According to an international task force at a recent virtual PAINWeek meeting, chronic pain patients can be treated with medical cannabis following one of three protocols based on patient characteristics.

One task force member says the recommendations are timely. “We as a task force believe it’s extremely important to bring [medical cannabis] to patients,” said Alan Bell, MD, of the University of Toronto, to MedPage Today. “Our main focus was to provide directions to clinicians.”

According to the task force while medicinal marijuana has been suggested as a treatment for chronic pain, many providers do not utilize it as the accepted guidelines about dosing and administration have not been accepted. Others prescribe medical cannabis without knowing how patients can properly dose.

“There’s a huge knowledge gap and no way clinicians can fall back on a specified dosing regimen,” Bell explained.

“Tailoring medical cannabis treatment to the individual is a critical component of successful treatment,” illustrated the group’s poster presentation at PAINWeek.

The task force recommends starting with CBD in most cases because they have seen many patients benefit solely from CBD. CBD does not have psychoactive properties.
The task force encourages providers to consider medical cannabis for patients dealing with neuropathic, inflammatory, nociplastic, and mixed pain and did not set a maximum treatment age.

Their poster suggested that the best administration method is oral because of “ease of dosing and safety.”

The task force also recommended pregnant and breastfeeding women, and people with psychotic disorders, not be administered medical cannabis. They also cautioned against mixing medical cannabis with anticoagulants, immunotherapy, or the epilepsy medication clobazam.

The task force needed 75% agreement to adopt any resolutions and Bell said they agreed to most of their recommendations on the first vote.

“There’s way too much of opioids being used for chronic pain despite a lack of evidence and the harms associated with opioids,” Bell commented. “We feel this is a major barrier that we are trying to overcome…that may exist because of the knowledge gap” regarding medical cannabis.


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