Are cannabinoids an effective and safe treatment option in the management of pain? A qualitative systematic review BMJ Volume 323, pp 13-16
Cannabinoids (the active substances in cannabis) are no more effective than conventional analgesics in controlling pain and have undesirable side effects, concludes a study in this week's BMJ. Their introduction into mainstream clinical practice for pain management is therefore undesirable, report the authors.
Campbell and colleagues reviewed nine trials, involving over 200 patients, to establish whether cannabinoids are an effective and safe treatment option in the treatment of acute or long-term (chronic) pain. In all trials, cannabinoids were given as tablets or by intramuscular injection. The authors found no studies on smoked cannabis.
In eight of the nine trials, cannabinoids were no more effective than codeine tablets in controlling acute and chronic pain. Furthermore, side effects associated with the cannabinoids were common and sometimes severe.
In acute postoperative pain, cannabinoids are unlikely to be useful, but may be effective in chronic non-cancer pain, say the authors. Cannabis is clearly unlikely to usurp existing effective treatments for postoperative pain, they conclude.
Fiona Campbell, Consultant in Anaesthetics and Pain Management, Pain Management Centre, Queen's Medical Centre, Nottingham, UK
Editorial: Cannabinoids for pain and nausea BMJ Volume 323, pp 2-3