MEDICAL cannabis, a widely debated topic, took center stage at the ACR Convergence 2024, where researchers explored its role in managing chronic pain related to rheumatic diseases. With legalization sweeping across 47 states, the District of Columbia, and several U.S. territories, the discussion focused on the efficacy and safety of cannabis as a therapeutic option.
Daniel Clauw, a professor of anesthesiology, rheumatology, and psychiatry at the University of Michigan, emphasized the need for rigorous research, noting that most existing studies are outdated or lack robust clinical data. “The primary problem is that very few appropriately powered randomized controlled trials have been completed,” Clauw stated. Despite these limitations, he described cannabis as a potentially safer alternative to opioids for chronic pain.
Current Data and Patient Interest
Cannabis contains THC, the psychoactive compound, and CBD, a non-intoxicating component. According to the National Institute on Drug Abuse, both compounds have shown potential benefits for pain relief. A 2019 Arthritis Foundation survey revealed that 79% of arthritis patients either used or considered using CBD to manage their symptoms.
However, cannabis use comes with variability in effectiveness. Factors such as dosage, formulation, and individual metabolism influence outcomes. Most reported side effects, including dry mouth, fatigue, and increased appetite, are mild and temporary. While dependency risks exist with THC, they are rare with CBD.
Clauw pointed out the challenges clinicians face due to legal restrictions. Providers in most states cannot prescribe cannabis but can discuss its use and guide patients. His presentation underscored that cannabis, while not a miracle cure, might offer relief for patients inadequately served by existing treatments.
Future Implications for Patient Care
“For chronic pain, cannabis is almost certainly more effective and safer than opioids,” said Clauw. “It’s neither the evil weed from hell nor the best thing since sliced bread.” With cannabis gaining traction as a medical option, the demand for well-designed clinical trials remains critical to optimize its use and safety.
Reference: ACR. Research at ACR’s Annual Meeting Explores Medicinal Marijuana Use and Rheumatic Disease-Related Pain? November 14, 2024. Available at: https://assets.contentstack.io/v3/assets/bltee37abb6b278ab2c/blt29e3560ef167806c/annual-meeting-news-release-clauw-cannabis.pdf. Last accessed: November 26, 2024. [Press release].
