IASP Position Statement on the Use of Cannabinoids to Treat Pain

Mar 18, 2021

INTERNATIONAL ASSOCIATION FOR THE STUDY OF PAIN COMPLETES COMPREHENSIVE REVIEW OF RESEARCH ON THE USE OF CANNABINOIDS TO TREAT PAIN AND FINDS THAT THERE IS A LACK OF SUFFICIENT EVIDENCE TO ENDORSE THE GENERAL USE OF CANNABINOIDS FOR THE TREATMENT OF PAIN

WASHINGTON, DC – MARCH 18, 2021 – The International Association for the Study of Pain (IASP) said in a statement today that due to a lack of evidence from high quality research, it does not endorse the general use of cannabinoids [1] to treat pain. IASP has also published a list of research priorities which need to be addressed in order to properly determine the potential efficacy, and to confirm the safety of, cannabinoids when used in the treatment of pain.

In addition to the statement, the IASP journal PAIN has published a series of 13 linked scientific articles that comprehensively review all of the relevant laboratory and clinical research on this topic. These reviews took place over the last two-and-a-half years and represent the work of IASP’s Presidential Task Force on Cannabis and Cannabinoid Analgesia. These articles form the body of evidence that informed IASP’s position.

Although there are preclinical data supporting the hypothesis of cannabinoid analgesia, current uncertainties, especially in the clinical evidence, dictate that the evidence base regarding efficacy and safety fails to reach the threshold at which IASP can endorse their general use for pain control. The studies and the statement are limited to the use of cannabinoids to treat pain, and not for other conditions for which cannabinoids are currently being used.

“While IASP cannot endorse the general use of cannabinoids for treatment of pain at this time, we do not wish to dismiss the lived experiences of people with pain who have found benefit from their use,” said Andrew Rice, Professor of Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London and chair of the IASP’s Presidential Task Force on Cannabis and Cannabinoid Analgesia.

“This is not a door closing on the topic,” he added, “but rather a call for more rigorous and robust research to better understand any potential benefits and harms related to the possible use of medical cannabis, cannabis-based medicines and synthetic cannabinoids for pain relief, and to ensure the safety of patients and the public through regulatory standards and safeguards.”

“The IASP statement is important and timely because we are concerned that in certain jurisdictions medical cannabis may have been introduced without reference to the conventional statutory regulatory procedures for approving marketing of medicines,” Rice said. “Furthermore, where “recreational” use of cannabis is now permitted, there is a risk that patients could use cannabis for pain relief without the usual safeguard of a medical consultation and monitoring.”

Previous president of IASP Dr. Lars Arendt-Nielsen, who established and co-chaired the Task Force emphasize that “IASP is also calling for the delivery of a comprehensive research agenda. Priorities include identifying patients with pain who may receive the most benefit from cannabis or cannabinoids, and who may be at risk of the most harm. It is also necessary to expand the range of chemical entities tested, identify appropriate doses and their effects, and determine optimal delivery methods.”

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NOTES

[1]   Cannabinoids are broadly defined here as constituents of cannabis or synthetic compounds with pharmacological activity on the endocannabinoid system. This covers:

• “Medical or medicinal cannabis” which is a term used for cannabis plants, plant material, or full plant extracts when used for medical purposes, but which do not have regulatory approval for marketing as a therapeutic.
• “Medicinal cannabis extracts” (also known as licensed cannabis-based medicines) this term has been used for preparations derived from cannabis plants and which have regulatory approval for marketing as a therapeutic.
• Synthetic cannabinoids are pharmacologically active compounds, usually having affinity for and activity at cannabinoid receptors, which may have regulatory approval for marketing as a therapeutic.