Pain and Marijuana

Cannabis Use Increases Pain After Surgery The Neuroscience News, 2022 October 23

“Cannabis is the most commonly used illicit drug in the United States and increasingly used as an alternative treatment for chronic pain, but there is limited data that shows how it affects patient outcomes after surgery”

“Our study shows that adults who use cannabis are having more — not less — postoperative pain. Consequently, they have higher opioid consumption after surgery.”

The patients who used cannabis experienced 14% more pain during the first 24 hours after surgery compared to the patients who never used cannabis.

Medicinal Cannabis For Treatment Of Chronic Pain
The National Center for Biotechnology Information 2022, October 3

Acute adverse effects to medicinal cannabis related to THC include anxiety, panic, disorientation, impaired attention, short-term memory, and driving performance. Hence, it is prudent to avoid medicinal cannabis in patients with psychiatric illnesses, such as schizophrenia, as it may exacerbate the condition. Additionally, in one study, about 50% of patients with cannabis-induced psychosis converted to schizophrenia or bipolar disorder.

The most common acute side effect of CBD is diarrhea. Additionally, CBD has potential drug interactions with conventional pharmacotherapies as it interacts with cytochrome P450 (CYP 450) enzymes involved in drug metabolism…


Medical cannabis or cannabinoids for chronic pain: a clinical practice guideline
BMJ 2021, September 9

Current practice Chronic pain is common and distressing and associated with considerable socioeconomic burden globally. Medical cannabis is increasingly used to manage chronic pain, particularly in jurisdictions that have enacted policies to reduce use of opioids; however, existing guideline recommendations are inconsistent, and cannabis remains illegal for therapeutic use in many countries.

The evidence This recommendation is informed by a linked series of four systematic reviews summarising the current body of evidence for benefits and harms, as well as patient values and preferences, regarding medical cannabis or cannabinoids for chronic pain…

The association between cannabis use disorder and the outcome following primary total hip arthroplasty
The National Center for Biotechnology Information 2021, July

Results: We found that patients in the study group had a significantly longer mean LOS compared with the controls (four days vs three days; p < 0.0001).The study group also had a significantly higher incidence and odds of developing medical (23.0 vs 9.8%, OR 1.6; p < 0.0001) and implant-related complications (16 vs 7.4%, OR 1.6; p < 0.0001) and incurred significantly higher mean 90-day costs ($16,938.00 vs $16,023.00; p < 0.0001).

With the increasing rates of cannabis use, these findings allow orthopaedic surgeons and other healthcare professionals to counsel patients with cannabis use disorder about the possible outcomes following their THA, with increased hospital stays, complications, and costs…


Perioperative cannabis use: a longitudinal study of associated clinical characteristics and surgical outcomes
The National Center for Biotechnology Information, 2021, Feb

Conclusions: Cannabis use is relatively low in this surgical population, yet cannabis users have higher clinical pain, poorer scores on quality of life indicators, and higher opioid use before and after surgery. Cannabis users reported similar surgical outcomes, suggesting that cannabis use did not impede recovery…

Cannabinoids for adult cancer-related pain: systematic review and meta-analysis
The National Center for Biotechnology Information, 2020, January 20

Objectives: There is increased interest in cannabinoids for cancer pain management and legislative changes are in progress in many countries. This study aims to determine the beneficial and adverse effects of cannabis/cannabinoids compared with placebo/other active agents for the treatment of cancer-related pain in adults.

Conclusions: Studies with a low risk of bias showed that for adults with advanced cancer, the addition of cannabinoids to opioids did not reduce cancer pain…


Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study
The Lancet, 2018, July

Cannabis use was common in people with chronic non-cancer pain who had been prescribed opioids, but we found no evidence that cannabis use improved patient outcomes. People who used cannabis had greater pain and lower self-efficacy in managing pain, and there was no evidence that cannabis use reduced pain severity or interference or exerted an opioid-sparing effect. As cannabis use for medicinal purposes increases globally, it is important that large well designed clinical trials, which include people with complex comorbidities, are conducted to determine the efficacy of cannabis for chronic non-cancer pain..

Cannabis for Chronic Pain: Challenges and Considerations
The National Center for Biotechnology Information, 2018, June

Abstract: The expanding and variable legalization of cannabis in multiple states nationwide represents an additional challenge for patients and the medical community because recreational and medicinal cannabis are irresponsibly overlapped. Cannabis designed for recreational use (containing high levels of active ingredients) is increasingly available to patients with chronic pain who do not find relief with current pharmacologic entities, which exposes patients to potential harm…


The Effects of Cannabis Among Adults With Chronic Pain and an Overview of General Harms
Annals of Internal Medicine, 2017, September 5

Limited evidence suggests that cannabis may alleviate neuropathic pain in some patients, but insufficient evidence exists for other types of chronic pain. Among general populations, limited evidence suggests that cannabis is associated with an increased risk for adverse mental health effects…

Why Smoking Pot Might Not Ease Your Pain
The National Center for Biotechnology Information, 2017, August 15

fter analyzing data from 27 previously published studies on marijuana and chronic pain, the researchers determined that there is low-strength evidence showing that it can help relieve nerve pain, but not enough evidence out there to prove it helps with other types of persistent pain, such as from cancer, multiple sclerosis, fibromyalgia, or rheumatoid arthritis…