Medical Cannabis for Chronic Pain: A Literature Review of the Evidence, Challenges, and Future Directions

A Narrative Review

Abstract

Chronic pain has been amongst the leading health issues globally, often treated with opioids carrying a significant level of risk. Medical Cannabis, in its forms like THC and CBD, has been used as an alternative, acting by endocannabinoid system interaction for pain management and inflammation. This review shines light on recent evidence based research on the safety, efficacy and the potential of MC for chronic pain modulation. The evidence for potential benefits remains inconsistent despite several studies reporting benefits like pain reduction in fibromyalgia, MS-associated neuropathic pain, opioid-sparing effects and outcomes like improved sleep pattern and quality of life, reported by the patients.

A significant variation of efficacy is found, by pain condition and cannabis formulation, in high quality RCTs yielding contradictory or inconsistent results. Some of the challenges include lack of guidelines for dosing and product standardization, psychiatric and cognitive adverse effects, drug interactions, and regulatory constraints. All in all, medical cannabis promises potential, but with practical challenges and significant gaps in evidence, it presents a clinical conundrum. More rigorous research is required urgently with individualized application, policy harmonization and clearly defined guidelines which are evidence based.