Brittany Van Dover* and Maria Rosario Sim*
SUNY Downstate Medical Center College of Nursing, USAFulltext PDF
Chronic pain is a common problem that affects patients in the United States (US), Canada, and Australia. The treatment of chronic pain includes the use of opioids, however, with the growing epidemic, alternative options are being sought. The use of medical cannabis (marijuana) as treatment for chronic pain is increasing in popularity as an alternative for opioids. The aim of this Integrative Research Review (IRR) was to explore the efficacy of medical cannabis for chronic non-cancer pain treatment. PubMed and Google Scholar were used for literature search engines. Keywords used to retrieve articles were efficacy, medical cannabis, medical marijuana, non-cancer chronic pain, neuropathic pain, opioids, substitution, and treatment. Inclusion criteria were articles published in the US, Canada and Australia, and those written in the English language. Exclusion criteria were articles prior to 2010 and subjects less than 18 years of age. Ten articles were included in the IRR: four systematic reviews of randomized controlled trials, one randomized controlled trial, two cross-sectional observational studies, one secondary data analysis, one prospective cohort study, and one historical cohort study. Pain was measured using the Visual Analog Scale (VAS), Descriptor Differential Scale (DDS), numerical rating scale, Brief Pain Inventory (BPI) and/or quality of life in these studies. Most results showed that medical cannabis was an effective treatment for the reduction of chronic pain and increased quality of life, with the exception of the Australian prospective cohort study. Adverse effects of cannabis included short-term neurocognitive decline and worsening of psychiatric illness. Cannabis was also associated with a reduction or cessation of opioid use in the US and Canadian articles, prescribing patterns and spending in medicare enrollees in states where medical cannabis laws were implemented. Findings suggest that clinical practice should include substituting medical cannabis for opioids in the long-term management of chronic pain in countries with medical cannabis laws.
Efficacy; Medical cannabis; Medical marijuana; Chronic pain; Non-cancer; Neuropathic pain; Opioids; Substitution
Van Dover B, Rosario Sim M. The Use of Medical Cannabis for Treatment of Chronic Pain: An Integrative Research Review. Ann Nurs Primary Care. 2019; 2(1): 1013.