Several cannabis-derived drugs are in development or already available for pain, including nabiximols (approved in Canada and Europe for MS-related spasticity and cancer pain) and newer synthetic cannabinoids targeting neuropathic pain.
Chronic pain patients, pain management physicians, and pharmaceutical researchers.
Nabiximols approved in Canada and Europe for MS pain
What the researchers found
Nabiximols, a specific cannabis extract, has demonstrated benefit for pain related to spasticity in multiple sclerosis, cancer pain, and chronic pain conditions. Epidiolex (CBD oral solution), approved in the US for epilepsy, may also offer pain relief. Investigational synthetic cannabinoids from companies like Cara Therapeutics and Zynerba Pharmaceuticals are targeting neuropathic pain and allodynia specifically.
Why it matters
The shift from smoked cannabis to pharmaceutical-grade cannabinoid products addresses the inconsistent delivery and dosing problems of smoking, potentially making cannabinoid therapy more precise and reliable.
The numbers in context
No specific trial data pooled. Review covered nabiximols (available in Canada and Europe), Epidiolex (available in US), and investigational drugs from Cara Therapeutics and Zynerba Pharmaceuticals.
How the study worked
Narrative review of currently available and developmental cannabis pharmaceutical derivatives for pain management.
What this study cannot tell us
Narrative review without systematic methodology. Many of the drugs discussed were still investigational at time of publication.
How to read the evidence
Narrative overview of a developing pharmaceutical field with varying levels of evidence for individual products.
When this study was published
2019 review.
The bigger picture
Pharmaceutical development of cannabinoids represents a move toward standardized, regulated products that could make cannabis-based pain treatment more mainstream and evidence-based.
Questions still open
- Will pharmaceutical cannabinoids prove more effective than whole-plant cannabis for pain? How will pricing and access compare to state-legal cannabis?
Common questions
Are there FDA-approved cannabis drugs for pain?
How are cannabis pharmaceuticals different from smoking cannabis?
Read the original research
An Update of Current Cannabis-Based Pharmaceuticals in Pain Medicine.
Pain and therapy, 8(1), 41-51
Citation
Urits, Ivan; Borchart, Matthew; Hasegawa, Morgan; Kochanski, Justin; Orhurhu, Vwaire; Viswanath, Omar. (2019). An Update of Current Cannabis-Based Pharmaceuticals in Pain Medicine.. Pain and therapy, 8(1), 41-51. https://doi.org/10.1007/s40122-019-0114-4
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