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A Clinical Review of Cannabis Therapeutics: What the Evidence Actually Supports

ReviewModerate evidence
The takeaway

As of 2025, strong evidence supports cannabis for chemotherapy nausea, HIV appetite loss, specific epilepsies, and MS spasticity, while evidence for pain, insomnia, and psychiatric conditions remains mixed.

Clinicians advising patients about medical cannabis, patients considering cannabis therapy, and anyone wanting a balanced view of benefits vs. risks.

What the researchers found

Key established indications include chemotherapy-induced nausea/vomiting, HIV/AIDS appetite loss, Dravet/Lennox-Gastaut/tuberous sclerosis seizures, and MS spasticity. Evidence for chronic pain, insomnia, and psychiatric disorders is inconclusive. Risks include addiction, cognitive impairment in adolescents, CHS, psychosis, perinatal complications, and cardiovascular/pulmonary effects.

Why it matters

As public interest in medical cannabis grows, clinicians need a clear evidence-based framework for what cannabis can and cannot do. This review separates established benefits from hype and honestly addresses risks.

The numbers in context

Established indications: 6 conditions with strong evidence. Emerging areas with mixed evidence: chronic pain, insomnia, opioid use disorder, neurological disorders.

How the study worked

Clinical review evaluating current evidence for cannabis and cannabinoid treatment across established and emerging indications, with assessment of known risks and harms.

What this study cannot tell us

Review scope limited to selected conditions. Cannabis research is hampered by historical scheduling restrictions. Evidence quality varies dramatically across conditions.

How to read the evidence

Comprehensive clinical review providing an up-to-date evidence synthesis, though dependent on available research which remains limited for many conditions.

When this study was published

2025 review providing the most current clinical evidence assessment for cannabis therapeutics.

The bigger picture

The gap between public perception of cannabis as medicine and actual clinical evidence remains significant. This review provides clinicians with the balanced assessment needed to counsel patients who increasingly arrive having already tried cannabis.

Questions still open

  • Will improved research access lead to more established indications? How should clinicians handle the gap between patient experience and clinical evidence?

Common questions

What conditions does cannabis actually help?
Strong evidence supports: chemotherapy nausea, HIV appetite loss, Dravet syndrome, Lennox-Gastaut syndrome, tuberous sclerosis seizures, and MS spasticity. Evidence for pain, sleep, and psychiatric conditions remains mixed.
What are the main risks of cannabis use?
Key risks include addiction potential, cognitive impairment (especially in adolescents), cannabinoid hyperemesis syndrome, psychosis risk, pregnancy complications, and cardiovascular/pulmonary effects.

Read the original research

Therapeutic use of cannabis and cannabinoids: benefits and risks.

Polish archives of internal medicine, 135(11)

Citation

Zhai, Xiadi; Sarkar, Pooja R; Hill, Kevin P. (2025). Therapeutic use of cannabis and cannabinoids: benefits and risks.. Polish archives of internal medicine, 135(11). https://doi.org/10.20452/pamw.17117

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