2018/04/10 by E. Alfonso Romero‐Sandoval, Jack E. Fincham, Ashley L. Kolano +3 · 124 citations
Medicine · Pharmacology, Toxicology and Pharmaceutics · Social Sciences · #Alternative medicine #Cannabidiol #Cannabinoid #Cannabis #Cannabis and Cannabinoid Research #Chronic pain #Effects of cannabis #Family medicine #Forensic Toxicology and Drug Analysis #Intensive care medicine #Legalization #Medicine #Psychiatry #Recreation #Religion, Spirituality, and Psychology #Scientific evidence
paper · pdf · doi:10.1002/phar.2115
published in Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy 38(6), 651-662 (Wiley)
openalex publication_date 2018/04/10 · crossref created 2018/04/10 · crossref issued 2018/05/16 · crossref published 2018/05/16 · crossref published-online 2018/05/16 · crossref published-print 2018/06/01 · openalex created_date 2025/10/10 · crossref deposited 2025/10/21 · crossref indexed 2026/08/05 · openalex updated_date 2026/08/06
The National Academies of Sciences, Engineering, and Medicine has found substantial evidence that cannabis (plant) is effective for the treatment of chronic pain in adults, and moderate evidence that oromucosal cannabinoids (extracts, especially nabiximols) improve short-term sleep disturbances in chronic pain. The paradoxical superiority of the cannabis plant over cannabinoid molecules represents a challenge for the medical community and the established processes that define modern pharmacy. The expanding and variable legalization of cannabis in multiple states nationwide represents an additional challenge for patients and the medical community because recreational and medicinal cannabis are irresponsibly overlapped. Cannabis designed for recreational use (containing high levels of active ingredients) is increasingly available to patients with chronic pain who do not find relief with current pharmacologic entities, which exposes patients to potential harm. This article analyzes the available scientific evidence to address controversial questions that the current state of cannabis poses for health care professionals and chronic pain patients and sets the basis for a more open discussion about the role of cannabis in modern medicine for pain management. A critical discussion on these points, the legal status of cannabis, and considerations for health care providers is presented.