Cannabis oil extracts for chronic pain: what else can be learned from another structured prospective cohort?

The use of medicinal cannabis for managing pain expands, although its efficacy and safety have not been fully established through randomized controlled trials. This structured, prospective questionnaire-based cohort was aimed to assess long-term effectiveness and safety of cannabis oil extracts in patients with chronic pain. Adult Israeli patients licensed to use cannabis oil extracts for chronic pain were followed prospectively for 6 months. The primary outcome measure was change from baseline in average weekly pain intensity, and secondary outcomes were changes in related symptoms and quality of life, recorded before treatment initiation and 1, 3, and 6 months thereafter. Generalized linear mixed model was used to analyze changes over time. In addition, "responders" (≥30% reduction in weekly pain at any time point) were identified. The study included 218 patients at baseline, and 188, 154, and 131 at 1, 3, and 6 months, respectively. At 6 months, the mean daily doses of cannabidiol and Δ9-tetrahydrocannabinol were 22.4 ± 24.0 mg and 20.8 ± 30.1 mg, respectively. Pain decreased from 7.9 ± 1.7 at baseline to 6.6 ± 2.2 at 6 months ( This prospective cohort demonstrated a modest overall long-term improvement in chronic pain and related symptoms and a reasonable safety profile with the use of relatively low doses of individually titrated Δ9-tetrahydrocannabinol and cannabidiol.

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Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.

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D. Pud received research grants from the Israel Pain Association and from Rafa Laboratories; H. Sharon received research grants, consulting or speaking fees, and/or honoraria from the Israel Pain Association, Bioevents, and Cellen Health; S. Haroutounian received research support or consulting fees from Disarm Therapeutics, Rafa Laboratories, GW Pharma, and Vertex Pharmaceuticals; E. Eisenberg received research grants, consulting or speaking fees, and/or honoraria from the Israel Pain Association, Rafa Laboratories, Syqe Medical, Teva Israel, Pfizer, Little Green Pharma, Bioevents, Greenwich Biosciences, Vectura Ferin Pharma, and Cannabotech. The other authors have no conflict of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.