Medical Cannabis A Focus on Use in Chronic Pain- Pharmacist
Cannabis has been legalized, decriminalized or approved for medical use in every US state except Alabama, Idaho, Kansas, South Carolina, Tennessee, Wisconsin,and Wyoming. The number of medical Cannabis users in the US is somewhere between 3 and 9 million. A review of individual states’ registries shows that the overwhelming majority of medical cannabis users are managing pain. Because most registries are designed to access and track tetrahydrocannabinol (THC)-type Cannabis products, the reasons for using cannabidiol (CBD) products are less clear. An online survey of 2,409 patients found that CBD was used for a variety of medical conditions, most frequently chronic pain, arthritis/joint pain, and anxiety. Although medical Cannabis may not be an item offered in most pharmacies, the American Pharmacy Association (APhA) released a policy statement in 2015 advocating for pharmacists to “collect and document information in the pharmacy patient profile about the use of Cannabis and its various components and provide appropriate patient counseling.” Many health care providers feel there isn’t enough information about Cannabis available to support evidence-based decision making. While that may be true, health care providers can participate in the collection of practice-based evidence and patient experience, as suggested by the APhA. This facilitates shared decision making and supports the effort to achieve optimal health care. This issue provides an overview of the physiological and clinical effects of Cannabis-based compounds and dosage forms. It is intended to help providers counsel patients about the potential benefit, or lack of benefit, of Cannabis for various types of chronic pain, and discuss safety considerations.