Medical cannabis is no magic bullet for arthritic pain

Wednesday, 18 Jul 2018

While interest in medical cannabis is stronger than ever, the evidence is weak and doesn’t support its use for persistent pain related to arthritis, according to Musculoskeletal Australia (MSK).

In a new information sheet for patients, MSK says that despite growing media and government interest in medical cannabis, the evidence for its use to treat pain associated with arthritis and musculoskeletal conditions is lacking.

“Cannabis has been illegal for so long that we just don’t have the thorough, scientific evidence we need about side effects or dosages, or the health conditions or symptoms it may be beneficial for,” it says.

And given the need for more research, medical cannabis should not be recommended for use outside of a clinical trial setting, MSK advises.

The statement acknowledges that the Commonwealth and state governments are taking steps to improve access to medical cannabis by easing prescribing rules, and also allowing Australian companies to produce cannabis for medical use.

But patients should note that the rules on accessing medical cannabis are still complicated, MSK suggests.

“We aren’t at the stage where a doctor can just write a prescription that you can fill at a chemist.

“In reality, for most people the use of medicinal cannabis is a long way off. And unlike the way it’s often portrayed in the media, it won’t be a panacea or magic bullet that will cure all ills,” patients are told.

The MSK advice follows the release of negative results for medicinal cannabis from a four-year study of over 1,500 Australians with chronic non-cancer pain.

In the Pain and Opioids IN Treatment (POINT) study, University of NSW researchers examined the effect of cannabis on pain in patients taking opioids for chronic non cancer pain..

While use of cannabis for pain was common (24% of participants), the study found no evidence that its 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,” the researchers wrote in Lancet Public Health.

People who used cannabis for pain reported that it was effective for their pain, a finding the researchers suggested might be due to cannabis improving sleep, which in turn improves well-being.

“Chronic non-cancer pain is a complex problem. For most people, there is unlikely to be a single effective treatment. In our study of people living with chronic non-cancer pain who were prescribed pharmaceutical opioids, despite reporting perceived benefits from cannabis use, we found no strong evidence that cannabis use reduced participants’ pain or opioid use over time,” said lead author Dr Gabrielle Campbell (PhD), a researcher at the UNSW National Drug and Alcohol  Research Centre (NDARC).

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