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The Effect of Medicinal Cannabis on Pain and Quality-of-Life Outcomes in Chronic Pain: A Prospective Open-label Study
Abstract
Objectives: The objective of this prospective, open-label study was to determine the long-term effect of medicinal cannabis treatment on pain and functional outcomes in participants with treatment-resistant chronic pain. Patients and Methods: The primary outcome was the change in the pain symptom score on the S-TOPS (Treatment Outcomes in Pain Survey—Short Form) questionnaire at the 6-month follow-up in an intent-to-treat population. Secondary outcomes included the change in S-TOPS physical, social, and emotional disability scales, the pain severity, and pain interference on the Brief Pain Inventory, sleep problems, and the change in opioid consumption. Results: A total of 274 participants were approved for treatment; complete baseline data were available for 206 (intent-to-treat), and complete follow-up data for 176 participants. At follow-up, the pain symptom score improved from median 83.3 (95% confidence interval [CI], 79.2-87.5) to 75.0 (95% CI, 70.8-79.2) ( P <0.001). The pain severity score (7.50 [95% CI, 6.75-7.75] to 6.25 [95% CI, 5.75-6.75]) and the pain interference score (8.14 [95% CI, 7.28-8.43] to 6.71 [95% CI, 6.14-7.14]) improved (both P <0.001), together with most social and emotional disability scores. Opioid consumption at follow-up decreased by 44% ( P <0.001). Serious adverse effects led to treatment discontinuation in 2 participants. Discussion: The treatment of chronic pain with medicinal cannabis in this open-label, prospective cohort resulted in improved pain and functional outcomes, and a significant reduction in opioid use. Results suggest long-term benefit of cannabis treatment in this group of patients, but the study’s noncontrolled nature should be considered when extrapolating the results.
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“Opioid sparing, or the reduction of opioid use, resulting from the use of CBM for pain management was the primary outcome in one study86 and a secondary outcome in six studies.69,73,81,84,87,91”
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 [73]
In the citing paper
“Three studies found positive associations between medical cannabis use and opioid sparing.69,73,102”
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 [73]
In the citing paper
“Two studies found 44-64% reductions in self-reported opioid consumption in cohorts of patients with chronic pain who were using cannabis (Boehnke et al, 2016;Haroutounian et al, 2016).”
From Opioid-Sparing Effect of Cannabinoids: A Systematic Review and Meta-Analysis (2017) · cites this paper as Haroutounian et al, 2016
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Metadata
- Authors
- Haroutounian, S., Ratz, Y., Ginosar, Y., Furmanov, K., Saifi, F., Meidan, R., & Davidson, E.
- Affiliations
- Washington University in St. Louis (US)
- Pain Relief Unit
- Hadassah Medical Center (IL)
- Hebrew University of Jerusalem (IL)
- Corresponding author
- Haroutounian, Simon
- Ratz, Yael
- Saifi, Fayez
- Meidan, Ronit
- Davidson, Elyad
- Venue
- The Clinical Journal of Pain
- Published
- 2016-12
- Volume
- 32
- Issue
- 12
- Pages
- 1036-1043
- ISSN
- 0749-8047 (ISSN-L)
- OpenAlex
- W2281864230
- Cited by
- 234
- References
- 69
- Citations by year
- 2026: 6 · 2025: 16 · 2024: 21 · 2023: 20 · 2022: 29 · 2021: 34 · 2020: 36 · 2019: 22 · 2018: 29 · 2017: 19 · 2016: 2
- FWCI
- 19.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Keywords
- medical cannabis, chronic pain, treatment-resistant pain, quality of life, disability, pain intensity, pain interference, opioid consumption, sleep disorders, long-term outcomes, adverse effects
- MeSH terms
- Analgesics, Disability Evaluation, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Pain Measurement, Prospective Studies, Surveys and Questionnaires, Sleep, Treatment Outcome, Chronic Pain, Pain Management, Medical Marijuana
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