Medical cannabis for the reduction of opioid dosage in the treatment of non-cancer chronic pain: a systematic review
Abstract
Background Medical cannabis (MC) is currently being used as an adjunct to opiates given its analgesic effects and potential to reduce opiate addiction. This review assessed if MC used in combination with opioids to treat non-cancer chronic pain would reduce opioid dosage. Methods Four databases—Ovid (Medline), Psyc-INFO, PubMed, Web of Science, and grey literature—were searched to identify original research that assessed the effects of MC on non-cancer chronic pain in humans. Study eligibility included randomized controlled trials, controlled before-and-after studies, cohort studies, cross-sectional studies, and case reports. All databases were searched for articles published from inception to October 31, 2019. Cochrane’s ROBINS-I tool and the AXIS tool were used for risk of bias assessment. PRISMA guidelines were followed in reporting the systematic review. Results Nine studies involving 7222 participants were included. There was a 64–75% reduction in opioid dosage when used in combination with MC. Use of MC for opioid substitution was reported by 32–59.3% of patients with non-cancer chronic pain. One study reported a slight decrease in mean hospital admissions in the past calendar year ( P = .53) and decreased mean emergency department visits in the past calendar year ( P = .39) for patients who received MC as an adjunct to opioids in the treatment of non-cancer chronic pain compared to those who did not receive MC. All included studies had high risk of bias, which was…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 7,222 participants or records.
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