The Effects of Cannabis Among Adults With Chronic Pain
Authors: David A. Gorelick
Journal: Annals of Internal Medicine (2018)

Letters3 April 2018The Effects of Cannabis Among Adults With Chronic PainDavid A. Gorelick, MD, PhDDavid A. Gorelick, MD, PhDUniversity of Maryland School of Medicine, Baltimore, Maryland (D.A.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0731 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I believe that there are 2 relevant omissions in Nugent and colleagues' (1) comprehensive and rigorous systematic review on the effects of cannabis on chronic pain in adults. The authors do not mention Andreae and associates' patient-level meta-analysis (2), which included data from 178 participants in 5 controlled clinical trials of inhaled cannabis for chronic neuropathic pain. (These trials were included in Nugent and colleagues' study-level meta-analysis on neuropathic pain.) This patient-level meta-analysis estimated an odds ratio of 3.2 (95% credible interval, 1.59 to 7.24) for a greater than 30% reduction in pain scores with inhaled cannabis ...References1. Nugent SM, Morasco BJ, O'Neil ME, Freeman M, Low A, Kondo K, et al. The effects of cannabis among adults with chronic pain and an overview of general harms: a systematic review. Ann Intern Med. 2017;167:319-31. [PMID: 28806817] LinkGoogle Scholar2. Andreae MH, Carter GM, Shaparin N, Suslov K, Ellis RJ, Ware MA, et al. Inhaled cannabis for chronic neuropathic pain: a meta-analysis of individual patient data. J Pain. 2015;16:1221-32. [PMID: 26362106] doi:10.1016/j.jpain.2015.07.009 CrossrefMedlineGoogle Scholar3. Tashkin DP. Effects of marijuana smoking on the lung. Ann Am Thorac Soc. 2013;10:239-47. [PMID: 23802821] doi:10.1513/AnnalsATS.201212-127FR CrossrefMedlineGoogle Scholar4. Pomahacova B, Van der Kooy F, Verpoorte R. Cannabis Smoke Condensate III: the cannabinoid content of vaporised Cannabis sativa. Inhal Toxicol. 2009;21:1108-12. [PMID: 19852551] doi:10.3109/08958370902748559 CrossrefMedlineGoogle Scholar5. Van Dam NT, Earleywine M. Pulmonary function in cannabis users: support for a clinical trial of the vaporizer. Int J Drug Policy. 2010;21:511-3. [PMID: 20451365] doi:10.1016/j.drugpo.2010.04.001 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Maryland School of Medicine, Baltimore, Maryland (D.A.G.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0731. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Effects of Cannabis Among Adults With Chronic Pain and an Overview of General Harms Shannon M. Nugent , Benjamin J. Morasco , Maya E. O'Neil , Michele Freeman , Allison Low , Karli Kondo , Camille Elven , Bernadette Zakher , Makalapua Motu'apuaka , Robin Paynter , and Devan Kansagara The Effects of Cannabis Among Adults With Chronic Pain Shannon M. Nugent and Devan Kansagara Metrics 3 April 2018Volume 168, Issue 7Page: 525KeywordsCannabisDisclosureHead and neck cancersLung and intrathoracic tumorsNeuropathic painPainPulmonary functionRoutes of administrationSystematic reviews ePublished: 3 April 2018 Issue Published: 3 April 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...