There was an increased risk of non-serious AEs with cannabinoids compared with placebo .
Conclusions There was moderate evidence to support cannabinoids in treating chronic , non-cancer pain at 2 weeks .
Similar results were observed at later time points , but the confidence in effect is low .
There is little evidence that cannabinoids increase the risk of experiencing serious AEs , although non-serious AEs may be common in the short-term period following use
Background For patients with chronic , non-cancer pain , traditional pain-relieving medications include opioids , which have shown benefits but are associated with increased risks of addiction and adverse effects .
Medical cannabis has emerged as a treatment alternative for managing these patients and there has been a rise in the number of r and omized clinical trials in recent years ; therefore , a systematic review of the evidence was warranted .
Objective To analyze the evidence surrounding the benefits and harms of medical cannabinoids in the treatment of chronic , non-cancer-related pain .
Dronabinol increases pain threshold in patients with functional chest pain: a pilot double-blind placebo-controlled trial.
Noncardiac chest pain is associated with poor quality of life and high care expenditure . The majority of noncardiac chest pain is either gastresophageal reflux disease related or due to esophageal motility disorders , and the rest are considered functional chest pain ( FCP ) due to central and peripheral hypersensitivity . Current treatment of FCP improves 40 - 50 % of patients . Cannabinoid receptors 1 ( CB1 ) and 2 ( CB2 ) modulate release of neurotransmitters ; CB1 is located in the esophageal epithelium and reduces excitatory enteric transmission and potentially could reduce esophageal hypersensitivity . We performed a prospect i ve study to evaluate its effects on pain threshold , frequency , and intensity in FCP . Subjects with FCP received dronabinol ( 5 mg , twice daily ; n = 7 ; average age , 44 years ; mean body mass index , 26.7 ) or placebo ( n = 6 ; average age , 42 years ; mean body mass index , 25.9 ) for 28 days ( 4 weeks ) . Chest pain , general health , and anxiety/depression question naires were assessed at baseline and at 4 weeks . Subjects underwent an esophageal balloon distention test prior to treatment and on last day of the study . Dronabinol  increased pain thresholds significantly ( 3.0 vs. 1.0 ; P = 0.03 ) and reduced pain intensity and odynophagia compared to placebo ( 0.18 vs. 0.01 and 0.12 vs. 0.01 , respectively , P = 0.04 ) . Depression and anxiety scores did not differ between the groups at baseline or after treatment . No significant adverse effects were observed . In this novel study , dronabinol increased pain threshold and reduced frequency and intensity of pain in FCP . Further , large scale studies are needed to substantiate these findings
There was an increased risk of non-serious AEs with cannabinoids compared with placebo .
Conclusions There was moderate evidence to support cannabinoids in treating chronic , non-cancer pain at 2 weeks .
Similar results were observed at later time points , but the confidence in effect is low .
There is little evidence that cannabinoids increase the risk of experiencing serious AEs , although non-serious AEs may be common in the short-term period following use
Background For patients with chronic , non-cancer pain , traditional pain-relieving medications include opioids , which have shown benefits but are associated with increased risks of addiction and adverse effects .
Medical cannabis has emerged as a treatment alternative for managing these patients and there has been a rise in the number of r and omized clinical trials in recent years ; therefore , a systematic review of the evidence was warranted .
Objective To analyze the evidence surrounding the benefits and harms of medical cannabinoids in the treatment of chronic , non-cancer-related pain .