Kimberly Atkinson, PhD
Touro University Nevada
Co-Authors: Vladimir Bondarenko1, Rakesh Singh1, Isbel Curbelo-Navarro1
1Touro University Nevada
Background: Chronic pain affects millions of people worldwide and is defined as persistent pain lasting more than three months. Approximately 20-30% of these patients are prescribed opioids. Many of these patients also self-treat with cannabinoid-containing products. Studies have shown that cannabis has analgesic properties, as well as may improve sleep, mood, and quality of life for chronic pain patients. With the increasing use of cannabis for pain and various conditions and with proven efficacy and safety over the years, use of cannabis may may reduce the risk of opioid addiction and dependency, particularly in patients with chronic pain and opioid use disorder.
Objective: This systematic review aims to evaluate the benefits of the co-administration of cannabis-derived compounds and opioids for chronic pain management.
Methods: We searched PubMed, EMBASE, and Cochrane for clinical trials comparing the effects of opioids, cannabinoids, and their co-administration in patients with chronic pain. We analyzed data from 12 studies involving chronic pain patients, examining the impacts of various cannabis formulations and opioid therapies. The studies included randomized controlled trials, observational surveys, and qualitative assessments, with sample sizes ranging from 24 to 790 participants with chronic pain. These studies included patients with a wide variety of sources of chronic pain, including peripheral neuropathic pain, cancer-related pain, and osteoarthritis.
Results: Ten of the twelve studies showed significant benefits of cannabinoid-containing treatments in patients with chronic pain. Several studies showed that cannabinoids have analgesic effects, in many cases, equal to those of opioids. Adjuvant cannabis use was associated with a reduction in the need for opioids, a decrease in the number of medications prescribed, and reduced adverse effects of opioid treatment. The most common benefits of cannabis reported in these studies involved enhancing mood, quality of life, sleep, and relief of pain and opioid-dependence.
Conclusion: Cannabinoid-based therapies demonstrate potential as effective adjuvants or alternatives to opioids for chronic pain management. The findings support the hypothesis that treatment of chronic pain with cannabinoids reduced pain, curbed opioid consumption, enhanced quality of life, and reduced side effects. Future studies are warranted to further explore the long-term safety and efficacy of these therapies in diverse chronic pain populations.