A Case Series of Patients Using Medicinal Marihuana for Management of Chronic Pain Under the Canadian Marihuana Medical Access Regulations
Open accessAbstract
The Canadian Marihuana Medical Access Regulations (MMAR) program allows Health Canada to grant access to marihuana for medical use to those who are suffering from grave and debilitating illnesses. This is a report on a case series of 30 patients followed at a tertiary care pain management center in Nova Scotia who have used medicinal marihuana for 1-5 years under the MMAR program. Patients completed a follow-up questionnaire containing demographic and dosing information, a series of 11-point numerical symptom relief rating scales, a side effect checklist, and a subjective measure of improvement in function. Doses of marihuana ranged from less than 1 to 5g per day via the smoked or oral route of administration. Ninety-three percent of patients reported moderate or greater pain relief. Side effects were reported by 76% of patients, the most common of which were increased appetite and a sense of well-being, weight gain, and slowed thoughts. Limitations of the study include self-selection bias, small size, and lack of a control group. The need for further study using controlled trials is discussed along with an overview of the MMAR program.
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In the five studies on nausea in chronic pain, each involved whole plant cannabis in inhaled or oral formats, and patients reported moderate relief.
“Each study involved whole plant cannabis in inhaled or oral formats, with patients reporting moderate relief.”
From Clinical Practice Guidelines for Cannabis and Cannabinoid-Based Medicines in the Management of Chronic Pain and Co-Occurring Conditions (2024) · cites this paper as [91]
The Results report smoked and oral use of medicinal marihuana, and 13 patients reported moderate-to-complete relief of nausea and vomiting. This case series supports that finding for its own patients, but it does not establish that all five studies used those formats or reported such relief. (LLM, conf=0.84)
Experimental — accuracy not yet measuredTwo other studies reported that the majority of participants reduced their routine pain medications by 60-70%; however, the extent to which opioid medications were specifically reduced was unclear.
“Two other studies reported that the majority of participants reduced their routine pain medications by 60–70%; however, the extent to which opioid medications were specifically reduced was unclear.87,99”
From Clinical Practice Guidelines for Cannabis and Cannabinoid-Based Medicines in the Management of Chronic Pain and Co-Occurring Conditions (2024) · cites this paper as [99]
The Results report that 15 patients (70%) decreased use of other medications, including NSAIDs, opioids, and antidepressants. The 70% describes the proportion of patients, not a 60–70% reduction in medication use. The paper does not quantify reductions in opioids specifically. (LLM, conf=0.88)
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- Authors
- Lynch, M. E., Young, J., & Clark, A. J.
- Affiliations
- Dalhousie University (CA)
- Corresponding author
- Lynch, Mary E.
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 2006-11
- Volume
- 32
- Issue
- 5
- Pages
- 497-501
- ISSN
- 0885-3924 (ISSN-L)
- OpenAlex
- W2095422124
- Cited by
- 34
- References
- 13
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 2 · 2022: 3 · 2021: 3 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 2 · 2014: 3 · 2013: 2 · 2012: 6
- FWCI
- 1.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
- Keywords
- medical cannabis, chronic pain, analgesia, cannabis side effects, symptom relief, functional improvement, long-term cannabis use, pain management
- MeSH terms
- Adult, Cannabis, Chronic Disease, Drug and Narcotic Control, Female, Follow-Up Studies, Humans, Male, Phytotherapy, Middle Aged, Nova Scotia, Pain, Treatment Outcome, Plant Preparations
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