Chronic pain

Chronic pain is pain persisting beyond 3 months or past expected tissue healing, encompassing nociceptive, neuropathic, and nociplastic mechanisms. It is among the most frequent indications cited by medical cannabis patients. NASEM (2017) concluded there is substantial evidence that cannabis or cannabinoids are effective for the treatment of chronic pain in adults—one of only three conditions receiving this rating. The Whiting et al. meta-analysis (JAMA 2015) of 79 trials found a pooled odds ratio of 1.41 (95% CI 0.99–2.00) for ≥30% pain reduction with cannabinoids versus placebo, with effect sizes comparable to gabapentinoids. Observational studies have suggested opioid-sparing effects, but randomized confirmation is lacking and more recent cohort analyses have produced mixed findings ⚠️. Adverse effects (dizziness, sedation, cognitive impairment) are common and dose-limiting. → See also: Neuropathic pain, Nabiximols, THC, CBD, Opioid-sparing effect.