Medical Marijuana
Northern Pain Centre does not prescribe Marijuana for medical use and does not support “off-label” or non-approved prescriptions of cannabinoid products. In Australia, cannabis possession is illegal. Currently clinical evidence is lacking and the superiority of cannabis compared with other analgesics that are currently available is not proven. Northern Pain Centre does not endorse the use of cannabinoids for chronic pain until such time as a clear therapeutic role for them is identified in scientific literature. Clinical trials are underway and until such time as the effectiveness of medical marijuana use is scientifically proven, cannabis does not form part of our treatment options.
Northern Pain Centre aligns with the IASP Councils statement released in February 2021. This lay statement summary on the use of cannabis and cannabinoids for pain relief was approved by the IASP Council on 9 February 2021.
Bottom Line
Reviews of preclinical research and clinical safety and efficacy of cannabis and cannabinoids for pain relief have identified important research gaps. Due to the lack of high-quality clinical evidence, IASP does not currently endorse general use of cannabis and cannabinoids for pain relief. IASP recognises the pressing need for preclinical and clinical studies to fill the research gap, and for education on this topic.
Background
The International Association for the Study of Pain (IASP) works to support research, education, clinical practice, and better patient outcomes for all pain conditions. As a global organization with the goal of improving pain relief worldwide, IASP has a duty to protect public health and address issues relevant to the study and treatment of pain. One such issue is the growing interest in and use of cannabis and cannabinoids for pain relief. A growing number of jurisdictions around the world already allow use of cannabis or cannabinoids, sometimes outside of conventional and well-established regulatory processes for approving new medicines.
In response to this pressing issue, IASP commissioned a Presidential Task Force. Under the leadership of Professor Andrew Rice (Imperial College London), the Task Force developed IASP’s position statement on the efficacy of cannabis and cannabinoids to reduce pain, and the safety of such use. To inform the Position Statement, the Task Force conducted an extensive, two-and-a-half-year appraisal of the available research. This resulted in the most detailed and robust analysis of the topic to date. The scientific outputs generated from this effort are published in the journal PAIN .
Summary
There is not enough high-quality human clinical safety and efficacy evidence to allow IASP to endorse the general use of cannabis and cannabinoids for pain at this time. Laboratory research on a wide variety of cannabinoids holds promise for effective pain relief, but most have not yet been tested in pain patients. More stringent regulatory safeguards, standards, and controls on production, marketing, and labeling are recommended to ensure the public is adequately informed and protected. The Task Force also identified a number of gaps in the evidence. A research agenda has been published that sets the priorities for closing these gaps. These priorities include identifying the characteristics of patients with pain who may receive the most benefit from cannabis or cannabinoids, and those who may experience the most harm. It is also necessary to expand the range of chemical entities tested, identify appropriate doses and their effects, and determine optimal delivery methods. Including patient partners on research teams is recommended.
Conclusion
While IASP cannot endorse general use of cannabis or cannabinoids for pain at this time, this is not intended to dismiss the lived experiences of people with pain who have found benefit from their use. IASP recognizes that reducing chronic pain and its impact on function, health, and quality of life will likely require a combination of approaches, sometimes including, but not restricted to, medications. These approaches will vary according to the specific needs of each individual. This is not a door closing on the topic, but rather a call for more rigorous and robust research to better understand any potential benefits and harms related to the use of cannabis for pain relief, and to ensure the safety of patients and the public through regulatory standards and safeguards.
Read the full statement and associated papers in PAIN.
Read this statement on the IASP website here