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  • Q&A with Australian Health Practitioners

    Why aren’t we using medicinal cannabis for pain?

    I have a chronic pain condition and I am trying to find a good solution to help me live with it. I have had friends from overseas who have used medical cannabis for similar conditions so I am curious why we don't use it for pain in Australia?
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    Thanks

    Dr Marc Russo

    Pain Medicine Specialist

    Dr Marc Russo is the Director of Hunter Pain Clinic; founded in 1999 with a vision of providing a multidisciplinary approach to pain management. With ... View Profile

    With our politicians lobbying to legalise medicinal cannabis and the media promoting it as a cure-all, I can understand why you are confused as to why we aren’t using it for pain. The answer is in the medical literature. The latest evidence comes from a systematic review in which 16 large studies (known as randomised, double-blind controlled trials) were analysed together. These studies trialled different medicinal cannabis formulations (i.e. plant-derived THC, CBD, synthetics, etc) and compared them against placebo or another treatment in patients with chronic neuropathic pain. The results of the systematic investigation suggested that medicinal cannabis only benefits between 1 in 12 to 1 in 24 patients in terms of reducing their pain, and that it harms somewhere between 1 in 6 and 1 in 12 patients in terms of side effects. This means that in its current formats it harms more people than it helps. This is why it isn’t really being used for chronic pain, except perhaps for severe multiple sclerosis pain for which research has shown it may be effective. More research needs to be done and new formulations need to be developed to increase the benefits and reduce the harms of medicinal cannabis for people living with chronic pain.

    An alternative to THC or CBD that could be tried is PEA (palmitoylethanolamide). This is a natural fatty acid that stimulates the body’s own cannabinoid production and it may be the safest way to access the cannabinoid receptor at present. PEA is available as an over-the-counter medication.

    For more information on the use of medicinal cannabis for chronic pain in Australia, you can read the Faculty of Pain Medicine (ANZCA)’s position statement here: http://fpm.anzca.edu.au/documents/pm10-2018.pdf

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