Cannabis for chronic pain: Case series and implications for clinicians
MA Ware, A Gamsa, J Persson, MA Fitzcharles
BACKGROUND: Chronic pain is one of the most common reasons for therapeutic
To describe therapeutic cannabis use among patients
with chronic pain.
Patients with chronic pain who voluntarily indicated
that they used cannabis therapeutically completed a
questionnaire about the type of cannabis used, the mode
of administration, the amount used and the frequency
of use, and their perception of the effectiveness of
cannabis on a set of pain-associated symptoms and side
effects. The study was approved by the McGill University
Health Centre Research Ethics Board.
Fifteen patients (10 male) were interviewed (median
age 49.5 years, range 24 to 68 years). All patients
smoked herbal cannabis for therapeutic reasons (median
duration of use six years, range two weeks to 37 years).
Seven patients only smoked at night-time (median dose
eight puffs, range two to eight puffs), and eight patients
used cannabis mainly during the day (median dose three
puffs, range two to eight puffs); the median frequency
of use was four times per day (range one to 16 times
Twelve patients reported improvement in pain and mood,
while 11 reported improvement in sleep. Eight patients
reported a 'high'; six denied a 'high'. Tolerance to
cannabis was not reported.
The results of this self-selected case series must be
interpreted with caution. Small doses of smoked cannabis
may improve pain, mood and sleep in some patients with
chronic pain. Clinical trials are warranted to test
these effects. Further prospective studies should examine
the patterns and prevalence of cannabis use among chronic