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Published in: European Archives of Psychiatry and Clinical Neuroscience 1/2019

01-02-2019 | Neuropathic Pain | Invited Review

Understanding the evidence for medical cannabis and cannabis-based medicines for the treatment of chronic non-cancer pain

Authors: Gabrielle Campbell, Emily Stockings, Suzanne Nielsen

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 1/2019

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Abstract

The use of medical cannabis and cannabis-based medicines has received increasing interest in recent years; with a corresponding surge in the number of studies and reviews conducted in the field. Despite this growth in evidence, the findings and conclusions of these studies have been inconsistent. In this paper, we outline the current evidence for medical cannabis and cannabis-based medicines in the treatment and management of chronic non-cancer pain. We discuss limitations of the current evidence, including limitations of randomised control trials in the field, limits on generalisability of previous findings and common issues such as problems with measurements of dose and type of cannabinoids. We discuss future directions for medicinal cannabinoid research, including addressing limitations in trial design; developing frameworks to monitor for use disorder and other unintended outcomes; and considering endpoints other than 30% or 50% reductions in pain severity.
Literature
1.
go back to reference National Academies of Sciences Engineering and Medicine (2017) The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research. The National Academies Press, Washington, DC National Academies of Sciences Engineering and Medicine (2017) The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research. The National Academies Press, Washington, DC
2.
go back to reference Hauser W, Fitzcharles MA, Radbruch L, Petzke F (2017) Cannabinoids in pain management and palliative medicine. Deutsch Arztebl Int 114(38):627–634 Hauser W, Fitzcharles MA, Radbruch L, Petzke F (2017) Cannabinoids in pain management and palliative medicine. Deutsch Arztebl Int 114(38):627–634
3.
go back to reference Whiting PF, Wolff RF, Deshpande S et al (2015) Cannabinoids for medical use: a systematic review and meta-analysis. JAMA 313(24):2456–2473CrossRefPubMed Whiting PF, Wolff RF, Deshpande S et al (2015) Cannabinoids for medical use: a systematic review and meta-analysis. JAMA 313(24):2456–2473CrossRefPubMed
4.
go back to reference Petzke F, Enax-Krumova EK, Hauser W (2016) Efficacy, tolerability and safety of cannabinoids for chronic neuropathic pain: a systematic review of randomized controlled studies. Schmerz (Berlin Germany) 30(1):62–88CrossRef Petzke F, Enax-Krumova EK, Hauser W (2016) Efficacy, tolerability and safety of cannabinoids for chronic neuropathic pain: a systematic review of randomized controlled studies. Schmerz (Berlin Germany) 30(1):62–88CrossRef
5.
go back to reference Stockings E, Campbell G, Hall WD et al (2018) Cannabis and cannabinoids for the treatment of people with chronic non-cancer pain conditions: a systematic review and meta-analysis of controlled and observational studies. Pain Stockings E, Campbell G, Hall WD et al (2018) Cannabis and cannabinoids for the treatment of people with chronic non-cancer pain conditions: a systematic review and meta-analysis of controlled and observational studies. Pain
6.
go back to reference Aviram J, Samuelly-Leichtag G (2017) Efficacy of cannabis-based medicines for pain management: a systematic review and meta-analysis of randomized controlled trials. Pain Phys 20(6):E755–E796 Aviram J, Samuelly-Leichtag G (2017) Efficacy of cannabis-based medicines for pain management: a systematic review and meta-analysis of randomized controlled trials. Pain Phys 20(6):E755–E796
7.
go back to reference Mücke M, Phillips T, Radbruch L, Petzke F, Hauser W (2018) Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev 3:CD012182PubMed Mücke M, Phillips T, Radbruch L, Petzke F, Hauser W (2018) Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev 3:CD012182PubMed
8.
go back to reference Hauser W, Finn DP, Kalso E et al (2018) European Pain Federation (EFIC) position paper on appropriate use of cannabis-based medicines and medical cannabis for chronic pain management. Eur J Pain (London England) 22(9):1547–1564CrossRef Hauser W, Finn DP, Kalso E et al (2018) European Pain Federation (EFIC) position paper on appropriate use of cannabis-based medicines and medical cannabis for chronic pain management. Eur J Pain (London England) 22(9):1547–1564CrossRef
9.
go back to reference Hauser W, Petzke F, Fitzcharles MA (2018) Efficacy, tolerability and safety of cannabis-based medicines for chronic pain management—an overview of systematic reviews. Eur J Pain (London England) 22(3):455–470CrossRef Hauser W, Petzke F, Fitzcharles MA (2018) Efficacy, tolerability and safety of cannabis-based medicines for chronic pain management—an overview of systematic reviews. Eur J Pain (London England) 22(3):455–470CrossRef
10.
go back to reference Allan GM, Finley CR, Ton J et al (2018) Systematic review of systematic reviews for medical cannabinoids: pain, nausea and vomiting, spasticity, and harms. Can Fam Phys (Med Fam Can) 64(2):e78–e94 Allan GM, Finley CR, Ton J et al (2018) Systematic review of systematic reviews for medical cannabinoids: pain, nausea and vomiting, spasticity, and harms. Can Fam Phys (Med Fam Can) 64(2):e78–e94
11.
go back to reference Deshpande A, Mailis-Gagnon A, Zoheiry N, Lakha SF (2015) Efficacy and adverse effects of medical marijuana for chronic noncancer pain: systematic review of randomized controlled trials. Can Fam Phys 61(8):e372–e381 Deshpande A, Mailis-Gagnon A, Zoheiry N, Lakha SF (2015) Efficacy and adverse effects of medical marijuana for chronic noncancer pain: systematic review of randomized controlled trials. Can Fam Phys 61(8):e372–e381
13.
go back to reference Nugent SM, Morasco BJ, O’Neil ME et al (2017) The effects of cannabis among adults with chronic pain and an overview of general harms: a systematic review. Ann Intern Med 167(5):319–331PubMedCrossRef Nugent SM, Morasco BJ, O’Neil ME et al (2017) The effects of cannabis among adults with chronic pain and an overview of general harms: a systematic review. Ann Intern Med 167(5):319–331PubMedCrossRef
14.
go back to reference Walitt B, Klose P, Fitzcharles MA, Phillips T, Hauser W (2016) Cannabinoids for fibromyalgia. Cochrane Database Syst Rev 7:CD011694PubMed Walitt B, Klose P, Fitzcharles MA, Phillips T, Hauser W (2016) Cannabinoids for fibromyalgia. Cochrane Database Syst Rev 7:CD011694PubMed
15.
go back to reference Allan GM, Ramji J, Perry D et al (2018) Simplified guideline for prescribing medical cannabinoids in primary care. Can Fam Phys (Med Fam Can) 64(2):111–120 Allan GM, Ramji J, Perry D et al (2018) Simplified guideline for prescribing medical cannabinoids in primary care. Can Fam Phys (Med Fam Can) 64(2):111–120
16.
go back to reference Nielsen S, Germanos R, Weier M et al (2018) The use of cannabis and cannabinoids in treating symptoms of multiple sclerosis: a systematic review of reviews. Curr Neurol Neurosci Rep 18(2):8PubMedCrossRef Nielsen S, Germanos R, Weier M et al (2018) The use of cannabis and cannabinoids in treating symptoms of multiple sclerosis: a systematic review of reviews. Curr Neurol Neurosci Rep 18(2):8PubMedCrossRef
17.
go back to reference Malik Z, Baik D, Schey R (2015) The role of cannabinoids in regulation of nausea and vomiting, and visceral pain. Curr Gastroenterol Rep 17(2):9CrossRef Malik Z, Baik D, Schey R (2015) The role of cannabinoids in regulation of nausea and vomiting, and visceral pain. Curr Gastroenterol Rep 17(2):9CrossRef
18.
go back to reference Kerlin AM, Long M, Kappelman M, Martin C, Sandler RS (2018) Profiles of patients who use marijuana for inflammatory bowel disease. Digest Dis Sci 63(6):1600–1604PubMedCrossRef Kerlin AM, Long M, Kappelman M, Martin C, Sandler RS (2018) Profiles of patients who use marijuana for inflammatory bowel disease. Digest Dis Sci 63(6):1600–1604PubMedCrossRef
19.
go back to reference de Vries M, van Rijckevorsel DCM, Vissers KCP, Wilder-Smith OHG, van Goor H (2017) Tetrahydrocannabinol does not reduce pain in patients with chronic abdominal pain in a phase 2 placebo-controlled study. Clin Gastroenterol Hepatol 15(7):1079–86.e4PubMedCrossRef de Vries M, van Rijckevorsel DCM, Vissers KCP, Wilder-Smith OHG, van Goor H (2017) Tetrahydrocannabinol does not reduce pain in patients with chronic abdominal pain in a phase 2 placebo-controlled study. Clin Gastroenterol Hepatol 15(7):1079–86.e4PubMedCrossRef
20.
go back to reference de Vries M, Van Rijckevorsel DC, Vissers KC, Wilder-Smith OH, Van Goor H (2016) Single dose delta-9-tetrahydrocannabinol in chronic pancreatitis patients: analgesic efficacy, pharmacokinetics and tolerability. Br J Clin Pharmacol 81(3):525–537PubMedPubMedCentralCrossRef de Vries M, Van Rijckevorsel DC, Vissers KC, Wilder-Smith OH, Van Goor H (2016) Single dose delta-9-tetrahydrocannabinol in chronic pancreatitis patients: analgesic efficacy, pharmacokinetics and tolerability. Br J Clin Pharmacol 81(3):525–537PubMedPubMedCentralCrossRef
21.
go back to reference Kafil TS, Nguyen TM, MacDonald JK, Chande N (2018) Cannabis for the treatment of ulcerative colitis. Cochrane Database Syst Rev 11(2):CD012954PubMed Kafil TS, Nguyen TM, MacDonald JK, Chande N (2018) Cannabis for the treatment of ulcerative colitis. Cochrane Database Syst Rev 11(2):CD012954PubMed
22.
go back to reference Walitt B, Klose P, Fitzcharles MA, Phillips T, Häuser W (2016) Cannabinoids for fibromyalgia. Cochrane Database Syst Rev 7:CD011694PubMed Walitt B, Klose P, Fitzcharles MA, Phillips T, Häuser W (2016) Cannabinoids for fibromyalgia. Cochrane Database Syst Rev 7:CD011694PubMed
23.
go back to reference Skrabek RQ, Galimova L, Ethans K, Perry D (2008) Nabilone for the treatment of pain in fibromyalgia. J Pain 9(2):164–173CrossRefPubMed Skrabek RQ, Galimova L, Ethans K, Perry D (2008) Nabilone for the treatment of pain in fibromyalgia. J Pain 9(2):164–173CrossRefPubMed
24.
go back to reference Blake DR, Robson P, Ho M, Jubb RW, McCabe CS (2006) Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis. Rheumatology 45(1):50–52PubMedCrossRef Blake DR, Robson P, Ho M, Jubb RW, McCabe CS (2006) Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis. Rheumatology 45(1):50–52PubMedCrossRef
25.
go back to reference Pinsger M, Schimetta W, Volc D, Hiermann E, Riederer F, Pölz W (2006) Nutzen einer add-on-therapie mit dem synthetischen cannabinomimetikum nabilone bei patienten mit chronischen Schmerzzuständen—eine randomisierte kontrollierte studie. Wien Klin Wochenschr 118(11):327–335PubMedCrossRef Pinsger M, Schimetta W, Volc D, Hiermann E, Riederer F, Pölz W (2006) Nutzen einer add-on-therapie mit dem synthetischen cannabinomimetikum nabilone bei patienten mit chronischen Schmerzzuständen—eine randomisierte kontrollierte studie. Wien Klin Wochenschr 118(11):327–335PubMedCrossRef
26.
go back to reference National Academies of Sciences, Engineering, and Medicine (2017) The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research. National Academies Press, Washington National Academies of Sciences, Engineering, and Medicine (2017) The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research. National Academies Press, Washington
27.
go back to reference Campbell G, Nielsen S, Bruno R et al (2015) The Pain and Opioids IN Treatment study: characteristics of a cohort using opioids to manage chronic non-cancer pain. Pain 156(2):231–242CrossRefPubMed Campbell G, Nielsen S, Bruno R et al (2015) The Pain and Opioids IN Treatment study: characteristics of a cohort using opioids to manage chronic non-cancer pain. Pain 156(2):231–242CrossRefPubMed
28.
go back to reference Rogers KD, Kemp A, McLachlan AJ, Blyth F (2013) Adverse selection? A multi-dimensional profile of people dispensed opioid analgesics for persistent non-cancer pain. PLoS ONE 8(12):e80095PubMedPubMedCentralCrossRef Rogers KD, Kemp A, McLachlan AJ, Blyth F (2013) Adverse selection? A multi-dimensional profile of people dispensed opioid analgesics for persistent non-cancer pain. PLoS ONE 8(12):e80095PubMedPubMedCentralCrossRef
29.
go back to reference Tunks ER, Crook J, Weir R (2008) Epidemiology of chronic pain with psychological comorbidity: prevalence, risk, course, and prognosis. Can J Psychiatry 53(4):224–234PubMedCrossRef Tunks ER, Crook J, Weir R (2008) Epidemiology of chronic pain with psychological comorbidity: prevalence, risk, course, and prognosis. Can J Psychiatry 53(4):224–234PubMedCrossRef
30.
go back to reference Walker ER, Druss BG (2017) Cumulative burden of comorbid mental disorders, substance use disorders, chronic medical conditions, and poverty on health among adults in the U.S.A. Psychol Health Med 22(6):727–735PubMedCrossRef Walker ER, Druss BG (2017) Cumulative burden of comorbid mental disorders, substance use disorders, chronic medical conditions, and poverty on health among adults in the U.S.A. Psychol Health Med 22(6):727–735PubMedCrossRef
31.
go back to reference Mücke M, Phillips T, Radbruch L, Petzke F, Häuser W (2018) Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev 3:CD012182PubMed Mücke M, Phillips T, Radbruch L, Petzke F, Häuser W (2018) Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev 3:CD012182PubMed
32.
go back to reference Dechartres A, Trinquart L, Boutron I, Ravaud P (2013) Influence of trial sample size on treatment effect estimates: meta-epidemiological study. BMJ Br Med J 346:f2304CrossRef Dechartres A, Trinquart L, Boutron I, Ravaud P (2013) Influence of trial sample size on treatment effect estimates: meta-epidemiological study. BMJ Br Med J 346:f2304CrossRef
33.
go back to reference Hauser W, Fitzcharles MA (2018) The perils of overestimating the efficacy of cannabis-based medicines for chronic pain management. Pain Phys 21(1):E79–E80 Hauser W, Fitzcharles MA (2018) The perils of overestimating the efficacy of cannabis-based medicines for chronic pain management. Pain Phys 21(1):E79–E80
34.
go back to reference Vos T, Barber RM, Bell B et al (2016) Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 386(9995):743–800CrossRef Vos T, Barber RM, Bell B et al (2016) Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 386(9995):743–800CrossRef
35.
go back to reference Lynch ME, Ware MA (2015) Cannabinoids for the treatment of chronic non-cancer pain: an updated systematic review of randomized controlled trials. J Neuroimmune Pharmacol 10(2):293–301PubMedCrossRef Lynch ME, Ware MA (2015) Cannabinoids for the treatment of chronic non-cancer pain: an updated systematic review of randomized controlled trials. J Neuroimmune Pharmacol 10(2):293–301PubMedCrossRef
36.
37.
go back to reference Turk DC, Dworkin RH, Allen RR et al (2003) Core outcome domains for chronic pain clinical trials: IMMPACT recommendations. Pain 106(3):337–345PubMedCrossRef Turk DC, Dworkin RH, Allen RR et al (2003) Core outcome domains for chronic pain clinical trials: IMMPACT recommendations. Pain 106(3):337–345PubMedCrossRef
38.
go back to reference Levy N, Sturgess J, Mills P (2018) “Pain as the fifth vital sign” and dependence on the “numerical pain scale” is being abandoned in the US: why? Br J Anaesth 120(3):435–438PubMedCrossRef Levy N, Sturgess J, Mills P (2018) “Pain as the fifth vital sign” and dependence on the “numerical pain scale” is being abandoned in the US: why? Br J Anaesth 120(3):435–438PubMedCrossRef
40.
go back to reference Campbell G, Hall WD, Peacock A et al (2018) Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study. Lancet Public Health 3(7):e341–e350PubMedPubMedCentralCrossRef Campbell G, Hall WD, Peacock A et al (2018) Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study. Lancet Public Health 3(7):e341–e350PubMedPubMedCentralCrossRef
41.
go back to reference Wilsey B, Deutsch R, Marcotte TD (2016) Maintenance of blinding in clinical trials and the implications for studying analgesia using cannabinoids. Cannabis Cannabinoid Res 1(1):139–148PubMedPubMedCentralCrossRef Wilsey B, Deutsch R, Marcotte TD (2016) Maintenance of blinding in clinical trials and the implications for studying analgesia using cannabinoids. Cannabis Cannabinoid Res 1(1):139–148PubMedPubMedCentralCrossRef
42.
go back to reference Ware MA, Fitzcharles M-A, Joseph L, Shir Y (2010) The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial. Anesth Analg 110(2):604–610PubMedCrossRef Ware MA, Fitzcharles M-A, Joseph L, Shir Y (2010) The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial. Anesth Analg 110(2):604–610PubMedCrossRef
43.
go back to reference Colagiuri B (2010) Participant expectancies in double-blind randomized placebo-controlled trials: potential limitations to trial validity. Clin Trials 7(3):246–255PubMedCrossRef Colagiuri B (2010) Participant expectancies in double-blind randomized placebo-controlled trials: potential limitations to trial validity. Clin Trials 7(3):246–255PubMedCrossRef
44.
go back to reference Goldstein RB, Chou SP, Smith SM et al (2015) Nosologic comparisons of DSM-IV and DSM-5 alcohol and drug use disorders: results from the national epidemiologic survey on alcohol and related conditions-III. J Stud Alcohol Drugs 76(3):378–388PubMedPubMedCentralCrossRef Goldstein RB, Chou SP, Smith SM et al (2015) Nosologic comparisons of DSM-IV and DSM-5 alcohol and drug use disorders: results from the national epidemiologic survey on alcohol and related conditions-III. J Stud Alcohol Drugs 76(3):378–388PubMedPubMedCentralCrossRef
45.
go back to reference Mewton L, Slade T, Teesson M (2013) An evaluation of the proposed DSM-5 cannabis use disorder criteria using Australian National Survey Data. J Stud Alcohol Drugs 74(4):614–621PubMedCrossRef Mewton L, Slade T, Teesson M (2013) An evaluation of the proposed DSM-5 cannabis use disorder criteria using Australian National Survey Data. J Stud Alcohol Drugs 74(4):614–621PubMedCrossRef
46.
go back to reference Hall W (2015) What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction 110(1):19–35PubMedCrossRef Hall W (2015) What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction 110(1):19–35PubMedCrossRef
47.
go back to reference Morasco BJ, Gritzner S, Lewis L, Oldham R, Turk DC, Dobscha SK (2011) Systematic review of prevalence, correlates, and treatment outcomes for chronic non-cancer pain in patients with comorbid substance use disorder. Pain 152(3):488–497PubMedCrossRef Morasco BJ, Gritzner S, Lewis L, Oldham R, Turk DC, Dobscha SK (2011) Systematic review of prevalence, correlates, and treatment outcomes for chronic non-cancer pain in patients with comorbid substance use disorder. Pain 152(3):488–497PubMedCrossRef
48.
go back to reference Turk DC, O’Connor AB, Dworkin RH et al (2012) Research design considerations for clinical studies of abuse-deterrent opioid analgesics: IMMPACT recommendations. Pain 153(10):1997–2008PubMedPubMedCentralCrossRef Turk DC, O’Connor AB, Dworkin RH et al (2012) Research design considerations for clinical studies of abuse-deterrent opioid analgesics: IMMPACT recommendations. Pain 153(10):1997–2008PubMedPubMedCentralCrossRef
49.
go back to reference Gourlay DL, Heit HA, Almahrezi A (2005) Universal precautions in pain medicine: a rational approach to the treatment of chronic pain. Pain Med 6(2):107–112PubMedCrossRef Gourlay DL, Heit HA, Almahrezi A (2005) Universal precautions in pain medicine: a rational approach to the treatment of chronic pain. Pain Med 6(2):107–112PubMedCrossRef
50.
go back to reference Schuermeyer J, Salomonsen-Sautel S, Price RK et al (2014) Temporal trends in marijuana attitudes, availability and use in Colorado compared to non-medical marijuana states: 2003–11. Drug Alcohol Depend 140:145–155 Schuermeyer J, Salomonsen-Sautel S, Price RK et al (2014) Temporal trends in marijuana attitudes, availability and use in Colorado compared to non-medical marijuana states: 2003–11. Drug Alcohol Depend 140:145–155
51.
go back to reference Troutt WD, DiDonato MD (2015) Medical cannabis in Arizona: patient characteristics, perceptions, and impressions of medical cannabis legalization. J Psychoact Drugs 47(4):259–266CrossRef Troutt WD, DiDonato MD (2015) Medical cannabis in Arizona: patient characteristics, perceptions, and impressions of medical cannabis legalization. J Psychoact Drugs 47(4):259–266CrossRef
52.
go back to reference Krcevski-Skvarc N, Wells C, Hauser W (2018) Availability and approval of cannabis-based medicines for chronic pain management and palliative/supportive care in Europe: a survey of the status in the chapters of the European Pain Federation. Eur J Pain 22(3):440–454CrossRefPubMed Krcevski-Skvarc N, Wells C, Hauser W (2018) Availability and approval of cannabis-based medicines for chronic pain management and palliative/supportive care in Europe: a survey of the status in the chapters of the European Pain Federation. Eur J Pain 22(3):440–454CrossRefPubMed
53.
go back to reference Nielsen S, Sabioni P, Trigo J et al (2017) Opioid-sparing effects of cannabinoids: a systematic review and meta-analyses. Neurospychopharmacology 49(9):1752–1765CrossRef Nielsen S, Sabioni P, Trigo J et al (2017) Opioid-sparing effects of cannabinoids: a systematic review and meta-analyses. Neurospychopharmacology 49(9):1752–1765CrossRef
54.
go back to reference Bachhuber MA, Saloner B, Cunningham CO, Barry CL (2014) Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999–2010. JAMA Intern Med 174(10):1668–1673PubMedPubMedCentralCrossRef Bachhuber MA, Saloner B, Cunningham CO, Barry CL (2014) Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999–2010. JAMA Intern Med 174(10):1668–1673PubMedPubMedCentralCrossRef
55.
go back to reference Bradford AC, Bradford W, Abraham A, Bagwell Adams G (2018) Association between us state medical cannabis laws and opioid prescribing in the medicare part D population. JAMA Intern Med Bradford AC, Bradford W, Abraham A, Bagwell Adams G (2018) Association between us state medical cannabis laws and opioid prescribing in the medicare part D population. JAMA Intern Med
56.
go back to reference Livingston MD, Barnett TE, Delcher C, Wagenaar AC (2017) Recreational cannabis legalization and opioid-related deaths in Colorado, 2000–2015. Am J Public Health 107(11):1827–1829PubMedCrossRefPubMedCentral Livingston MD, Barnett TE, Delcher C, Wagenaar AC (2017) Recreational cannabis legalization and opioid-related deaths in Colorado, 2000–2015. Am J Public Health 107(11):1827–1829PubMedCrossRefPubMedCentral
57.
go back to reference Pardo B (2017) Do more robust prescription drug monitoring programs reduce prescription opioid overdose? Addiction 112(10):1773–1783PubMedCrossRef Pardo B (2017) Do more robust prescription drug monitoring programs reduce prescription opioid overdose? Addiction 112(10):1773–1783PubMedCrossRef
58.
go back to reference Abuhasira R, Schleider LB, Mechoulam R, Novack V (2018) Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly. Eur J Intern Med 49:44–50PubMedCrossRef Abuhasira R, Schleider LB, Mechoulam R, Novack V (2018) Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly. Eur J Intern Med 49:44–50PubMedCrossRef
59.
go back to reference Boehnke KF, Litinas E, Clauw DJ (2016) Medical cannabis use is associated with decreased opiate medication use in a retrospective cross-sectional survey of patients with chronic pain. J Pain 17(6):739–744CrossRefPubMed Boehnke KF, Litinas E, Clauw DJ (2016) Medical cannabis use is associated with decreased opiate medication use in a retrospective cross-sectional survey of patients with chronic pain. J Pain 17(6):739–744CrossRefPubMed
61.
go back to reference Haroutounian S, Ratz Y, Ginosar Y et al (2016) The effect of medicinal cannabis on pain and quality-of-life outcomes in chronic pain: a prospective open-label study. Clin J Pain 32(12):1036–1043PubMedCrossRef Haroutounian S, Ratz Y, Ginosar Y et al (2016) The effect of medicinal cannabis on pain and quality-of-life outcomes in chronic pain: a prospective open-label study. Clin J Pain 32(12):1036–1043PubMedCrossRef
62.
go back to reference Campbell G, Hall W, Nielsen S (2018) What does the ecological and epidemiological evidence indicate about the potential for cannabinoids to reduce opioid use and harms? A comprehensive review. Int Rev Psychiatry (in press, accepted 6 Aug 2018) Campbell G, Hall W, Nielsen S (2018) What does the ecological and epidemiological evidence indicate about the potential for cannabinoids to reduce opioid use and harms? A comprehensive review. Int Rev Psychiatry (in press, accepted 6 Aug 2018)
63.
go back to reference Klieger SB, Gutman A, Allen L, Pacula RL, Ibrahim JK, Burris S (2017) Mapping medical marijuana: state laws regulating patients, product safety, supply chains and dispensaries, 2017. Addiction 112(12):2206–2216PubMedPubMedCentralCrossRef Klieger SB, Gutman A, Allen L, Pacula RL, Ibrahim JK, Burris S (2017) Mapping medical marijuana: state laws regulating patients, product safety, supply chains and dispensaries, 2017. Addiction 112(12):2206–2216PubMedPubMedCentralCrossRef
64.
66.
go back to reference Oliveira CB, Maher CG, Pinto RZ et al (2018) Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J 27(11):2791–2803CrossRefPubMed Oliveira CB, Maher CG, Pinto RZ et al (2018) Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J 27(11):2791–2803CrossRefPubMed
67.
go back to reference Häuser W, Fitzcharles M-A, Radbruch L, Petzke F (2017) Cannabinoids in pain management and palliative medicine. Dtsch Arztebl Int 114(38):627–634PubMedPubMedCentral Häuser W, Fitzcharles M-A, Radbruch L, Petzke F (2017) Cannabinoids in pain management and palliative medicine. Dtsch Arztebl Int 114(38):627–634PubMedPubMedCentral
Metadata
Title
Understanding the evidence for medical cannabis and cannabis-based medicines for the treatment of chronic non-cancer pain
Authors
Gabrielle Campbell
Emily Stockings
Suzanne Nielsen
Publication date
01-02-2019
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Psychiatry and Clinical Neuroscience / Issue 1/2019
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-018-0960-9

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