Clinical practice guidelines for cannabis and cannabinoid-based medicines in the management of chronic pain and co-occurring conditions

Medscape describes this helpful new cannabis pain management guideline noting - "New clinical practice guidelines for cannabis in chronic pain management have been released. Developed by a group of Canadian researchers, clinicians, and patients the guidelines note that cannabinoid-based medicines (CBM) may help clinicians offer an effective, less addictive, alternative to opioids in patients with chronic noncancer pain and comorbid conditions. "We don't recommend using CBM first line for anything pretty much because there are other alternatives that may be more effective and also offer fewer side effects," lead guideline author Alan Bell, MD, assistant professor of family and community medicine at the University of Toronto, Toronto, Ontario, Canada, told Medscape Medical News. "But I would strongly argue that I would use cannabis-based medicine over opioids every time. Why would you use a high potency-high toxicity agent when there's a low potency-low toxicity alternative?" he said." The guideline itself comments "From our literature search, 70 articles met inclusion criteria and were utilized in guideline development, including 19 systematic reviews and 51 original research studies. Research typically demonstrates moderate benefit of CBM in chronic pain management. There is also evidence for efficacy of CBM in the management of comorbidities, including sleep problems, anxiety, appetite suppression, and for managing symptoms in some chronic conditions associated with pain including HIV, multiple sclerosis, fibromyalgia, and arthritis. Conclusions: All patients considering CBM should be educated on risks and adverse events. Patients and clinicians should work collaboratively to identify appropriate dosing, titration, and administration routes for each individual."

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