clinical development of Sativex as a combined cannabinoid medicine (THC and CBD) delivered via oromucosal spray.

Recent developments in the therapeutic potential of cannabinoids.

Corey, Susan · 2005

This review identified 15 independent, qualifying clinical trials (randomized, double-blind, placebo-controlled) of cannabinoid therapeutics published since 1997.

Cannabinoids.

Grotenhermen, Franjo · 2005

This comprehensive review covered 15 years of research since the discovery of the endocannabinoid system.

Sativex for the management of multiple sclerosis symptoms.

Perras C · 2005

Sativex, containing THC and CBD in a 1:1 ratio delivered as an oromucosal spray, was one of the first cannabis-based medicines to undergo conventional clinical development and receive prescription approval.

Human studies of cannabinoids and medicinal cannabis.

Robson, P · 2005

This review traced the arc of medicinal cannabis from its prominence in 19th century Western medicine through its early 20th century prohibition and 1960s recreational explosion, to the current state of clinical research. The author identified major methodological challenges that had kept clinical evidence weak: studies tended to be small, imperfectly controlled, and often used synthetic cannabinoid analogs or smoked herbal material with uncertain composition and irregular bioavailability. New research opportunities were emerging from three developments: the discovery of the endocannabinoid system, expanding knowledge of cannabinoid pharmacology, and a more sympathetic political environment in several countries.

Efficacy of two cannabis based medicinal extracts for relief of central neuropathic pain from brachial plexus avulsion: results of a randomised controlled trial.

Berman, Jonathan S · 2004

In 48 patients with chronic nerve pain from brachial plexus root avulsion, both Sativex (THC:CBD approximately 1:1) and a THC-only extract delivered by oral spray produced statistically significant improvements in pain severity compared to placebo during two-week treatment periods.

Towards cannabis and cannabinoid treatment of multiple sclerosis.

Croxford, J Ludovic · 2004

The review identified a gap between promising preclinical evidence and disappointing clinical results.

Cannabinoids in multiple sclerosis: do they have a therapeutic role?

Killestein, Joep · 2004

While the identification of cannabinoid receptors and endocannabinoid ligands, along with animal model efficacy, generated excitement about cannabinoid treatment for MS, the clinical evidence was described as equivocal.

Initial experiences with medicinal extracts of cannabis for chronic pain: results from 34 'N of 1' studies.

Notcutt, William · 2004

Thirty-four patients with chronic, mainly neuropathic, pain used three cannabis-based sublingual sprays (THC, CBD, and 1:1 THC:CBD) over 12 weeks in individual randomized crossover trials.

Medicinal cannabis extracts for the treatment of multiple sclerosis.

Smith, Paul F · 2004

The review contrasted two approaches to cannabis-based MS treatment.

Efficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled, crossover study.

Vaney, C · 2004

Researchers enrolled 57 MS patients with poorly controlled spasticity into a randomized, double-blind, placebo-controlled crossover study during inpatient rehabilitation.

Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on 160 patients.

Wade, Derick T · 2004

Researchers recruited 160 MS outpatients experiencing significant problems with spasticity, spasms, bladder issues, tremor, or pain across three centers.

Cannabis-based medicines--GW pharmaceuticals: high CBD, high THC, medicinal cannabis--GW pharmaceuticals, THC:CBD.

· 2003

GW Pharmaceuticals was developing distinct cannabis-based prescription medicines using three delivery systems: sublingual spray, sublingual tablet, and inhaled (non-smoked) forms.

Therapeutic potential of cannabinoids in CNS disease.

Croxford, J Ludovic · 2003

The review mapped cannabinoid therapeutic potential across multiple CNS conditions.

Cannabis use as described by people with multiple sclerosis.

Page, S A · 2003

Of 420 MS patients who completed the survey (62% response rate), 96% were aware that cannabis could potentially be therapeutically useful for MS and 72% supported legalization for medical purposes.

A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms.

Wade, Derick T · 2003

In 24 patients with neurological conditions (18 MS, 4 spinal cord injury, 2 other) whose symptoms had not responded to standard treatments, sublingual cannabis extracts produced significant pain relief.

Cannabinoids and multiple sclerosis.

Pertwee, Roger G · 2002

Clinical evidence from 8 trials in MS patients and 1 in spinal cord injury showed that cannabis, THC, and nabilone produced objective or subjective relief from spasticity, pain, tremor, and nocturia.

Cannabinoids in the treatment of pain and spasticity in multiple sclerosis.

Smith, Paul F · 2002

The review acknowledged substantial evidence that cannabinoids could reduce muscle spasticity and pain through CB1 receptor mechanisms.

Medicinal use of cannabis: history and current status.

Kalant, H · 2001

THC and several analogues showed significant therapeutic benefits for nausea, vomiting, and appetite stimulation in patients with wasting syndrome.

Pain, Depression, and Functional Outcomes Among Older Adults Who Use Cannabis or Opioid Analgesics for Chronic Pain Conditions.

Aebischer, Jonathan H · 2026

This longitudinal study tracked older adults enrolled in the Oregon Center for Aging and Technology with chronic pain lasting at least 12 weeks.

Cannabidiol reduces oxycodone self-administration while preserving its analgesic efficacy in a rat model of neuropathic pain.

Bruijnzeel, Adriaan W · 2026

This study addresses one of the most pressing questions in pain medicine: can we reduce opioid misuse without taking away pain relief? Rats were trained to self-administer oxycodone (pressing a lever to receive intravenous doses), then given chronic neuropathic pain via sciatic nerve injury.

Endocannabinoids, perioperative pain, and acetaminophen in patients undergoing total knee arthroplasty: a prospective cohort study.

Clendenen, Nathan · 2026

Knee replacement patients had higher CSF and plasma concentrations of anandamide and related N-acylethanolamines compared to controls.

Exploring the effects of cannabidiol on pain sensitivity using quantitative sensory testing among individuals receiving methadone or buprenorphine for opioid use disorder: an open-label, proof-of-concept study.

Costa, Gabriel P A · 2026

CBD showed a significant interaction with medication type for heat pain measures: buprenorphine patients had significantly higher heat pain threshold (at 400mg CBD) and heat tolerance (at 800mg CBD) compared to methadone patients.

A comparative study on phytochemical analysis and biological properties of three varieties of cannabis sativa L. seeds.

El-Mernissi, Rafik · 2026

Researchers compared the chemical composition and biological activity of three Moroccan Cannabis sativa seed varieties: Cric, Khard, and Beldiya.

A Longitudinal Assessment of Endometriosis Patients Prescribed Cannabis-Based Medicinal Products: A Case Series From the UK Medical Cannabis Registry.

Getter, Sara · 2026

Cannabis-based medicinal products were associated with significant improvements in all pain-specific measures from baseline to 18 months (p<.050).

The parabss1 Drosophila melanogaster as Model for Chronic Nociception: Insights Into Cannabidiol Analgesic Effects.

Malta, Serena Mares · 2026

The parabss1 Drosophila mutant exhibited enhanced chemical nociceptive sensitivity compared to wild-type.

A Scoping Systematic Review of Cannabis Use in Endometriosis.

McLaren, Kindha · 2026

Pain indication: 57.3-95.5%.

Cannabinoids and drug-drug pharmacokinetic interactions: Deciphering the risks.

Papakyriakopoulou, Paraskevi · 2026

This review mapped the pharmacokinetic drug-drug interactions involving cannabinoids across the full ADME framework (absorption, distribution, metabolism, excretion). The metabolism interactions are the most clinically significant.

A qualitative study on cannabis use for harm reduction and pain among veterans enrolled in an SUD treatment program.

Pleasant, Traben · 2026

Through interviews with 33 veterans receiving care in a VA substance use disorder treatment program, researchers documented how veterans with chronic pain viewed and used cannabis alongside their addiction treatment. Most participants had a primary diagnosis of alcohol use disorder (70%), followed by opioid use disorder (18%) and stimulant use disorder (12%).

Therapeutic use of cannabinoids in age-related pain: Current evidence and clinical perspectives.

Pulone, Sabina · 2026

This review explored the intersection of aging, chronic pain, and the endocannabinoid system (ECS), building a case for why cannabinoids might be particularly relevant for older adults. The key biological insight is that aging involves a process called "inflammaging" — chronic low-grade inflammation driven by immune system changes (immunosenescence).

Perioperative cannabis use on postoperative pain in immediate alloplastic breast reconstruction.

Qin, Nancy · 2026

Cannabis users reported significantly higher pain scores at 0-12 hours (4.42 vs 3.68, p=0.018) and 12-24 hours (4.53 vs 3.36, p=0.004) post-surgery.

Cannabivarin and tetrahydrocannabivarin modulate nociception via vanilloid channels and cannabinoid-like receptors in Caenorhabditis elegans.

Rahmani, Nasim · 2026

Both CBV and THCV produced dose-dependent antinociceptive effects in C.

Endocannabinoid response to social stress in chronic non-medical prescription opioid users.

Schmid, Vinzenz K · 2026

A significant GROUP x TIME interaction was found for 2-AG.

Medical cannabis authorization and opioid milligram equivalents over time in patients with chronic pain: a retrospective analysis.

Sexton, Michelle · 2026

Average opioid dose at the final time point was 33.4 mg/day OME overall.

Effect of Preoperative Cannabis Use on Postoperative Pain and Outcomes Following Cardiothoracic Surgery.

Shah, Sareena · 2026

Average morphine equivalents in the first 48 hours: cannabis users 60.98 vs non-users 59.90 (p=0.93).

Medical Cannabis for the Treatment of Peripheral Neuropathy due to Diabetes: A Systematic Review.

Sherman, Justin J · 2026

Three of four RCTs reported statistically significant reductions in neuropathic pain with cannabinoid interventions compared to placebo.

Cannabis and Endometriosis: When Is an Adverse Effect Not Adverse?

Sinclair, Justin · 2026

Among endometriosis patients using cannabis for symptom management, 32% experienced side effects, consistent with published literature.

Therapeutic potential of cannabidiol-rich Cannabis sativa to mitigate the severity of inflammation and pain: A pre-clinical study.

Singh, Munmun Kumar · 2026

The CBD-rich cannabis extract (CSFE) significantly reduced TNF-alpha and IL-6 production in LPS-stimulated macrophages at 3, 10, and 30 mcg/ml without cytotoxicity.

Cannabidiol-hyaluronic acid combination delivered rectally for attenuating abacterial prostatitis symptoms: Single-arm open-label pilot clinical trial.

Student, Vladimir · 2026

In this pilot trial, 16 men aged 24–49 with chronic nonbacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS) self-administered rectal suppositories containing 100 mg CBD and 6.6 mg hyaluronic acid nightly for 30 days. The primary outcome — the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) — decreased from a median of 24.5 to 20.0 points (p=0.003), with a median reduction of 7.0 points.

Cannabis and cannabidiol for postoperative pain management in orthopedic surgery: a scoping review.

Tran, Kevin · 2026

CBD-only interventions showed mixed results for post-orthopedic surgical pain.

Patients' Perspectives and Experiences of Cannabinoids to Manage Symptoms of Chronic Kidney Disease: An In-Depth Interview Study.

Walker, Rachael C · 2026

Of 17 participants, 13 used non-prescribed and 4 used prescribed cannabis.

Pilot Randomized Trial of Medical Cannabis to Reduce Symptom Burden in Patients With Newly Diagnosed Advanced Pancreatic Cancer (CanPan).

Zylla, Dylan · 2026

The trial met all prespecified feasibility benchmarks: 74% enrollment (goal 20%), 81% compliance (goal 60%), and 75% outcome completion (goal 50%).

A Randomized, Open-Label Trial to Assess Feasibility and Tolerability of Topical Cannabis Balms for the Treatment of Aromatase Inhibitor-Associated Musculoskeletal Syndrome (AIMSS).

Zylla, Dylan · 2026

86% of participants reported improvement in hand-related symptoms from baseline to week 2.

Oral Cannabidiol for Acute Post-Extraction Pain: A Randomized Pilot Study.

Abidi, Ammaar H · 2025

Dental extractions are one of the most common surgeries worldwide, and post-operative pain management typically relies on ibuprofen, acetaminophen, or opioids.

The impact of tetrahydrocannabinol on central pain modulation in chronic pain: a randomized clinical comparative study of offset analgesia and conditioned pain modulation in fibromyalgia.

Agbaria, Yara · 2025

THC (0.2 mg/kg sublingual) significantly reduced spontaneous pain ratings on the McGill scale compared to both baseline and placebo.

Elucidating interplay between myrcene and cannabinoid receptor 1 receptors to produce antinociception in mouse models of neuropathic pain.

Alayoubi, Myra · 2025

Myrcene (1-200 mg/kg) dose-dependently increased mechanical pain thresholds in neuropathic pain mice, with greater potency in females than males.

Understanding Cannabis Use After Spinal Cord Injury: A Canadian Survey Study.

Allison, David J · 2025

Of 80 Canadian adults with spinal cord injury, 42.5% reported cannabis use post-injury and 37.5% were current users, exceeding the general Canadian population rate of 25%.

Cannabidiol and Beta-Caryophyllene: Chronic inflammatory pain.

Alnoud, Mohammed · 2025

In a chronic inflammatory pain model (CFA-induced), the combination of CBD and beta-caryophyllene (BCP) produced synergistic pain-relieving effects that exceeded either compound alone.

Modulatory Effects of "Minor" Cannabinoids in an in vitro Model of Neuronal Hypersensitivity.

Anand, Uma · 2025

Cannabis produces over 100 cannabinoids, but research has focused almost exclusively on THC and CBD.

High CBD extract (CBD-X) modulates inflammation and immune cell activity in rheumatoid arthritis.

Aswad, Miran · 2025

This study takes the rheumatoid arthritis (RA) cannabis research a significant step forward from RTHC-00097 (CBG in RA cells) by testing a high-CBD extract not just in isolated human cells but also in two animal models of the disease. The ex vivo experiments showed that CBD-X inhibited the secretion of key inflammatory cytokines: IL-1β from macrophages and IL-8, IL-6, and TNF-α from human neutrophils — all central players in RA joint destruction.

Symptom management, adherence to therapy, and filling the gaps of medical cannabis therapy: a qualitative study on the importance of nursing consultations for fibromyalgia patients.

Bassi, Giulia Martina · 2025

Among 30 fibromyalgia patients, 20 reported that medical cannabis had never been proposed despite years of ineffective therapies.

Young Adults' Use of Prescription Opioids and Cannabis Postoperatively: A Qualitative Study.

Battison, Eleanor A J · 2025

Key themes included a "fear of opioids" and "fear messaging from parents" that led young adults to take opioids less than prescribed and endure pain instead.

Feasibility pilot of a novel coaching intervention to optimize cannabis use for chronic pain management among Veterans.

Boehnke, Kevin F · 2025

After up to 4 coaching sessions, all participants reported improvement.

Combination of Cannabidiol and Low-Dose Buprenorphine Suggests Synergistic Analgesia and Attenuates Buprenorphine-Induced Respiratory Depression.

Briones, Marisa S · 2025

The combination of a sub-analgesic buprenorphine dose and CBD produced statistically significant increases in pain threshold compared to either compound alone.

Effects of Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD), and THC:CBD mixtures on behavioral and physiological signs of morphine withdrawal in rhesus monkeys.

Carey, Lawrence M · 2025

THC at 1.0 mg/kg decreased unusual tongue movements (a key behavioral sign of opioid withdrawal in monkeys) and heart rate.

Challenges in conducting a feasibility randomized controlled trial of medicinal cannabis for endometriosis pain in Australia.

Chesterman, Susan · 2025

Only 12 of 63 target participants enrolled; 7 withdrew and only 4 completed; the primary barrier was the requirement to abstain from driving during THC treatment; high withdrawal rate made efficacy assessment impossible..

Parental Perceptions and Practices Regarding Pain Management and Medical Marijuana Use in Patients With Sickle Cell Disease.

Cinquepalmi, Loretta · 2025

Parents had significant concerns about societal implications of medical marijuana use in their children; concerns about marijuana were similar to those about opioids despite marijuana being potentially safer; social consequences may impact treatment acceptability..

The Role of Childhood Trauma in Chronic Pain and Substance Use Among Individuals Receiving Methadone Treatment for Opioid Use Disorder.

Costa, Gabriel P A · 2025

Higher childhood trauma scores correlated with greater pain severity, increased alcohol consumption, and earlier age of first cannabis use.

A pilot study of dronabinol for the treatment of pain in sickle cell disease.

Curtis, Susanna A · 2025

Of 27 patients approached, 85% were interested.

Efficacy of different cannabinoid compounds on migraine-like responses in female rats.

da Luz, Fernanda Mariano Ribeiro · 2025

CBD/THC combination produced the longest-lasting pain relief (up to 3 hours) and was the only compound that reduced light sensitivity in the CGRP-induced migraine model.

Therapeutic potential of cannabidiol in oral disorders: A systematic review of clinical evidence.

de Abreu, Lukas Mendes · 2025

Across six RCTs and one non-randomized trial, topical and intraoral CBD reduced pain, muscle tension, gingival inflammation, bacterial load, and aphthous ulcer symptoms, with no serious adverse effects.

Cannabidiol engages the peripheral endogenous opioid system to produce analgesia in neuropathic mice.

de Almeida, Douglas Lamounier · 2025

CBD at 20 mg/kg produced significant antinociception in mice with sciatic nerve injury.

Cannabis use frequency is associated with emotion dysregulation among persons receiving long-term opioid therapy for chronic pain: A psychophysiological study.

De Aquino, Joao P · 2025

Smaller reductions in skin conductance and corrugator muscle activity during emotion regulation tasks were associated with more days of cannabis use over 90 days.

Modulation of the endocannabinoid system in chronic conditions: a potential therapeutic intervention yet to be explored in sickle cell disease.

de Oliveira Souza, Lucas Bibiano · 2025

The review compiles evidence that the endocannabinoid system is involved in pain modulation, inflammation, and vascular function, all of which are disrupted in sickle cell disease.

Medical Cannabis and Psychological Well-Being in Illinois' Opioid Alternative Pilot Program.

Dubois, Cerina · 2025

Average psychological well-being was 3.18 out of 5 (good) across the full sample.

The association of medical cannabis use with quality of life in Illinois' opioid alternative pilot program.

Dubois, Cerina · 2025

Quality of life averaged 2.86 (between "good" and "fair") across the full sample, with no significant difference between non-users (2.85) and cannabis users (2.86, p=0.92).

Full spectrum cannabis oil combined with omega-3 fish oil for neuropathic pain management: a novel therapeutic approach.

Elorriaga, Cristina F · 2025

Combined CBD-cannabis oil and omega-3 treatment effectively prevented both thermal and mechanical hypersensitivity in nerve-injured rats, while also improving motor impairment and showing protective effects against nerve degeneration on histological analysis..

UK Medical Cannabis Registry: A Clinical Outcomes Analysis for Complex Regional Pain Syndrome.

Evans, Lilia · 2025

Pain severity on the Brief Pain Inventory improved from 6.69 at baseline to 5.85 at 1 month and 6.05 at 6 months.

Effectiveness of Full Spectrum Cannabis Extracts in the Treatment of Chronic Pain: An Open Label Study.

F, Aragon · 2025

51 of 88 patients achieved 50% or greater pain reduction.

Rapid suppression of neuropathic pain and somatosensory hyperactivity by nano-formulated cannabidiol.

Feng, Jingyu · 2025

An inclusion-complex-enhanced nano-micelle formulation (CBD-IN) significantly improved CBD delivery to the brain and fully suppressed both allodynia and hyperalgesia in a neuropathic pain mouse model with a single dose, while leaving normal sensorimotor and cognitive functions intact..

Aspirin-triggered lipoxin A4 reduces neuropathic pain and anxiety-like behaviours in male diabetic rats: antinociceptive enhancement by cannabinoid receptor agonists.

Ferreira, Matheus Vinícius · 2025

Aspirin-triggered lipoxin A4 (ATL) reduced mechanical hyperalgesia in diabetic rats both acutely and cumulatively.

Pilot Study of Cannabidiol for Treatment of Aromatase Inhibitor-Associated Musculoskeletal Symptoms in Breast Cancer.

Fleege, Nicole M G · 2025

In a phase 2 clinical trial, 17 of 39 breast cancer patients (43.6%) taking CBD (Epidiolex, titrated to 100mg twice daily) achieved at least a 2-point reduction in worst pain from aromatase inhibitor therapy.

Characterizing Cannabidiol Use in a Breast Cancer Population.

Fleege, Nicole M G · 2025

Of 141 breast cancer patients surveyed, 68 (48.2%) reported prior or current CBD use.

Characterizing the Population of a Medical Cannabis Clinic in a Pediatric Hospital.

Free, Taylor · 2025

Among 46 pediatric palliative care patients (mean age 11.7), there was a significant decrease in inpatient days and cost.

Role of the Endocannabinoid System in Fibromyalgia.

García-Domínguez, Mario · 2025

The endocannabinoid system plays a central role in pain perception, mood regulation, and inflammation, and variations in endocannabinoid levels and receptor activity in fibromyalgia patients may contribute to clinical symptoms..

Investigation of endocannabinoids in plasma and their correlation with physical fitness and resting state functional connectivity of the periaqueductal grey in women with fibromyalgia: An exploratory secondary study.

Ghafouri, Bijar · 2025

Significantly higher anandamide (AEA) concentrations were found in fibromyalgia patients compared to controls.

A Qualitative Investigation Into the Experiences of Medicinal Cannabis Use Among Chronic Pain and PTSD Patients in Israel.

Gliksberg, Or · 2025

Two main themes emerged: (1) Coping with adverse effects through concealment, justification, protective behavioral strategies, and rejection of stigmatized identity; and (2) Utilizing positive effects including using cannabis to forget/disconnect, cope with helplessness, and build camaraderie with other patients against perceived institutional barriers..

Cannabidiol and ∆9-Tetrahydrocannabinol in Endometriosis: A Literature Review on Therapeutic Applications and Mechanisms.

Godoy, Joana Retzke · 2025

An experimental rat study demonstrated CBD's anti-inflammatory, antioxidant, and antiangiogenic effects in endometriosis treatment via intraperitoneal administration.

Association of Serum Endocannabinoid Levels with Pancreatitis and Pancreatitis-Related Pain.

Goodman, Marc T · 2025

In a case-control study of 231 participants, circulating anandamide (AEA) levels were significantly higher in pancreatitis patients compared to controls, with the highest levels in acute pancreatitis.

Oral Cannabis for Taxane-Induced Neuropathy: A Pilot Randomized Placebo-Controlled Study.

Haney, Margaret · 2025

All 12 participants completed the 8-week trial.

Prevalence of THC-Positive Urine Drug Screens in Patients Receiving Chronic Opioid Therapy: A Retrospective Review.

Hasoon, Jamal · 2025

Of 244 urine drug screens from patients receiving chronic opioid therapy for pain at a single academic center (2024), 24 (9.8%) tested positive for THC.

Pilot Study Measuring Patient Reported Outcomes in Cannabinoid Hyperemesis Syndrome (CHS) patients treated in the Emergency Department.

Heidish, Ryan · 2025

In a pilot study of 18 CHS patients (mean age 34, 56% female), pain severity was high (mean triage score 6.4/10) and pain significantly interfered with daily activities (PROMIS T-score 62.2).

Dispensing Medical Advice: San Francisco Bay Area Budtender Recommendations for Pain and Sleep Relief.

Hoang, Christine · 2025

Across 35 Bay Area dispensaries, budtenders showed strong consensus: 77% recommended topicals for pain and 60% recommended edibles for sleep.

Differential inhibitory effects of endocannabinoids on neuronal firing of mouse meningeal afferents.

Krivoshein, Georgii · 2025

AEA reduced meningeal nerve firing more profoundly and for longer than 2-AG.

Inflammatory bowel disease patients believe cannabis and cannabidiol oil relieve symptoms.

Lala, Ayati · 2025

53.8% of IBD patients used cannabis (vs.

Pediatric Patient Experiences Using Medical Cannabis in Cancer Symptom Management as Reported by Parents of Children and Adolescents and by Young Adults.

Langevin, Mary · 2025

Top symptoms targeted: nausea/vomiting (n=20), appetite (n=15), pain (n=13), sadness/anxiety (n=7), sleep (n=7).

Cross-sectional comparison of cannabis use in adults with neuropathic versus non-neuropathic pain.

Laroya, Carl Joshua P · 2025

This study surveyed 104 adults at a pain clinic, comparing cannabis use patterns between those whose most bothersome pain was neuropathic (nerve-related, 36.5%) versus non-neuropathic (63.5%). Patients with neuropathic pain reported significantly more days per month of THC/CBD product use compared to those with non-neuropathic pain.

Clinical and psychosocial changes in adults with opioid use disorder and chronic pain using medical cannabis: a brief report.

Lent, Michelle R · 2025

Over three months, participants taking a 1:1 THC:CBD capsule alongside buprenorphine/naloxone reported significant decreases in pain severity, improved sleep quality, and better quality of life across seven of eight domains.

Motivation and experiences of individuals with opioid use disorder and chronic pain using medical cannabis for 12 months.

Lent, Michelle R · 2025

Across 10 interviews, participants consistently described four benefits from 12 months of medical cannabis: reduced pain levels, improved emotional regulation and mood, better sleep quality and duration, and reduced cravings for illicit drugs.

Patient-centered approach to evaluating the role of medical cannabis in the treatment of chronic pain.

Liang, Connie · 2025

Across 28 participants in focus groups, seven key themes emerged: efficacy, safety, stigma, cost, convenience, government/legal considerations, and interactions with healthcare providers.

COMT Genetic Variants and BDNF Level Associations with Cannabinoid Plasma Exposure: A Preliminary Study.

Manca, Alessandra · 2025

The COMT 680 T>C genetic variant significantly influenced plasma levels of THC (p = 0.017).

Enhancement of the endocannabinoid system through monoacylglycerol lipase inhibition relieves migraine-associated pain in mice.

Mangutov, Elizaveta · 2025

The MAGL inhibitor ABD-1970 blocked cephalic allodynia in both acute and chronic nitroglycerin-induced migraine models.

Improving Awareness and Use of Medical Cannabis for Fibromyalgia.

McClure, Linh M · 2025

Following an educational intervention on the benefits of medical cannabis for fibromyalgia, medical cannabis referrals increased from 4% to 17% of eligible patients (Z-score 2.3143, p = 0.0103)..

Antinociceptive, anti-inflammatory, and anti-dysmenorrheal activities of aerial parts of Cannabis sativa L. from the sub-middle region of the Vale do São Francisco.

Menezes, Pedro Modesto Nascimento · 2025

An ethanolic extract of Cannabis sativa aerial parts demonstrated antinociceptive effects in multiple pain models (hot plate, formalin, writhing tests), anti-inflammatory activity in paw edema, and reduced uterine contractions in a dysmenorrhea model, all at doses of 1-10 mg/kg..

Exploring therapeutic potential of Cannabis based therapy in autoimmune and rheumatic disorders.

Michaeli, Inbar · 2025

Cannabis-based treatments show potential benefits across various autoimmune and rheumatic conditions, but in many cases the supporting evidence is insufficient.

Cannabis: What We Use, Why It Matters, and When It Is Prescribed (Ethics, Policy, and Practice).

Mistry, Laresh N · 2025

Cannabinoids show potential for treating orofacial pain, TMJ disorders, bruxism, and dental anxiety.

Cannabis use across the menstrual cycle: The impact of negative affect and cannabis use motives.

Morris, Paige E · 2025

Among 40 normally cycling women tracked for 65 days, cannabis use was more frequent during the premenstrual phase.

Field safety and efficacy study with a cannabidiol/cannabidiol acid-rich hemp paste in cats with osteoarthritic pain.

Mulder, Liza M · 2025

Among 26 cats with OA, 14 completed the crossover study.

Efficacy and Safety of Topical 5% Cannabidiol Plus Myrcene for the Treatment of Vestibulodynia: A Multi-Centric Randomized Controlled Trial.

Murina, Filippo · 2025

Women applying 5% CBD plus myrcene gel to the vulvar vestibule for 60 days experienced significantly greater reductions in pain during intercourse compared to placebo, though both groups showed some improvement in overall pain scores..

Clinicians' Perspectives on Cannabis Use and Cannabis Treatment in Clients Undertaking Opioid Dependence Treatment.

Parvaresh, Laila · 2025

Clinicians estimated 56.1% of OTP clients had used cannabis in the past month and 44.9% had cannabis dependence, but only 15.3% identified their cannabis use as problematic and 10.7% sought treatment.

Design Considerations for Medicinal Cannabis Clinical Trials in People Receiving Palliative Care.

Razmovski-Naumovski, Valentina · 2025

This paper is a practical roadmap for researchers, drawn from the investigators' experience running a Phase I/IIb trial of vaporized cannabis for cancer anorexia.

Cannabigerol Modulates Cannabinoid Receptor Type 2 Expression in the Spinal Dorsal Horn and Attenuates Neuropathic Pain Models.

Rezende, Bismarck · 2025

Most cannabis research focuses on THC and CBD.

Long-Term Efficacy and Safety of Inhaled Cannabis Therapy for Painful Diabetic Neuropathy: A 5-Year Longitudinal Observational Study.

Robinson, Dror · 2025

52 patients with painful diabetic neuropathy who had failed at least three prior pain medications used inhaled medical cannabis (20% THC) as add-on therapy for five years.

Combined Endocannabinoid and Cyclooxygenase Inhibition Additively Attenuates Post-Surgical Pain.

Rodriguez, Carl E B · 2025

MAGL inhibitors (JZL184 and MJN110) reduced mechanical pain sensitivity after hindpaw surgery in mice.

Genetic characterization of the endocannabinoid system and psychiatric features in patients with migraine and medication overuse headache.

Romozzi, Marina · 2025

FAAH (fatty acid amide hydrolase), the enzyme that breaks down the endocannabinoid anandamide, showed significantly lower gene expression in medication overuse headache (MOH) patients compared to episodic migraine (EM) patients.

A Treatment Approach for Severe Pain in Mast Cell Activation Syndrome: A Case Report.

Russo, Marc A · 2025

A patient with widespread, severe, refractory MCAS pain was treated with orphenadrine and CBD oil.

Efficacy, pharmacokinetics and safety of liposomal synthetic cannabidiol injected subcutaneously in dogs: a randomized, blinded, placebo-controlled, crossover clinical trial.

Shilo-Benjamini, Yael · 2025

Oral CBD has a fundamental problem: most of it gets destroyed by the liver before reaching the bloodstream (first-pass metabolism).

Pain Is Not a Predictor of Cannabis Use in People With Psychotic Disorders.

Smid, Mirjam H · 2025

Pain and interference from pain were not significant predictors of cannabis use (yes/no) or amount of cannabis use in people with psychotic disorders.

Opposing Synovial Cannabinoid Receptor Type 2 and Transient Receptor Potential Vanilloid 1 Expression in Painful Osteoarthritis.

Toups, Collin A · 2025

Dual modulation of CB2R (agonist) and TRPV1 (antagonist) produced greater analgesic and anti-inflammatory effects than either approach alone in a mouse osteoarthritis model.

Sex-related differences in cannabidiol's antinociceptive efficacy in a trigeminal neuralgia rodent model.

Vivanco-Estela, Airam · 2025

CBD demonstrated potent antinociceptive effects in both male and female rats with trigeminal neuralgia, without affecting locomotor activity.

Development and Implementation of a Medical Cannabis Clinic Within a Geriatrics Primary Care Clinic: Preliminary Data.

Weaver, Ryan · 2025

Cannabis use among older adults is rising, but most use it without medical supervision—a gap this clinic aimed to fill.

Cannabinoids rescue migraine symptoms caused by central CGRP administration in mice.

Zorrilla, Erik · 2025

Pretreatment with 100 mg/kg CBD + 1 mg/kg THC rescued CGRP-induced light aversion, reduced resting time in darkness, increased light/dark transitions, and partially rescued spontaneous pain (squint assay) in mice.

Cannabidiol and Tetrahydrocannabinol Antinociceptive Activity is Mediated by Distinct Receptors in Caenorhabditis elegans.

Boujenoui, Fatma · 2024

CBD and THC both reduced the nocifensive response to noxious heat in C.

Drug-Cannabinoid Interactions in Selected Therapeutics for Symptoms Associated with Epilepsy, Autism Spectrum Disorder, Cancer, Multiple Sclerosis, and Pain.

Campos, Maria G · 2024

As medical cannabis use expands, patients are increasingly combining cannabinoids with prescription medications for serious conditions.

The potential neuroprotective effects of cannabinoids against paclitaxel-induced peripheral neuropathy: in vitro study on neurite outgrowth.

Creanga-Murariu, Ioana · 2024

When combined with paclitaxel, cannabinoids maintained cell viability at 70-89% compared to 40% with chemotherapy alone at 48 hours.

Unveiling the link between chronic pain and misuse of opioids and cannabis.

Dagher, Merel · 2024

Over 50 million Americans live with chronic pain, and many don't receive adequate treatment.

Associations of discomfort intolerance, discomfort avoidance, and cannabis and alcohol use among persons with chronic pain receiving prescription buprenorphine for opioid use disorder.

Haley, Danielle F · 2024

In 163 chronic pain patients on buprenorphine for OUD, higher discomfort intolerance (difficulty tolerating uncomfortable physical sensations) was associated with more frequent cannabis use (IRR 1.11) and alcohol use (IRR 1.14).

Pharmacokinetics and pharmacodynamics of cannabis-based medicine in a patient population included in a randomized, placebo-controlled, clinical trial.

Hansen, Julie Schjødtz · 2024

Among 23 MS patients taking oral THC (max 22.5 mg/day), CBD (max 45 mg/day), or combination capsules, pharmacokinetic parameters showed considerable individual variation but were comparable to previous reports from healthy controls.

Characteristics of Cannabis and Opioid Users Among Older U.S. Veterans and Their Health Outcomes: A Longitudinal Perspective.

Kang, Hyojung · 2024

Older veterans reported positive outcomes for pain, sleep, and emotional problems across two survey periods.

Elevating levels of the endocannabinoid 2-arachidonoylglycerol blunts opioid reward but not analgesia.

Martínez-Rivera, Arlene · 2024

Pharmacologically boosting 2-AG levels via MAGL inhibition attenuated opioid reward in both conditioned place preference and self-administration paradigms without affecting opioid analgesia.

Exploring the Possible Role of Cannabinoids in Managing Post-cardiac Surgery Complications: A Narrative Review of Preclinical Evidence and a Call for Future Research Directions.

Pollak, Uri · 2024

Preclinical evidence suggests CBD has anti-inflammatory, analgesic, and neuroprotective properties relevant to post-cardiac surgery recovery.

Patient-Reported Outcomes of Pain, Stiffness, and Fatigue Reduction in Rheumatoid and Psoriatic Arthritis With Cannabinoid Use.

Purohit, Richa · 2024

About 16.95% of RA and 11.63% of PsA patients reported cannabinoid use, primarily inhaled for RA and topical/liquid for PsA.

The Potential Antinociceptive Effect and Mechanism of Cannabis sativa L. Extract on Paclitaxel-Induced Neuropathic Pain in Rats Uncovered by Multi-Omics Analysis.

Xu, Yunhui · 2024

Hemp extract significantly decreased mechanical allodynia, thermal hyperalgesia, and inflammatory cytokines in rats with paclitaxel-induced neuropathy.

Acute Effects of Monoacylglycerol Lipase Inhibitor ABX1431 on Neuronal Hyperexcitability, Nociception, Locomotion, and the Endocannabinoid System in HIV-1 Tat Male Mice.

Yadav-Samudrala, Barkha J · 2024

In vitro, ABX1431 completely reversed Tat-induced neuronal calcium overexcitement at all tested concentrations, partially through CB1 receptors.

Medical Marijuana for Pain Management in Hospice Care as a Complementary Approach to Scheduled Opioids: A Single Arm Study.

Zanker, Theodore · 2024

The combination of medical cannabis (CBD-dominant formulation) and scheduled opioids showed a statistically significant longitudinal reduction in pain intensity (p = .0029).

Altered endocannabinoid metabolism compromises the brain-CSF barrier and exacerbates chronic deficits after traumatic brain injury in mice.

Ahluwalia, Meenakshi · 2023

TBI increased expression of enzymes that break down endocannabinoids (MAGL, FAAH, Cox-2), leading to reduced 2-AG and AEA levels in plasma.

Medical Cannabis in the Treatment of Parkinson's Disease.

Aladeen, Traci S · 2023

87% of patients (60/69) reported improvement in at least one PD symptom after starting medical cannabis (most commonly 1:1 THC:CBD tincture).

A type II cannabis extract and a 1:1 blend of Δ(9)-tetrahydrocannabinol and cannabidiol display distinct antinociceptive profiles and engage different endocannabinoid targets when administered into the subarachnoid space.

Benredjem, Besma · 2023

When injected into the spinal fluid of rats with diabetic neuropathy, a type II cannabis extract and a 1:1 THC:CBD mix produced different antinociceptive responses despite equivalent THC content.

Anti-Inflammatory Effects of Cannabigerol in Rheumatoid Arthritis Synovial Fibroblasts and Peripheral Blood Mononuclear Cell Cultures Are Partly Mediated by TRPA1.

Lowin, Torsten · 2023

Most cannabis research focuses on THC and CBD, but the cannabis plant produces over 100 cannabinoids.

Perceived Effectiveness of Medical Cannabis Among Adults with Chronic Pain: Findings from Interview Data in a Three-Month Pilot Study.

McMahon, Alexandra N · 2023

Patient experience data is often overlooked in cannabis research, where the focus tends to be on controlled trials.

Assessing Efficacy and Use Patterns of Medical Cannabis for Symptom Management in Elderly Cancer Patients.

Nathan, Rachel · 2023

There was no statistically significant difference in symptom scores for pain, nausea, appetite, insomnia, or anxiety before versus after medical cannabis initiation.

Cannabis and Rheumatoid Arthritis: A Scoping Review Evaluating the Benefits, Risks, and Future Research Directions.

Paland, Nicole · 2023

Preclinical studies demonstrated cannabinoids can halt disease progression and relieve pain.

Cannabinoid CB1 Receptor Expression and Localization in the Dorsal Horn of Male and Female Rat and Human Spinal Cord.

Parnell, Jessica · 2023

CB1 immunoreactivity was significantly higher in the superficial vs deep dorsal horn in both species, conserved across sex.

High-CBD Cannabis Vapor Attenuates Opioid Reward and Partially Modulates Nociception in Female Rats.

Rivera-Garcia, Maria T · 2023

High-CBD whole-plant extract (WPE) vapor prevented morphine-induced conditioned place preference and reinstatement.

The Reversal of Empathy-Induced Hypernociception in Male Mice by Intra-Amygdala Administration of Midazolam and Cannabidiol Depends on 5-HT3 Receptors.

Rodrigues Tavares, Lígia Renata · 2023

Mice housed with chronic pain partners showed hypernociception and increased 5-HT3 receptor and GAD67 expression in the amygdala.

Unlocking the Healing Potential: Cannabinoids in Spine Surgery for Pain Relief and Recovery.

Shahzad, Hania · 2023

THC and CBD interact with endocannabinoid receptors in the CNS and immune system, potentially offering pain relief.

The Place of Cannabinoids in the Treatment of Gynecological Pain.

Sinclair, Justin · 2023

Cannabis has a long history of use for menstrual and reproductive pain, predating modern medicine by centuries.

Pilot clinical and pharmacokinetic study of Δ9-Tetrahydrocannabinol (THC)/Cannabidiol (CBD) nanoparticle oro-buccal spray in patients with advanced cancer experiencing uncontrolled pain.

Clarke, Stephen · 2022

The water-soluble formulation produced dose-dependent plasma cannabinoid levels, with higher systemic exposure for THC than CBD.

Alleviation of opioid withdrawal by cannabis and delta-9-tetrahydrocannabinol: A systematic review of observational and experimental human studies.

De Aquino, Joao P · 2022

Of 11 studies with 5,330 participants, four observational studies found cannabis use was associated with reduced opioid withdrawal, one found worsening symptoms, and four found no association.

Inhibiting Endocannabinoid Hydrolysis as Emerging Analgesic Strategy Targeting a Spectrum of Ion Channels Implicated in Migraine Pain.

Della Pietra, Adriana · 2022

MAGL and FAAH, the enzymes that degrade endocannabinoids, are distributed differently across brain regions involved in migraine pain.

Cannabis in Palliative Care: A Systematic Review of Current Evidence.

Doppen, Marjan · 2022

Across 52 studies with 4,786 participants, some cannabis products showed positive effects on pain, nausea/vomiting, appetite, sleep, fatigue, and night sweats in cancer patients; appetite and agitation in dementia patients; and appetite and nausea in AIDS patients.

Making a joint decision: Cannabis as a potential substitute for opioids in obstetrics and gynecology.

Eichorn, Nicole L · 2022

Reports suggest cannabis use is associated with decreased opioid consumption in conditions including ovarian, uterine, endometrial, and cervical cancers, as well as chronic pelvic pain.

Acidic Cannabinoids Suppress Proinflammatory Cytokine Release by Blocking Store-operated Calcium Entry.

Faouzi, Malika · 2022

Several minor cannabinoids, mainly the carboxylic acid derivatives and especially CBGA, demonstrated high potency in blocking store-operated calcium entry (SOCE) in immune cell lines.

Broad-spectrum cannabis oil ameliorates reserpine-induced fibromyalgia model in mice.

Ferrarini, Eduarda Gomes · 2022

Oral broad-spectrum cannabis oil (0.1-3 mg/kg) inhibited both mechanical hyperalgesia and thermal allodynia in a single dose.

Cannabidiol as a treatment for arthritis and joint pain: an exploratory cross-sectional study.

Frane, Nicholas · 2022

CBD use was associated with improvements in pain (83%), physical function (66%), and sleep quality (66%).

Metabolic effects of medical cannabis treatment.

Habib, George · 2022

There was no significant change in any metabolic parameter evaluated, including fasting blood glucose, hemoglobin A1c, insulin, lipid profile, cortisol, uric acid, or body weight, after three months of medical cannabis consumption..

Adjunctive Management of Opioid Withdrawal with the Nonopioid Medication Cannabidiol.

Kudrich, Christopher · 2022

CBD has been reported to have anxiolytic, antidepressant, anti-inflammatory, anti-emetic, and analgesic properties, plus reduction of cue-induced craving for opioids, all highly relevant to withdrawal symptoms.

Use of Capsaicin Cream in Cannabinoid Hyperemesis Syndrome in Patients Presenting to the Emergency Department.

Lee, Allison · 2022

Among 57 patients receiving capsaicin for suspected CHS, pain scores dropped from a median of 8 to 5.5, and nearly half required no additional symptomatic therapy after application..

"I got a bunch of weed to help me through the withdrawals": Naturalistic cannabis use reported in online opioid and opioid recovery community discussion forums.

Meacham, Meredith C · 2022

Cannabis-related posts were twice as prevalent in the recovery subreddit (5.4%) as in the active opioid use subreddit (2.6%).

Real-Time Monitoring of Cannabis and Prescription Opioid Co-Use Patterns, Analgesic Effectiveness, and the Opioid-Sparing Effect of Cannabis in Individuals With Chronic Pain.

Mun, Chung Jung · 2022

Using 30-day ecological momentary assessment, neither cannabis-opioid co-use nor sole use of either substance reduced pain in the next moment.

Oral cannabidiol for prevention of acute and transient chemotherapy-induced peripheral neuropathy.

Nielsen, Sebastian W · 2022

CBD-treated patients receiving CAPOX or Carbo-Tax chemotherapy showed significantly better high-frequency vibrometry scores compared to controls.

Insomnia treatment: a new multitasking natural compound based on melatonin and cannabis extracts.

Palmieri, G · 2022

PSQI (sleep quality) and HAM-A (anxiety) scores showed significant improvements.

Survey of Patients Employing Cannabigerol-Predominant Cannabis Preparations: Perceived Medical Effects, Adverse Events, and Withdrawal Symptoms.

Russo, Ethan B · 2022

Most common conditions treated: anxiety (51.2%), chronic pain (40.9%), depression (33.1%), insomnia (30.7%).

"Should I Inhale?"-Perceptions, Barriers, and Drivers for Medicinal Cannabis Use amongst Australian Women with Primary Dysmenorrhoea: A Qualitative Study.

Sinclair, Justin · 2022

Dissatisfaction with over-the-counter pain medication was the primary driver for wanting medicinal cannabis.

Illicit Cannabis Usage as a Management Strategy in New Zealand Women with Endometriosis: An Online Survey.

Armour, Mike · 2021

Among endometriosis patients using cannabis, 95.5% used it for pain relief, 81% rated their pain as "much better," and 81.4% reported reducing their pharmaceutical medications, with 59% completely stopping at least one medication..

Pain Profiles among Young Adult Cannabis Users: An Analysis of Antecedent Factors and Distal Outcomes.

Ataiants, Janna · 2021

Three pain classes emerged: Low pain (56.3%), Multiple pain (27.3%), and Nonspecific pain (16.4%).

Substituting Cannabidiol for Opioids and Pain Medications Among Individuals With Fibromyalgia: A Large Online Survey.

Boehnke, Kevin F · 2021

72% of CBD-using fibromyalgia patients substituted CBD for medications: NSAIDs (59%), opioids (53.3%), gabapentinoids (35%), and benzodiazepines (23.1%).

Cannabidiol Use for Fibromyalgia: Prevalence of Use and Perceptions of Effectiveness in a Large Online Survey.

Boehnke, Kevin F · 2021

Among 2,701 fibromyalgia patients, 32.4% currently used CBD and 29.4% had used it previously.

Cannabis and Cannabis Derivatives for Abdominal Pain Management in Inflammatory Bowel Disease.

Bogale, Kaleb · 2021

There is little clinical evidence that cannabis treats the gastrointestinal inflammation underlying IBD.

Inflammatory Bowel Disease and Cannabis: A Practical Approach for Clinicians.

Buckley, Megan C · 2021

Cannabis has gained popularity for IBD symptom management but has not been proven to reduce inflammation or correct underlying disease processes.

Use of cannabis in patients with multiple sclerosis from Argentina.

Carnero Contentti, Edgar · 2021

34.2% were current cannabis users, 22.7% former users.

Use of Cannabis for Self-Management of Chronic Pelvic Pain.

Carrubba, Aakriti R · 2021

23% of chronic pelvic pain patients used cannabis, with 72% using at least weekly.

Factors associated with health-related cannabis use intentions among a community sample of people who inject drugs in Los Angeles and San Francisco, CA 2016 to 2018.

Ceasar, Rachel Carmen · 2021

Cannabis use for physical pain relief was associated with higher odds of using cannabis as an opioid substitute.

The use of medical cannabis in pediatric palliative care: a case series.

Divisic, Antuan · 2021

All six patients experienced a reduction in seizure frequency (with variable extent) after starting medical cannabis.

An initial analysis of the UK Medical Cannabis Registry: Outcomes analysis of first 129 patients.

Erridge, Simon · 2021

Among 129 patients (most common indication: chronic pain, 37.2%), statistically significant improvements were seen at 1 and 3 months in GAD-7 (anxiety), sleep quality, EQ-5D-5L pain and discomfort, anxiety and depression subscales, and overall quality of life indices.

Medical marijuana utilization in gynecologic cancer patients.

Fehniger, Julia · 2021

Of 45 patients (89% receiving chemotherapy), 71% reported improvement in at least one symptom after a median 5.2 months of use.

Evaluating the Suitability and Potential Efficiency of Cannabis sativa Oil for Patients with Primary Burning Mouth Syndrome: A Prospective, Open-Label, Single-Arm Pilot Study.

Gambino, Alessio · 2021

All 17 patients showed statistically significant improvement in oral pain intensity over time (assessed by VAS, Present Pain Intensity, McGill Pain Questionnaire, and OHIP).

Dual Inhibition of FAAH and MAGL Counteracts Migraine-like Pain and Behavior in an Animal Model of Migraine.

Greco, Rosaria · 2021

The dual FAAH/MAGL inhibitor JZL195 significantly reduced nitroglycerin-induced trigeminal hyperalgesia and pain-associated behavior, likely via CB1 receptors.

Morphine Induces Upregulation of Neuronally Expressed CB2 Receptors in the Spinal Dorsal Horn of Rats.

Grenier, Patrick · 2021

CB2 receptors were predominantly expressed on neurons (NeuN-labeled cells) rather than microglia in the spinal dorsal horn.

Sex Differences in Tolerance to Delta-9-Tetrahydrocannabinol in Mice With Cisplatin-Evoked Chronic Neuropathic Pain.

Henderson-Redmond, Angela N · 2021

Female mice developed tolerance to the anti-allodynic (pain-relieving) effects of both 6 mg/kg and 10 mg/kg THC faster than males.

Activation of GPR18 by Resolvin D2 Relieves Pain and Improves Bladder Function in Cyclophosphamide-Induced Cystitis Through Inhibiting TRPV1.

Lu, Qudong · 2021

Intrathecal injection of Resolvin D2 (a GPR18 agonist) increased paw withdrawal threshold and micturition interval in rats with cyclophosphamide-induced cystitis.

Persistent Exposure to Δ9-Tetrahydrocannabinol during Adolescence Does Not Affect Nociceptive Responding in Adult Mice.

Mabou Tagne, Alex · 2021

Adolescent mice receiving daily THC (5 mg/kg) from postnatal day 30-43 showed no significant differences from controls in formalin-induced pain behavior, chronic nerve injury pain responses, morphine antinociception, or morphine tolerance when tested at postnatal day 70.

Medical cannabis for the treatment of fibromyalgia syndrome: a retrospective, open-label case series.

Mazza, Manuela · 2021

Significant improvements (P < 0.01) were observed in pain scores (NRS), disability (ODI), widespread pain (WPI), and symptom severity (SyS) at various time points up to 12 months.

Evaluation of Cannabinoids on the Odonto/Osteogenesis in Human Dental Pulp Cells In Vitro.

Qi, Xia · 2021

In a finding that surprised even the researchers (their null hypothesis was that THC would induce dental tissue repair), THC showed biphasic effects on human dental pulp cells.

Demographics, Perceptions, and Use of Medical Marijuana among Patients in Florida.

Rosenthal, Martha S · 2021

Patients most commonly used medical marijuana for anxiety, pain, and stress symptoms.

Safety and efficacy of low-dose medical cannabis oils in multiple sclerosis.

S, Gustavsen · 2021

Pain decreased from median NRS 7 to 4 (p=0.01), spasticity from 6 to 2.5 (p=0.01), and sleep disturbances from 7 to 3 (p<0.001).

Health Outcomes among Adults Initiating Medical Cannabis for Chronic Pain: A 3-month Prospective Study Incorporating Ecological Momentary Assessment (EMA).

Wang, Yan · 2021

Real-time EMA data (2,535 random + 705 daily assessments) showed significant reductions in momentary pain intensity after starting medical cannabis.

Cannabinoid CB2 Receptor Activation Attenuates Fentanyl-Induced Respiratory Depression.

Zavala, Carmen A · 2021

Co-administration of LY2828360 (3 mg/kg) with fentanyl (0.2 mg/kg) attenuated respiratory depression in wild-type mice but not CB2 knockout mice, confirming the effect was CB2-mediated.

A randomized trial of medical cannabis in patients with stage IV cancers to assess feasibility, dose requirements, impact on pain and opioid use, safety, and overall patient satisfaction.

Zylla, Dylan M · 2021

High enrollment interest (36% of eligible patients enrolled).

Cannabinoids for fibromyalgia pain: a critical review of recent studies (2015-2019).

Cameron, Erinn C · 2020

Five studies using six different cannabis treatments (including nabilone, dronabinol, Bedrocan, Bediol, CBD, and medical cannabis) showed generally favorable patient-reported outcomes for fibromyalgia pain.

Ingestion of a THC-Rich Cannabis Oil in People with Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Chaves, Carolina · 2020

After 8 weeks, the cannabis group showed significant FIQ score improvement vs.

Attenuation of fear-conditioned analgesia in rats by monoacylglycerol lipase inhibition in the anterior cingulate cortex: Potential role for CB2 receptors.

Corcoran, Louise · 2020

MGL inhibition (increasing 2-AG) in the ACC attenuated fear-conditioned analgesia.

Cannabidiol increases the nociceptive threshold in a preclinical model of Parkinson's disease.

Crivelaro do Nascimento, Glauce · 2020

The Parkinson's model (6-OHDA) decreased thermal and mechanical pain thresholds.

Daily Cannabis Users with Sickle Cell Disease Show Fewer Admissions than Others with Similar Pain Complaints.

Curtis, Susanna A · 2020

Daily cannabis users with SCD had worse pain episode severity scores than others (56.7 vs.

Positive allosteric modulation of the cannabinoid type-1 receptor (CB1R) in periaqueductal gray (PAG) antagonizes anti-nociceptive and cellular effects of a mu-opioid receptor agonist in morphine-withdrawn rats.

Datta, Udita · 2020

Intra-PAG DAMGO (opioid agonist) dose-dependently reversed morphine-induced hyperalgesia.

Disease-modifying effects of natural Δ9-tetrahydrocannabinol in endometriosis-associated pain.

Escudero-Lara, Alejandra · 2020

THC alleviated mechanical pain hypersensitivity, reduced pain unpleasantness, restored memory deficits, and inhibited the growth of endometrial cysts.

Age-dependent hormesis-like effects of the synthetic cannabinoid CP55940 in C57BL/6 mice.

Hodges, Erik L · 2020

CP55940 produced greater antinociception (pain relief) and locomotor inhibition in aged (21-24 month) compared to young-adult (4 month) mice.

Cannabidiol and Sports Performance: a Narrative Review of Relevant Evidence and Recommendations for Future Research.

McCartney, Danielle · 2020

Preclinical studies show CBD has anti-inflammatory, neuroprotective, and analgesic properties potentially beneficial for athletes.

Allosteric Cannabinoid Receptor 1 (CB1) Ligands Reduce Ocular Pain and Inflammation.

Thapa, Dinesh · 2020

The CB1 allosteric ligand GAT228 reduced pain on its own, while GAT229 and GAT211 reduced pain when combined with a low dose of THC.

Peripheral deficiency and antiallodynic effects of 2-arachidonoyl glycerol in a mouse model of paclitaxel-induced neuropathic pain.

Thomas, Amal · 2020

2-AG levels were significantly reduced in the paw skin but not in the brain or spinal cord of paclitaxel-treated mice.

Cannabis treatment in hospitalized patients using the SYQE inhaler: Results of a pilot open-label study.

Vulfsons, Simon · 2020

Daily cannabis consumption dropped from a median of 1,000 mg to 51 mg when using the SYQE Inhaler.

Peripheral versus central mechanisms of the cannabinoid type 2 receptor agonist AM1710 in a mouse model of neuropathic pain.

Wilkerson, Jenny L · 2020

AM1710 reversed mechanical allodynia to sham levels in CB1 knockout, heterozygous, and wildtype mice via both peripheral (i.p.) and spinal (i.t.) routes.

Cannabis Use in Children With Pantothenate Kinase-Associated Neurodegeneration.

Wilson, Jenny L · 2020

7 of 18 respondents (39%) had used cannabis for their child.

β-Caryophyllene, a CB2-Receptor-Selective Phytocannabinoid, Suppresses Mechanical Allodynia in a Mouse Model of Antiretroviral-Induced Neuropathic Pain.

Aly, Esraa · 2019

Beta-caryophyllene (BCP) prevented the development of mechanical allodynia when co-administered with the NRTI zalcitabine and attenuated established pain through CB2 receptor activation.

Experimental Cannabinoid 2 Receptor Activation by Phyto-Derived and Synthetic Cannabinoid Ligands in LPS-Induced Interstitial Cystitis in Mice.

Berger, Geraint · 2019

Both beta-caryophyllene (BCP) and the synthetic CB2 agonist HU308 significantly reduced leukocyte adhesion in bladder venules and improved capillary perfusion when instilled directly into the bladder.

Caring for people with multiple sclerosis who use cannabis for symptom control.

Daly, Laura · 2019

A large proportion of people with MS use cannabis to self-manage symptoms or believe in its potential benefits.

Endocannabinoid modulation of inflammatory hyperalgesia in the IFN-α mouse model of depression.

Fitzgibbon, Marie · 2019

Repeated IFN-alpha treatment increased formalin-evoked pain behavior in mice.

Cannabidiol (CBD) for Treatment of Neurofibromatosis-related Pain and Concomitant Mood Disorder: A Case Report.

Hegazy, Omar · 2019

CBD was used to manage chronic pain from neurofibromas and associated mood disorder (depression and anxiety) in a patient with neurofibromatosis type 1, leveraging its reported anti-inflammatory, analgesic, mood-stabilizing, and anxiolytic properties..

Cannabidiol attenuates mechanical allodynia in streptozotocin-induced diabetic rats via serotonergic system activation through 5-HT1A receptors.

Jesus, Carlos Henrique Alves · 2019

Acute CBD (0.3 and 3 mg/kg) reduced mechanical allodynia in diabetic rats.

Cannabinoid CB2 Agonist AM1710 Differentially Suppresses Distinct Pathological Pain States and Attenuates Morphine Tolerance and Withdrawal.

Li, Ai-Ling · 2019

AM1710 produced sustained relief from paclitaxel-induced nerve pain without tolerance.

Marijuana as a Substitute for Prescription Medications: A Qualitative Study.

Mercurio, Alana · 2019

Three key themes emerged: (1) patients perceived cannabis as having fewer/better side effects and improving quality of life versus prescriptions, (2) patients used cannabis to supplement or replace other medications including opioids, and (3) stigma, travel restrictions, cost, and inability of providers to give dosing/strain guidance significantly limited use..

The prefrontal cortical endocannabinoid system modulates fear-pain interactions in a subregion-specific manner.

Rea, Kieran · 2019

The CB1 receptor antagonist AM251 attenuated fear-conditioned analgesia (FCA) when injected into the infralimbic or prelimbic cortex, but reduced freezing only in the infralimbic region.

Effect of adding medical cannabis to analgesic treatment in patients with low back pain related to fibromyalgia: an observational cross-over single centre study.

Yassin, Mustafa · 2019

Standard analgesic therapy (oxycodone/naloxone + duloxetine) produced minor improvement over baseline.

Self-initiated use of topical cannabidiol oil for epidermolysis bullosa.

Chelliah, Malcolm P · 2018

Epidermolysis bullosa (EB) is a rare genetic blistering skin disorder that causes chronic wounds, pain, and limited mobility with few effective treatments.

Medical Cannabis and Cannabinoids: An Option for the Treatment of Inflammatory Bowel Disease and Cancer of the Colon?

Grill, Magdalena · 2018

Researchers reviewed the evidence on cannabinoids for inflammatory bowel disease (IBD) and colorectal cancer. For IBD, in vitro and animal data showed cannabinoids reduce intestinal inflammation through multiple mechanisms.

The Consumption of Cannabis by Fibromyalgia Patients in Israel.

Habib, George · 2018

Researchers surveyed 383 fibromyalgia patients through Israeli Facebook support groups. Of respondents, 84% reported consuming cannabis, but only 44% had a medical cannabis license.

Medical Cannabis for the Treatment of Fibromyalgia.

Habib, George · 2018

Researchers collected data from registries at two Israeli hospitals on fibromyalgia patients treated with medical cannabis. Of 30 identified patients, 26 were included.

Cannabis Use in Individuals With Spinal Cord Injury or Moderate to Severe Traumatic Brain Injury in Colorado.

Hawley, Lenore A · 2018

Researchers surveyed 116 Colorado adults who had sustained spinal cord injury (SCI) or moderate to severe traumatic brain injury (TBI), combining focus group data with a telephone survey. 70% reported cannabis use before their injury (67% SCI, 74% TBI) and 48% reported use after their injury (53% SCI, 45% TBI). Reasons for use differed between groups.

Circulating endocannabinoids: from whence do they come and where are they going?

Hillard, Cecilia J. · 2018

Endocannabinoids aren't just in the brain.

Medical Cannabis for Pediatric Moderate to Severe Complex Motor Disorders.

Libzon, Stephanie · 2018

Twenty-five children aged 1-17 with complex motor disorders (combinations of spasticity, dystonia, and other movement abnormalities) were enrolled in a pilot study testing CBD-enriched cannabis oil. Two formulations were compared: a 20:1 CBD:THC ratio (0.25% THC) and a 6:1 ratio (0.83% THC).

Mother of Berries, ACDC, or Chocolope: Examination of the Strains Used by Medical Cannabis Patients in New England.

Piper, Brian J · 2018

Researchers conducted two studies to understand cannabis strain preferences among medical patients. Study I catalogued strains from the online database Leafly.com, finding 1,987 strains listed.

Marijuana and Cannabinoids in ESRD and Earlier Stages of CKD.

Rein, Joshua L · 2018

The review found emerging evidence supporting potential benefits of medical marijuana for four common symptoms in advanced CKD and dialysis patients: chronic pain, nausea/vomiting, anorexia/cachexia, and pruritus (itching).

Cannabis and the Health and Performance of the Elite Athlete.

Ware, Mark A · 2018

There is no direct evidence of cannabis as a performance-enhancing drug.

Medical Cannabis in Parkinson Disease: Real-Life Patients' Experience.

Balash, Yacov · 2017

Forty-seven Parkinson's patients (40 men, median Hoehn & Yahr stage III) who had used medical cannabis for at least 3 months reported their symptom changes via structured telephone interviews. The largest effect sizes for improvement were: falls (r=0.89), pain relief (r=0.73), depression (r=0.64), tremor (r=0.64), muscle stiffness (r=0.62), and sleep (r=0.60).

The Clinical Significance of Endocannabinoids in Endometriosis Pain Management.

Bouaziz, Jerome · 2017

Endometriosis causes diffuse and poorly localized severe pain that is often inadequately managed by current medical, hormonal, and surgical approaches.

Cannabis use patterns and motives: A comparison of younger, middle-aged, and older medical cannabis dispensary patients.

Haug, Nancy A · 2017

This dispensary-based study compared 217 medical cannabis patients across three age groups: younger (18-30), middle-aged (31-50), and older (51-72). All age groups used cannabis at similar frequencies over the past month.

Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients.

Lucas, Philippe · 2017

This survey of 271 patients enrolled in Canada's medical cannabis program revealed widespread substitution of cannabis for other substances. The headline finding: 63% of patients reported using cannabis as a substitute for prescription drugs.

System-specific activity in response to Δ9 -tetrahydrocannabinol: a functional magnetic resonance imaging study in awake male rats.

Madularu, Dan · 2017

This study produced the first functional MRI maps of THC effects in awake, drug-naive rats, avoiding the confounding effects of anesthesia used in most animal brain imaging studies. Low-dose THC produced more robust brain changes than high-dose THC, generating both increased and decreased BOLD (blood-oxygen-level dependent) signals.

Short-Term Efficacy of CBD-Enriched Hemp Oil in Girls with Dysautonomic Syndrome after Human Papillomavirus Vaccination.

Palmieri, Beniamino · 2017

Twelve females aged 12 to 24 with severe somatoform and dysautonomic symptoms following HPV vaccination received escalating doses of sublingual CBD-rich hemp oil over three months, starting at 25 mg/kg per day and increasing to a maximum of 150 mg/ml per day. Of the 12 participants, 8 completed the full treatment period.

Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis.

Philpott, Holly T · 2017

Researchers tested CBD's effects on osteoarthritis (OA) pain in rats using both therapeutic and preventive approaches.

An Endocannabinoid Uptake Inhibitor from Black Pepper Exerts Pronounced Anti-Inflammatory Effects in Mice.

Reynoso-Moreno, Inés · 2017

Guineensine, a dietary compound present in both black and long pepper, was previously shown to inhibit cellular endocannabinoid uptake, effectively boosting the body's own cannabinoid levels.

The endocannabinoid hydrolysis inhibitor SA-57: Intrinsic antinociceptive effects, augmented morphine-induced antinociception, and attenuated heroin seeking behavior in mice.

Wilkerson, Jenny L · 2017

SA-57, which simultaneously boosts both endocannabinoids (anandamide via FAAH inhibition and 2-AG via MAGL inhibition), produced multiple therapeutically relevant effects in mice. For pain: SA-57 reversed both neuropathic pain (nerve injury model) and inflammatory pain (carrageenan model).

The effect of O-1602, an atypical cannabinoid, on morphine-induced conditioned place preference and physical dependence.

Alavi, Mohaddeseh Sadat · 2016

Researchers tested whether O-1602, a compound that activates the GPR55 receptor (sometimes called a third cannabinoid receptor), could affect morphine reward and dependence in mice. In a conditioned place preference test, O-1602 at lower doses (0.2 and 1 mg/kg) reduced the acquisition of morphine reward, meaning mice spent less time in the chamber associated with morphine.

Medical Cannabis Use Is Associated With Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain.

Boehnke, Kevin F · 2016

Researchers surveyed 244 medical cannabis patients with chronic pain at a Michigan dispensary about how starting cannabis changed their medication patterns and quality of life. Among participants, medical cannabis use was associated with a 64% decrease in opioid use (based on 118 patients who had previously used opioids).

Understanding Patients' Process to Use Medical Marijuana: A Southern New Jersey Community Engagement Project.

Crowell, Tara L · 2016

Researchers surveyed 240 new patients at a New Jersey medical cannabis dispensary (Compassion Care Foundation) about their experience navigating the qualification process. The most common qualifying conditions were intractable skeletal spasticity, chronic and severe pain, multiple sclerosis, and inflammatory bowel disease.

Combined Treatment with Morphine and Δ9-Tetrahydrocannabinol in Rhesus Monkeys: Antinociceptive Tolerance and Withdrawal.

Gerak, L R · 2016

Combining opioids with cannabinoids is proposed as a way to enhance pain relief while potentially reducing opioid doses.

Difference and Influence of Inactive and Active States of Cannabinoid Receptor Subtype CB2: From Conformation to Drug Discovery.

Hu, Jianping · 2016

Without an experimental crystal structure of the CB2 cannabinoid receptor, researchers have struggled to design drugs that precisely target it.

Repeated forced swim stress differentially affects formalin-evoked nociceptive behaviour and the endocannabinoid system in stress normo-responsive and stress hyper-responsive rat strains.

Jennings, Elaine M · 2016

Chronic stress can make pain worse, but this study showed that genetic background dramatically changes this relationship.

Adolescent social rejection alters pain processing in a CB1 receptor dependent manner.

Schneider, Peggy · 2016

Researchers modeled adolescent social rejection by pairing adolescent Wistar rats with Fischer 344 rats, a strain known for being unresponsive to play solicitations.

HU-444, a Novel, Potent Anti-Inflammatory, Nonpsychotropic Cannabinoid.

Haj, Christeene G · 2015

Researchers synthesized HU-444, a novel derivative of CBD designed to be structurally incapable of converting to THC in acidic conditions (a potential concern with natural CBD).

A safer alternative: Cannabis substitution as harm reduction.

Lau, Nicholas · 2015

Researchers conducted in-depth life history interviews with Baby Boomer (born 1946-1964) marijuana users in the San Francisco Bay Area to understand their harm reduction beliefs and substitution practices. Participants described consciously choosing cannabis over alcohol, illicit drugs, and prescription medications.

Inhibition of FAAH reduces nitroglycerin-induced migraine-like pain and trigeminal neuronal hyperactivity in mice.

Nozaki, Chihiro · 2015

Researchers used a nitroglycerin-induced migraine model in mice to test whether the endocannabinoid system could be targeted for migraine treatment.

Profiles of medicinal cannabis patients attending compassion centers in rhode island.

Zaller, Nickolas · 2015

Researchers surveyed 200 patients at two medical cannabis dispensaries in Rhode Island to understand who uses dispensaries and why. The typical patient was male (73%), white (80%), college-educated (68%), and had health insurance (89%).

In vivo characterization of the highly selective monoacylglycerol lipase inhibitor KML29: antinociceptive activity without cannabimimetic side effects.

Ignatowska-Jankowska, B M · 2014

Researchers tested KML29, a highly selective inhibitor of the enzyme MAGL (which breaks down the endocannabinoid 2-AG), in mouse models of pain.

Clinical endocannabinoid deficiency (CECD) revisited: can this concept explain the therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions?

Smith, Steele Clarke · 2014

The review revisits Ethan Russo's 2004 hypothesis that migraine, fibromyalgia, irritable bowel syndrome, and related conditions may share a common underlying cause: deficient endocannabinoid system function.

Cannabinoid receptor 2 agonist attenuates pain related behavior in rats with chronic alcohol/high fat diet induced pancreatitis.

Zhang, Liping · 2014

Rats with chronic pancreatitis induced by an alcohol/high-fat diet developed visceral pain behaviors by week 3 that persisted as long as the diet continued.

Cannabinoids and hallucinogens for headache.

McGeeney, Brian E · 2013

The review traced the historical use of cannabis for headache treatment, noting that it was a standard medicine for migraine before the 1937 prohibition.

A questionnaire survey of patients and carers of patients prescribed Sativex as an unlicensed medicine.

Notcutt, William G · 2013

One hundred twenty-four patients who had received repeat Sativex prescriptions completed a questionnaire survey (57% response rate).

Headaches related to psychoactive substance use.

Beckmann, Yeşim Yetimalar · 2012

Researchers surveyed 1,015 consecutively admitted substance users about headaches.

The antinociceptive triterpene β-amyrin inhibits 2-arachidonoylglycerol (2-AG) hydrolysis without directly targeting cannabinoid receptors.

Chicca, A · 2012

Previous research claimed the natural triterpenes alpha- and beta-amyrin bound directly to CB1 receptors at subnanomolar concentrations and relieved pain through cannabinoid receptors.

O-hydroxyacetamide carbamates as a highly potent and selective class of endocannabinoid hydrolase inhibitors.

Niphakis, Micah J · 2012

The researchers investigated O-hydroxyacetamide carbamate compounds and found they could be tuned to selectively inhibit FAAH (the enzyme that breaks down anandamide) or to simultaneously inhibit both FAAH and MAGL (which breaks down 2-AG).

Cannabinoids and muscular pain. Effectiveness of the local administration in rat.

Sánchez Robles, E Ma · 2012

Researchers tested cannabinoid agonists in two muscle pain models (masseter jaw muscle and gastrocnemius calf muscle) induced by hypertonic saline injection.

Association of herbal cannabis use with negative psychosocial parameters in patients with fibromyalgia.

Ste-Marie, Peter A · 2012

Researchers surveyed 457 patients referred to a tertiary pain center with a fibromyalgia diagnosis.

Spinal administration of the monoacylglycerol lipase inhibitor JZL184 produces robust inhibitory effects on nociceptive processing and the development of central sensitization in the rat.

Woodhams, S G · 2012

Researchers applied JZL184, an inhibitor of the enzyme that breaks down the endocannabinoid 2-AG, directly to the spinal cord of anesthetized rats.

Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life.

Fiz, Jimena · 2011

Researchers compared 28 fibromyalgia patients who used cannabis to 28 matched non-users.

Inhibition of monoacylglycerol lipase attenuates nonsteroidal anti-inflammatory drug-induced gastric hemorrhages in mice.

Kinsey, Steven G · 2011

NSAIDs (common painkillers like ibuprofen) frequently cause stomach bleeding and ulcers.

Cannabis use amongst patients with inflammatory bowel disease.

Lal, Simon · 2011

Researchers surveyed 100 ulcerative colitis (UC) and 191 Crohn's disease (CD) patients at a specialty clinic about cannabis use. Lifetime cannabis use was similar between groups: 51% of UC and 48% of CD patients.

Lack of positive allosteric modulation of mutated alpha(1)S267I glycine receptors by cannabinoids.

Foadi, Nilufar · 2010

Loss of inhibitory glycine signaling in the spinal cord plays a key role in chronic pain.

The nonpsychotropic cannabinoid cannabidiol modulates and directly activates alpha-1 and alpha-1-Beta glycine receptor function.

Ahrens, Jörg · 2009

Researchers investigated whether CBD interacts with glycine receptors, which are the main inhibitory neurotransmitter receptors in the adult spinal cord and are important for pain processing. CBD showed a positive allosteric modulating effect on alpha1 and alpha1-beta glycine receptors at low micromolar concentrations (EC50 of 12.3 and 18.1 micromolar).

Gz mediates the long-lasting desensitization of brain CB1 receptors and is essential for cross-tolerance with morphine.

Garzón, Javier · 2009

Injecting CB1 receptor agonists into the brain ventricles of mice produced dose-dependent pain relief, then a long-lasting drop in analgesic effect that persisted for more than 14 days.

Expression of the endocannabinoid system in fibroblasts and myofascial tissues.

McPartland, John M · 2008

Using bioinformatics analysis of publicly available gene expression data, the researcher found that fibroblasts, myofibroblasts, chondrocytes, and synoviocytes all express CB1 receptors, CB2 receptors, and the enzymes that make and break down endocannabinoids. Fibroblast CB1 levels were notably high, nearly matching adipocyte (fat cell) levels.

Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions?

Russo, Ethan B · 2008

Ethan Russo proposed the concept of Clinical Endocannabinoid Deficiency (CECD), arguing that migraine, fibromyalgia, and irritable bowel syndrome (IBS) may share a common underlying cause: insufficient endocannabinoid system function. The evidence included: all three conditions involve central sensitization and hyperalgesia (amplified pain processing); they frequently co-occur in the same patients; they respond to cannabis-based treatments in clinical reports; and endocannabinoid system components interact with pathways relevant to each condition. For migraine specifically, anandamide modulates serotonin receptors, is active in the periaqueductal gray (a migraine generator region), and cannabinoids have anti-inflammatory and glutamate-modulating effects relevant to migraine pathophysiology. The review proposed testing this hypothesis through cerebrospinal fluid endocannabinoid measurement and neuroimaging studies..

Carpal tunnel syndrome, diabetic neuropathy, fibromyalgia, glucosamine and chondroitin, hypnosis in pain management, marijuana for pain.

Fishman, Scott M · 2007

This publication used a question-and-answer format designed for patients, covering multiple pain management topics including carpal tunnel syndrome, fibromyalgia, glucosamine and chondroitin, hypnosis, and marijuana. The marijuana section addressed common patient questions about cannabis for pain in accessible language.

Implication of cannabinoids in neurological diseases.

Alsasua del Valle, Angela · 2006

This brief review summarized how recent advances in understanding THC's pharmacological properties and the endocannabinoid system have created new therapeutic opportunities. Potential therapeutic applications for CB1 receptor agonists include managing spasticity and tremor in MS and spinal cord injury, pain, inflammatory disorders, glaucoma, bronchial asthma, cancer, and vasodilation in advanced cirrhosis. CB1 receptor antagonists were identified as having therapeutic potential for Parkinson's disease, based on the rationale that blocking endocannabinoid activity in the basal ganglia could improve motor function. The review also noted the contributions of Dr.

Experience with the synthetic cannabinoid nabilone in chronic noncancer pain.

Berlach, David M · 2006

This report described clinical experience with off-label nabilone (a synthetic cannabinoid approved only for chemotherapy nausea) for chronic non-cancer pain at a Canadian pain clinic from 1999 onward. Twenty adult patients with chronic non-cancer pain were followed for an average of 1.5 years.

Cannabis and endocannabinoid modulators: Therapeutic promises and challenges.

Grant, Igor · 2005

This review examined the endocannabinoid signaling system, including CB1 receptors (heavily represented in the central nervous system), CB2 receptors (localized to immune cells), and their endogenous ligands anandamide and 2-arachidonoyl glycerol. A key insight was that endocannabinoid system activation can enhance or dampen neural circuit activity depending on the circuit's existing state of activation.

Patterns of cannabis use among patients with multiple sclerosis.

Clark, A J · 2004

Of 220 MS patients surveyed in Halifax, Nova Scotia, 36% reported ever using cannabis for any purpose and 14% were currently using it for symptom treatment.

Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions?

Russo, Ethan B · 2004

The review proposed a novel medical theory: clinical endocannabinoid deficiency (CECD).

The perceived effects of smoked cannabis on patients with multiple sclerosis.

Consroe, P · 1997

This was the first survey specifically asking people with MS about their cannabis use.

Effect of cannabinoids on spasticity and ataxia in multiple sclerosis.

Meinck, H M · 1989

A 30-year-old man with chronic multiple sclerosis experienced acute improvement in his motor symptoms while smoking a marijuana cigarette.

Treatment of human spasticity with delta 9-tetrahydrocannabinol.

Petro, D J · 1981

Spasticity, the involuntary tightening of muscles, is a common and disabling symptom in conditions like multiple sclerosis, stroke, cerebral palsy, and spinal cord injury.

Antagonism by chlornaltrexamine of some effects of delta 9-tetrahydrocannabinol in rats.

Tulunay, F C · 1981

Researchers administered chlornaltrexamine (beta-CNA), a long-acting irreversible opiate receptor blocker, to rats before giving them THC.

Ewing sarcoma-related pain: potential role of medical cannabis monotherapy in symptom management - a case report.

De Virgilio Suglia, Cesare · 2026

After initiating THC-rich cannabis (Bedrocan, 22% THC, 1% CBD, 1g/day), the patient's pain dropped from VAS 9-10 to VAS 2-3.

A Survey on the Use of Cannabidiol (CBD) Isolate, Its Perceived Benefits, and Associated Side Effects Among Subjects With Chronic Pain.

Huang, Austin · 2025

Survey respondents using CBD isolate for chronic pain reported positive associations between CBD use and decreased chronic pain, even at doses under 100 mg.

Prevalence of Cannabidiol (CBD) Use in an Outpatient Hand Surgery Clinic.

Iturregui, Jose M · 2025

15% of hand surgery patients (135/918) reported prior CBD use.

Cannabidiol interactions with Δ-9-tetrahydrocannabinol on antinociception after carrageenan-induced inflammatory pain in male and female rats.

Jenkins, Bryan W · 2025

Oral THC dose-dependently decreased hyperalgesia and allodynia in a carrageenan inflammatory pain model, with stronger effects in females than males.

Cannabis or Cannabinoids for the Management of Chronic Noncancer Pain: Best Practice Advice From the American College of Physicians.

Kansagara, Devan · 2025

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..

Full-spectrum extract from Cannabis sativa DKJ127 for chronic low back pain: a phase 3 randomized placebo-controlled trial.

Karst, Matthias · 2025

VER-01 met its primary endpoint with a mean pain reduction of 1.9 NRS points (vs.

Patterns, Efficacy, and Cognitive Effects of Medical Cannabis Use in Chronic Musculoskeletal Pain Patients.

Khak, Mohammad · 2025

In a prospective survey of 129 long-term medical cannabis users with chronic musculoskeletal pain, 93.8% agreed or strongly agreed that cannabis improved their primary symptoms.

Cannabis use and illicit opioid cessation among people who use drugs living with chronic pain.

Kitchen, Chenai · 2025

Daily cannabis use was associated with a 40% higher rate of opioid cessation (adjusted HR 1.40, 95% CI 1.08-1.81, p = 0.011).

Endocannabinoid Tone and Oxylipins in Rheumatoid Arthritis and Osteoarthritis-A Novel Target for the Treatment of Pain and Inflammation?

Klawitter, Jost · 2025

Among 80 participants (25 RA, 18 OA, 37 healthy), 2-arachidonoylglycerol (2-AG) levels were significantly lower in both RA and OA patients compared to controls.

Prevalence Rates, Perceptions of Risk, and Motivations for Nonmedical Cannabis Use in Pediatric Pain.

Kossowsky, Joe · 2025

25.3% of treatment-seeking adolescents with chronic pain reported lifetime cannabis use (mean first use age 15.3).

Cannabidiol Use and Perceptions of Effectiveness in Women With Chronic Pelvic Pain.

Till, Sara R · 2025

36.3% never used CBD, 29.2% past users, 34.5% current users.

Antinociceptive action of cannabidiol on thermal sensitivity and post-operative pain in male and female rats.

Arantes, Ana Luisa Ferreira · 2024

CBD 30 mg/kg reduced thermal pain sensitivity in males.

Cannabis sativa L. Extract Alleviates Neuropathic Pain and Modulates CB1 and CB2 Receptor Expression in Rat.

Bartkowiak-Wieczorek, Joanna · 2024

Cannabis extracts demonstrated antinociceptive effects comparable to gabapentin in vincristine-induced neuropathic pain.

Substituting Medical Cannabis for Medications Among Patients with Rheumatic Conditions in the United States and Canada.

Boehnke, Kevin F · 2024

62.5% substituted medical cannabis for medications: NSAIDs (54.7%), opioids (48.6%), sleep aids (29.6%), muscle relaxants (25.2%).

The Effect of Marijuana on Postoperative Spine Patients' Emergency Department Visits, Readmission Rates, and Opioid Consumption.

Buddle, Vincent Patrick · 2024

THC-positive and multi-drug-positive patients showed higher 90-day morphine milligram equivalents (MMEs) compared to THC-negative controls.

Clinical endocannabinoid deficiency: 20 years later

Russo, Ethan B · 2024

CECD has evolved from simple deficiency to dysregulation model — endocannabinoid signaling is measurably altered in predicted conditions, but the picture is more complex than "too little." Both deficiency and excess can be pathological, suggesting tissue-specific imbalances rather than global shortage..

Cannabis and Cannabinoids in Multiple Sclerosis: From Experimental Models to Clinical Practice-A Review.

Sirbu, Carmen-Adella · 2023

The endocannabinoid system plays a documented role in demyelination and neuroinflammation.

Opioid and healthcare service use in medical cannabis patients with chronic pain: a prospective study.

Sznitman, Sharon · 2023

Patients filled fewer opioid prescriptions at 6-month follow-up compared to the 6 months before starting medical cannabis.

Medical Cannabis in Hand Surgery: A Review of the Current Evidence.

Yang, Andrew · 2023

Medical cannabis is being explored as an opioid-sparing option for acute and chronic pain in hand surgery.

Oral capsules of tetra-hydro-cannabinol (THC), cannabidiol (CBD) and their combination in peripheral neuropathic pain treatment.

Zubcevic, Kanita · 2023

The trial compared four conditions (CBD alone, THC alone, CBD/THC combination, and placebo) for neuropathic pain.