Cannabinoids as a Potential Alternative to Opioids in the Management of Various Pain Subtypes: Benefits, Limitations, and Risks

Pain is a global phenomenon encompassing many subtypes that include neuropathic, musculoskeletal, acute postoperative, cancer, and geriatric pain. Traditionally, opioids have been a mainstay pharmacological agent for managing many types of pain. However, opioids have been a subject of controversy with increased addiction, fatality rates, and cost burden on the US healthcare system. Cannabinoids have emerged as a potentially favorable alternative or adjunctive treatment for various types of acute and chronic pain. This narrative review seeks to describe the efficacy, risks, and benefits of cannabinoids as an adjunct or even potential replacement for opioids in the treatment of various subtypes of pain.

Practical Strategies Using Medical Cannabis to Reduce Harms Associated With Long Term Opioid Use in Chronic Pain

Chronic non-cancer pain (CNCP) is estimated to affect 20% of the adult population. Current United States and Canadian Chronic non-cancer pain guidelines recommend careful reassessment of the risk-benefit ratio for doses greater than 90 mg morphine equivalent dose (MED), due to low evidence for improved pain efficacy at higher morphine equivalent dose and a significant increase in morbidity and mortality. There are a number of human studies demonstrating cannabis opioid synergy. This preliminary evidence suggests a potential role of cannabis as an adjunctive therapy with or without opioids to optimize pain control.

To describe the prevalence and patterns of cannabidiol (CBD) use in women with co-existing chronic pelvic pain (CPP) and fibromyalgia, and to evaluate characteristics associated with pain improvement.
To describe the prevalence and patterns of cannabidiol (CBD) use in women with co-existing chronic pelvic pain (CPP) and fibromyalgia, and to evaluate characteristics associated with pain improvement.

To describe the prevalence and patterns of cannabidiol (CBD) use in women with co-existing chronic pelvic pain (CPP) and fibromyalgia, and to evaluate characteristics associated with pain improvement.

Many cannabinoids display promising non-hallucinogenic bioactivities that are determined by the variable nature of the side chain and prenyl group defined by the enzymes involved in their synthesis.

Cannabis Significantly Reduces the Use of Prescription Opioids and Improves Quality of Life in Authorized Patients: Results of a Large Prospective Study

Authors Philippe Lucas, MA PhD, Susan Boyd, PhD, M -J Milloy, PhD, Zach Walsh, PhD Published in Pain Medicine December 2020 Abstract Objective This article presents findings from a large…

Association of Medical and Adult-Use Marijuana Laws With Opioid Prescribing for Medicaid Enrollees

Authors Hefei Wen, PhD; Jason M. Hockenberry, PhD Published in JAMA Internal Medicine May 2018 Abstract Importance Overprescribing of opioids is considered a major driving force behind the opioid epidemic in…

Prescribed medical cannabis in women with gynecologic malignancies: A single-institution survey-based study

Authors: Emily M.Webster, Ghanshyam S.Yadav, Stefan Gysler, Blair McNamara, Jonathan Black, Joan Tymon-Rosario, Burak Zeybek, Chanhee Han, Christopher K. Arkfeld, Vaagn Andikyan, Gulden Menderes, Gloria Huang, Masoud Azodi, Dan-Arin Silasi,…

Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study

Author: Alex Capano, Richard Weaver & Elisa Burkman Published in Postgraduate Medicine   November 2019 Abstract Context: Chronic pain is highly prevalent in most of the industrialized nations around the world….

A Comprehensive Patient and Public Involvement Program Evaluating Perception of Cannabis-Derived Medicinal Products in the Treatment of Acute Postoperative Pain, Nausea, and Vomiting Using a Qualitative Thematic Framework

Author: Simon Erridge, Marie Miller, Tamara Gall, Antonio Costanzo, Barbara Pacchetti, and Mikael H. Sodergren Published in Mary Ann Liebert, Inc Publishers  February 2020 Abstract Introduction: Cannabis-derived medicinal products (CDMPs) have antiemetic…

A Comprehensive Patient and Public Involvement Program Evaluating Perception of Cannabis-Derived Medicinal Products in the Treatment of Acute Postoperative Pain, Nausea, and Vomiting Using a Qualitative Thematic Framework

Author: Simon Erridge, Marie Miller, Tamara Gall, Antonio Costanzo, Barbara Pacchetti, and Mikael H. Sodergren Published in Mary Ann Liebert, Inc Publishers  February 2020 Abstract Introduction: Cannabis-derived medicinal products (CDMPs) have…

The Impact of Medical Cannabis on Intermittent and Chronic Opioid Users with Back Pain: How Cannabis Diminished Prescription Opioid Usage

Author: Kevin M. Takakuwa, Jeffrey Y. Hergenrather, Frances S. Shofer, and Raquel M. Schears Published in Mary Ann Liebert, Inc. Publishers January 2020 Abstract Objectives: To determine if cannabis may be…

Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science

Author: Eric P. Baron DO Published in HEADACHE Journal of Headache and face pain August 2018 Abstract Background Comprehensive literature reviews of historical perspectives and evidence supporting cannabis/cannabinoids in the treatment…

A Scoping Review of the Use of Cannabis and Its Extracts as Potential Harm Reduction Strategies: Insights from Preclinical and Clinical Research

Authors: James Siklos-Whillans, Alia Bacchus, Laurie A. Manwell Published in International Journal of Mental Health and Addiction March 2020 Abstract Cannabis as a harm reduction strategy (HRS) is supported by evidence…

Emerging evidence for Cannabis Role in Opioid Use Disorder

Authors: Beth Weise and Adrianne R. Wilson-Poe Published in Mary Ann Leibert Inc. Publishers September 2018 Abstract Introduction: The opioid epidemic has become an immense problem in North America, and…