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|Issue 122||February 2017|
The report is a product of the VA/HSR&D Evidence Synthesis Program.
Benefits and Harms of Cannabis in Chronic Pain or PTSD: A Systematic Review
Recent studies suggest that from 45% to 80% of individuals who seek cannabis for medical purposes do so for pain management, and an estimated 6% to 39% of patients who are prescribed opioid medication for pain also use cannabis. In addition, more than one-third of patients seeking cannabis for medical purposes cite post-traumatic stress disorder (PTSD) as the primary reason for the request. Approximately 15% of Veterans who are treated in VA outpatient PTSD clinics report recent (past six months) cannabis use. Thus, given the social, political, and legal changes surrounding cannabis use, physicians in both VA and non-VA settings will increasingly need to engage in evidence-informed discussions about the potential benefits and harms of cannabis use with their patients.
This systematic review sought to assess the effectiveness of plant-based cannabis preparations in treating chronic pain or PTSD. In addition, investigators sought to:
Investigators with VA's Evidence-based Synthesis Program Center located in Portland, OR searched multiple data sources (i.e., MEDLINE, Embase, PubMed) and grey literature (outside traditional publishing channels) sources from database inception through February 2016. After reviewing 10,875 titles and abstracts, they identified 12 systematic studies and 48 primary studies that were relevant to their analysis.
Summary of Review
Treatment of chronic pain
Treatment of PTSD
Evidence gaps and ongoing research
The authors identified 10 ongoing clinical trials examining the effectiveness of cannabis for a variety of chronic pain populations including patients with neuropathic pain, cancer, osteoarthritis, sickle cell disease, low back pain, and ulcerative colitis. There are also two trials examining the benefits and harms of cannabis for PTSD that should add to the body of evidence.
A cyberseminar session titled "Benefits and Harms of Cannabis in Chronic Pain or Post-Traumatic Stress Disorder: A Systematic Review" will be held on Monday, March 20, 2017 from 1:00pm to 2:00pm (ET). To register, go to the HSR&D Cyberseminar web page.
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Please feel free to forward this information to others!
ESP is currently soliciting review topics from the broader VA community. Nominations will be accepted electronically using the online Topic Submission Form. If your topic is selected for a synthesis, you will be contacted by an ESP Center to refine the questions and determine a timeline for the report.
This Management e-Brief is provided to inform you about recent HSR&D findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR&D Resource Center charged with disseminating important HSR&D findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.
This report is a product of VA/HSR&D's Quality Enhancement Research Initiative's (QUERI) Evidence-Based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers – and to disseminate these reports throughout VA.
See all reports online.