Around the world, more people are turning to cannabis products to help manage pain. Many people believe cannabis may be a natural alternative to traditional pain medicines, especially as laws around cannabis have become more relaxed in many countries and regions.
Today, cannabis products are commonly used for problems such as chronic pain, arthritis, nerve pain, cancer-related pain, anxiety, and sleep difficulties.
Because cannabis is now widely available in many places, interest in its medical benefits has grown quickly. However, scientific evidence about how well cannabis works for pain relief has often been unclear.
Some studies suggest it may help, while others show little effect. This has made it difficult for doctors and patients to understand whether cannabis is truly useful for treating pain.
A new large scientific review has now taken a closer look at the evidence. The review analyzed results from many clinical studies and found that cannabis products containing high levels of THC may provide small improvements in pain in the short term. THC, or tetrahydrocannabinol, is the main chemical in cannabis that causes the “high” feeling.
At the same time, the researchers also found that these THC-rich products were linked to a higher chance of unpleasant side effects. These side effects included dizziness, extreme sleepiness, and nausea. In contrast, products that mainly contain CBD, another well-known compound from cannabis, did not show clear benefits for relieving pain.
CBD, short for cannabidiol, has become extremely popular in recent years. It is widely sold in oils, creams, capsules, and other products. Many people believe CBD helps with pain and inflammation, partly because it does not produce the “high” that THC causes. Because of this, CBD is often viewed as a safer option.
However, the review found that CBD on its own did not work better than a placebo. A placebo is a fake treatment used in medical studies to compare whether a real treatment actually works. When researchers compared CBD-only products with placebos, the pain relief was nearly the same.
The study was led by Dr. Roger Chou and his research team at Oregon Health & Science University. Their work was published in the journal Annals of Internal Medicine and updates an earlier review that was first released in 2022.
To reach their conclusions, the researchers focused on randomized controlled trials. These studies are considered the most reliable type of medical research because participants are randomly assigned to receive either the treatment or a placebo. This helps reduce bias and gives scientists stronger evidence about whether a treatment truly works.
Cannabis is a complex plant that contains many chemical compounds. The two most widely studied are THC and CBD, but there are many others that scientists are still learning about. These chemicals interact with the body’s endocannabinoid system, which helps regulate pain, mood, appetite, and sleep.
Because cannabis products vary greatly in how they are grown, processed, and used, studying them can be difficult. Different products may contain different levels of THC, CBD, and other compounds. They may also be taken in different ways, such as through smoking, vaping, oils, or pills.
The review found the strongest evidence for two prescription medicines that contain THC or chemicals similar to THC. These medicines are called dronabinol and nabilone.
Both drugs are already approved by the U.S. Food and Drug Administration to treat nausea and vomiting caused by chemotherapy. One of them is also approved to help patients with HIV who experience severe weight loss.
In the studies analyzed in the review, these THC-based medicines produced small improvements in pain compared with placebo treatments. However, the level of improvement was modest. On a pain scale from zero to ten, the reduction was usually only about half a point to one point.
This means some patients may experience mild relief, but the effect is unlikely to be dramatic.
At the same time, people taking THC-based treatments were more likely to experience side effects. Dizziness, strong drowsiness, and nausea were the most common problems reported. These effects could be particularly risky for older adults or for people who need to stay alert during the day.
Another important finding was that most of the research evidence came from oral cannabis products, such as capsules, tablets, or oils. There is much less reliable research on smoked or inhaled cannabis. Because of concerns about lung health and other risks, many medical organizations do not recommend inhaled cannabis for pain treatment.
Doctors and researchers remain divided about the role of cannabis in managing pain. Some experts believe cannabis-based treatments may be useful when other standard treatments have not worked. Others remain cautious because the benefits appear small and the risks are not fully understood.
The researchers who conducted this review say more long-term studies are needed. Future research should examine how cannabis products sold in real-world dispensaries compare with the carefully controlled products used in clinical trials.
For now, the study highlights an important message. Public enthusiasm for cannabis as a pain treatment is growing, but the scientific evidence shows that its benefits may be limited.
Patients who are considering cannabis for pain should discuss it with healthcare professionals. Understanding both the potential benefits and the possible risks is essential for making informed decisions.
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The study is published in Annals of Internal Medicine.
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