The study, published in the Annals of Internal Medicine and conducted by researchers at Oregon Health and Science University (OHSU), “sought to evaluate the benefits and harms of cannabis products used to treat chronic pain in a review of 18 placebo-controlled trials and seven cohort studies,”
“Oral, synthetic cannabis products with high THC-to-CBD ratios and sublingual, extracted cannabis products with comparable THC-to-CBD ratios may be associated with short-term improvements in chronic pain and increased risk for dizziness and sedation,” the researchers wrote in their conclusion. “Studies are needed on long-term outcomes and further evaluation of product formulation effects.”
The review was commissioned by the Agency for Healthcare Research and Quality, a division of the U.S. Department of Health and Human Services.
“Staff from the [Agency for Healthcare Research and Quality] assisted in developing the scope and key questions. A representative from the AHRQ served as a Contracting Officer’s Technical Representative and provided technical assistance during the conduct of the full evidence report and comments on draft versions of the report. The AHRQ did not directly participate in the literature search, determination of study eligibility criteria, data analysis, interpretation, or decision to submit this manuscript,” the researchers wrote.
As for the source material, the researchers said that they “included English-language studies of patients with chronic pain that compared cannabis products with a placebo or no treatment (that is, usual care) for at least 4 weeks of treatment or follow-up (detailed criteria are in the full report).”
Medical Cannabis Instead of Opioids for Chronic Pain
Medicinal cannabis is legal in majority of states in the U.S., and has increasingly been offered up as a safer, less addictive alternative to opioid prescription drugs.
As the NIH explains, the epidemic stems from the 1990s, when “pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates.”
“This subsequently led to widespread diversion and misuse of these medications before it became clear that these medications could indeed be highly addictive. Opioid overdose rates began to increase,” the agency said. “In 2017, more than 47,000 Americans died as a result of an opioid overdose, including prescription opioids, heroin, and illicitly manufactured fentanyl, a powerful synthetic opioid. That same year, an estimated 1.7 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers, and 652,000 suffered from a heroin use disorder (not mutually exclusive).”
But due in large part to the federal prohibition of cannabis in the United States, there has been a dearth of research examining its medicinal effects.
According to the Jerusalem Post, the researcher team from the Oregon Healther and Science University “found that only 25 of the 3,000 scientific studies they searched contained scientifically valid evidence.”
The Post reported that “Marian S. McDonagh, Pharm.D. and emeritus professor of medical informatics and clinical epidemiology at the OHSU’s School of Medicine expressed her surprise at the lack of evidence surrounding cannabis products.”
“With so much buzz around cannabis-related products, and the easy availability of recreational and medical marijuana in many states, consumers and patients might assume there would be more evidence about the benefits and side effects,” she said in an interview with the university’s newspaper,” McDonagh said, as quoted by the Jerusalem Post, adding that “there is very little scientifically valid research into most of these products.”
“We saw only a small group of observational cohort studies on cannabis products that would be easily available in states that allow it, and these were not designed to answer the important questions on treating chronic pain,” McDonagh said, according to the Jerusalem Post.