APS Releases Guidance on Medical Marijuana Use for Pain Treatment

(Pain Medicine News – July 8, 2016) — The American Pain Society just released a guidance on the use of cannabis for pain treatment (J Pain 2016;17:654-668). The guidance is intended for physicians treating patients who use cannabis.

There is increasing interest and availability of herbal cannabis for clinical use in the United States despite uncertainties over its safety and efficacy, according to the authors. Cannabis for clinical use is currently permitted in 23 states, and approximately 9% of nonmedical users develop cannabis addiction, the authors noted. The guidance, a review of clinical, research and policy data related to herbal cannabis, was written to “better prepare clinicians to care for patients who use it,” according to the authors.

“We looked at the evidence that is available on the use of clinical cannabis and extrapolated to some degree on management strategies from our experiences with the prescribing of controlled substances,” said Seddon R. Savage, MD, lead author and medical director at Silver Hill Hospital Chronic Pain and Recovery Center, in New Canaan, Conn., in a press release.

The researchers found that cannabinoids show promise as therapeutics, but more research is needed to maximize their potential use in a clinical setting. Some of the clinical practice recommendations and areas of research include:

• knowing federal and state laws for medical cannabis use;
• being clear with patients about therapeutic cannabis treatment goals, routes of administration, potential risksand benefits, and comorbidities;
• monitoring patients as if they were using opioids and other controlled substances;
• increasing federal funding for pain-related cannabis research and expanding pain conditions being studied (e.g., non-neuropathic pain); and
• conducting research on cannabis cultivation and improving access to high-quality medical-grade access for research.

—PMN Staff Based on a press release from the American Pain Society.