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

Structured Narrative Review

Abstract

Background: Chronic pain is a major global health concern that significantly affects quality of life and increases healthcare burden. Conventional treatments, particularly opioids, are associated with limited efficacy and substantial adverse effects. Medical cannabis has emerged as a potential alternative, attracting increasing clinical and research interest due to its analgesic properties.

Objectives: To evaluate the efficacy and safety of medical cannabis in the management of chronic pain and to explore its role as an alternative to conventional therapies.

Methods: This Structured Narrative Review  analyzed recent literature on medical cannabis for chronic pain management. Relevant studies, including randomized controlled trials, systematic reviews, and clinical guidelines, were identified through electronic databases. The review focused on the pharmacological mechanisms, clinical effectiveness, safety profile, and potential role of cannabis in reducing opioid use.

Results: Evidence suggests that cannabis-based medicines provide modest pain relief in patients with chronic pain, particularly neuropathic pain. Cannabinoids such as tetrahydrocannabinol (THC) and cannabidiol (CBD) interact with the endocannabinoid system to modulate pain pathways. Several studies reported improvements in pain intensity and quality of life, along with a potential opioid-sparing effect. However, adverse effects, including dizziness, sedation, and cognitive impairment, were commonly reported.

Conclusion: Medical cannabis shows promise as an adjunct or alternative therapy for chronic pain management. While evidence supports its potential benefits, variability in study outcomes and safety concerns highlight the need for further high-quality research. Careful patient selection and clinical monitoring are essential for optimizing therapeutic outcomes.