The Effects of Cannabis Among Adults With Chronic Pain and an Overview of General Harms: A Systematic Review

Nugent, Shannon M.; Morasco, Benjamin J.; O'Neil, Maya E.; Freeman, Michele; Low, Allison; Kondo, Karli; Elven, Camille; Zakher, Bernadette; Motu'apuaka, Makalapua; Paynter, Robin; Kansagara, Devan

doi:10.7326/m17-0155

Cited by 301Cannabis and Cannabinoid ResearchPain Management and Opioid UsePain Mechanisms and Treatments

The Effects of Cannabis Among Adults With Chronic Pain and an Overview of General Harms: A Systematic Review

Nugent, Shannon M., Morasco, Benjamin J., O'Neil, Maya E., Freeman, Michele, Low, Allison, Kondo, Karli, Elven, Camille, Zakher, Bernadette +3 more·2017·Annals of Internal Medicine

DOI 10.7326/m17-0155

Open this paper in CoChat — free account

Abstract

BACKGROUND: Cannabis is increasingly available for the treatment of chronic pain, yet its efficacy remains uncertain. PURPOSE: To review the benefits of plant-based cannabis preparations for treating chronic pain in adults and the harms of cannabis use in chronic pain and general adult populations. DATA SOURCES: MEDLINE, Cochrane Database of Systematic Reviews, and several other sources from database inception to March 2017. STUDY SELECTION: Intervention trials and observational studies, published in English, involving adults using plant-based cannabis preparations that reported pain, quality of life, or adverse effect outcomes. DATA EXTRACTION: Two investigators independently abstracted study characteristics and assessed study quality, and the investigator group graded the overall strength of evidence using standard criteria. DATA SYNTHESIS: From 27 chronic pain trials, there is low-strength evidence that cannabis alleviates neuropathic pain but insufficient evidence in other pain populations. According to 11 systematic reviews and 32 primary studies, harms in general population studies include increased risk for motor vehicle accidents, psychotic symptoms, and short-term cognitive impairment. Although adverse pulmonary effects were not seen in younger populations, evidence on most other long-term physical harms, in heavy or long-term cannabis users, or in older populations is insufficient. LIMITATION: Few methodologically rigorous trials; the cannabis formulations studied may not reflect commercially available products; and limited applicability to older, chronically ill populations and patients who use cannabis heavily. CONCLUSION: Limited evidence suggests that cannabis may alleviate neuropathic pain in some patients, but insufficient evidence exists for other types of chronic pain. Among general populations, limited evidence suggests that cannabis is associated with an increased risk for adverse mental health effects. PRIMARY FUNDING SOURCE: U.S. Department of Veterans Affairs. (PROSPERO: CRD42016033623).

Integrity signals

Registry

Crossref · 10.7326/m17-0155

Cites

86 of 86 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

There is insufficient evidence for cannabinoids for other types of chronic pain.
“Cannabinoids may alleviate neuropathic pain in some patients [82], but there is insufficient evidence for other types of chronic pain [83, 84].”
From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [84]

Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139 · see citing works
CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016
Dowell, D., Haegerich, T. M., & Chou, R. (2016) · JAMA · doi:10.1001/jama.2016.1464 · Cited by 5,161 · see citing works
Development of AMSTAR: A measurement tool to assess the methodological quality of systematic reviews
Shea, B. J., Grimshaw, J. M., Wells, G. A., Boers, M., Andersson, N., Hamel, C., Porter, A. C., Tugwell, P., Moher, D., & Bouter, L. M. (2007) · BMC Medical Research Methodology · doi:10.1186/1471-2288-7-10 · Cited by 4,374 · see citing works
CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016
Dowell, D., Haegerich, T. M., & Chou, R. (2016) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr6501e1 · Cited by 2,697 · see citing works
Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review.
Moore, T. H., Zammit, S., Lingford-Hughes, A., Barnes, T. R., Jones, P. B., Burke, M., & Lewis, G. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61162-3 · Cited by 2,224 · see citing works
Cannabinoids for Medical Use: A Systematic Review and Meta-analysis
Whiting, P. F., Wolff, R. F., Deshpande, S., Di Nisio, M., Duffy, S., Hernandez, A. V., Keurentjes, J. C., Lang, S., Misso, K., Ryder, S., et al. (2015) · JAMA · doi:10.1001/jama.2015.6358 · Cited by 2,169 · see citing works
Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial
Zajicek, J., Fox, P., Sanders, H., Wright, D., Vickery, J., Nunn, A., & Thompson, A. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14738-1 · Cited by 827 · see citing works
Triggering Myocardial Infarction by Marijuana
Mittleman, M. A., Lewis, R. A., Maclure, M., Sherwood, J. B., & Muller, J. E. (2001) · Circulation · doi:10.1161/01.cir.103.23.2805 · Cited by 769 · see citing works
Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis
Rog, D. J., Nurmikko, T. J., Friede, T., & Young, C. A. (2005) · Neurology · doi:10.1212/01.wnl.0000176753.45410.8b · Cited by 679 · see citing works
Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety, and Tolerability of THC:CBD Extract and THC Extract in Patients with Intractable Cancer-Related Pain
Johnson, J. R., Burnell-Nugent, M., Lossignol, D., Ganae-Motan, E. D., Potts, R., & Fallon, M. T. (2010) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2009.06.008 · Cited by 622 · see citing works
Cannabis in painful HIV-associated sensory neuropathy: A randomized placebo-controlled trial
Abrams, D. I., Jay, C. A., Shade, S. B., Vizoso, H., Reda, H., Press, S., Kelly, M. E., Rowbotham, M. C., & Petersen, K. L. (2007) · Neurology · doi:10.1212/01.wnl.0000253187.66183.9c · Cited by 598 · see citing works
High-potency cannabis and the risk of psychosis
Di Forti, M., Morgan, C., Dazzan, P., Pariante, C., Mondelli, V., Marques, T. R., Handley, R., Luzi, S., Russo, M., Paparelli, A., et al. (2009) · British Journal of Psychiatry · doi:10.1192/bjp.bp.109.064220 · Cited by 567 · see citing works
A LIKELIHOOD APPROACH TO META-ANALYSIS WITH RANDOM EFFECTS
Hardy, R., & Thompson, S. G. (1996) · Statistics in Medicine · doi:10.1002/(sici)1097-0258(19960330)15:6 · Cited by 517 · see citing works
Cannabidiol inhibits THC-elicited paranoid symptoms and hippocampal-dependent memory impairment
Englund, A., Morrison, P. D., Nottage, J. F., Hague, D., Kane, F., Bonaccorso, S., Stone, J. M., Reichenberg, A., Brenneisen, R., Holt, D., et al. (2012) · Journal of Psychopharmacology · doi:10.1177/0269881112460109 · Cited by 462 · see citing works
Smoked Medicinal Cannabis for Neuropathic Pain in HIV: A Randomized, Crossover Clinical Trial
Ellis, R. J., Toperoff, W., Vaida, F., van den Brande, G., Gonzales, J., Gouaux, B., Bentley, H., & Atkinson, J. H. (2009) · Neuropsychopharmacology · doi:10.1038/npp.2008.120 · Cited by 461 · see citing works
The Health Effects of Cannabis and Cannabinoids
Board on Population Health and Public Health Practice, Division, H. A. M., & National Academies of Sciences, E. (2017) · National Academies Press eBooks · doi:10.17226/24625 · Cited by 460 · see citing works
Smoked cannabis for chronic neuropathic pain: a randomized controlled trial
Ware, M. A., Wang, T., Shapiro, S., Robinson, A., Ducruet, T., Huynh, T., Gamsa, A., Bennett, G. J., & Collet, J.-P. (2010) · Canadian Medical Association Journal · doi:10.1503/cmaj.091414 · Cited by 450 · see citing works
A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms
Wade, D. T., Robson, P., House, H., Makela, P., & Aram, J. (2003) · Clinical Rehabilitation · doi:10.1191/0269215503cr581oa · Cited by 441 · see citing works
Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis
Blake, D. R., Robson, P., Ho, M., Jubb, R. W., & McCabe, C. S. (2006) · Rheumatology · doi:10.1093/rheumatology/kei183 · Cited by 433 · see citing works
Sativex successfully treats neuropathic pain characterised by allodynia: A randomised, double-blind, placebo-controlled clinical trial
Nurmikko, T. J., Serpell, M. G., Hoggart, B., Toomey, P. J., Morlion, B. J., & Haines, D. (2007) · Pain · doi:10.1016/j.pain.2007.08.028 · Cited by 431 · see citing works
Nabiximols for Opioid-Treated Cancer Patients With Poorly-Controlled Chronic Pain: A Randomized, Placebo-Controlled, Graded-Dose Trial
Portenoy, R. K., Ganae-Motan, E. D., Allende, S., Yanagihara, R., Shaiova, L., Weinstein, S., McQuade, R., Wright, S., & Fallon, M. T. (2012) · The Journal of Pain · doi:10.1016/j.jpain.2012.01.003 · Cited by 420 · see citing works
The analgesic properties of delta‐9‐tetrahydrocannabinol and codeine
Noyes, R., Brunk, S. F., Avery, D. H., & Canter, A. (1975) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt197518184 · Cited by 378 · see citing works
Cannabinoid Hyperemesis Syndrome: Diagnosis, Pathophysiology, and Treatment—a Systematic Review
Sorensen, C. J., DeSanto, K., Borgelt, L. M., Phillips, K. T., & Monte, A. A. (2016) · Journal of Medical Toxicology · doi:10.1007/s13181-016-0595-z · Cited by 374 · see citing works
Cannabinoid Dose and Label Accuracy in Edible Medical Cannabis Products
Vandrey, R. G., Raber, J. C., Raber, M. E., Douglass, B., Miller, C., & Bonn‐Miller, M. O. (2015) · JAMA · doi:10.1001/jama.2015.6613 · Cited by 368 · see citing works
Efficacy of two cannabis based medicinal extracts for relief of central neuropathic pain from brachial plexus avulsion: results of a randomised controlled trial
Berman, J. S., Symonds, C., & Birch, R. (2004) · Pain · doi:10.1016/j.pain.2004.09.013 · Cited by 362 · see citing works
Cannabis Use and Risk of Psychiatric Disorders
Blanco, C., Hasin, D. S., Wall, M. M., Flórez‐Salamanca, L., Hoertel, N., Wang, S., Kerridge, B. T., & Olfson, M. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2015.3229 · Cited by 337 · see citing works
A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain
Wilsey, B., Marcotte, T., Tsodikov, A., Millman, J., Bentley, H., Gouaux, B., & Fishman, S. (2008) · The Journal of Pain · doi:10.1016/j.jpain.2007.12.010 · Cited by 327 · see citing works
Cannabinoid–Opioid Interaction in Chronic Pain
Abrams, D. I., Couey, P., Shade, S. B., Kelly, M. E., & Benowitz, N. L. (2011) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.2011.188 · Cited by 319 · see citing works
The effects of cannabis intoxication on motor vehicle collision revisited and revised
Røgeberg, O. J., & Elvik, R. (2016) · Addiction · doi:10.1111/add.13347 · Cited by 317 · see citing works
Low-Dose Vaporized Cannabis Significantly Improves Neuropathic Pain
Wilsey, B., Marcotte, T., Deutsch, R., Gouaux, B., Sakai, S., & Donaghe, H. (2013) · The Journal of Pain · doi:10.1016/j.jpain.2012.10.009 · Cited by 314 · see citing works
Initial experiences with medicinal extracts of cannabis for chronic pain: results from 34 ‘N of 1’ studies
Notcutt, W., Price, M., Miller, R., Newport, S., Phillips, C., Simmons, S., & Sansom, C. (2004) · Anaesthesia · doi:10.1111/j.1365-2044.2004.03674.x · Cited by 305 · see citing works
Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study
Kuepper, R., van Os, J., Lieb, R., Wittchen, H.-U., Hofler, M., & Henquet, C. (2011) · BMJ · doi:10.1136/bmj.d738 · Cited by 304 · cited 1× · see citing works
“Psychosis 1 systematic review (64) 8 studies (65-71, 74) including patients without psychotic symptoms at baseline: 3 low ROB, 3 medium ROB, 2 high ROB History of cannabis use associated with increased risk for psychotic symptoms Low Consistent evidence from large observational studies and some evidence of increased r…”
Result
A double-blind, randomized, placebo-controlled, parallel-group study of THC/CBD oromucosal spray in combination with the existing treatment regimen, in the relief of central neuropathic pain in patients with multiple sclerosis
Langford, R. M., Mares, J., Novotna, A., Vachova, M., Novakova, I., Notcutt, W., & Ratcliffe, S. (2013) · Journal of Neurology · doi:10.1007/s00415-012-6739-4 · Cited by 298 · see citing works
Residual effects of cannabis use on neurocognitive performance after prolonged abstinence: A meta-analysis.
Schreiner, A. M., & Dunn, M. E. (2012) · Experimental and Clinical Psychopharmacology · doi:10.1037/a0029117 · Cited by 289 · see citing works
A double-blind, randomized, placebo-controlled, parallel-group study of Sativex, in subjects with symptoms of spasticity due to multiple sclerosis
Collin, C., Ehler, E., Waberzinek, G., Alsindi, Z., Davies, P., Powell, K., Notcutt, W., O'Leary, C., Ratcliffe, S., Nováková, I., et al. (2010) · Neurological Research · doi:10.1179/016164109x12590518685660 · Cited by 283 · see citing works
Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users
Bonn-Miller, M. O., Boden, M. T., Bucossi, M. M., & Babson, K. A. (2014) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2013.821477 · Cited by 281 · see citing works
MUltiple Sclerosis and Extract of Cannabis: results of the MUSEC trial
Zajicek, J., Hobart, J. C., Slade, A. L., Barnes, D., & Mattison, P. (2012) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2012-302468 · Cited by 277 · see citing works
Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy
Wallace, M. S., Marcotte, T. D., Umlauf, A., Gouaux, B., & Atkinson, J. H. (2015) · The Journal of Pain · doi:10.1016/j.jpain.2015.03.008 · Cited by 276 · see citing works
Substance Use Disorders in a Primary Care Sample Receiving Daily Opioid Therapy
Fleming, M. F., Balousek, S. L., Klessig, C. L., Mundt, M. P., & Brown, D. D. (2007) · The Journal of Pain · doi:10.1016/j.jpain.2007.02.432 · Cited by 274 · see citing works
A Double-Blind, Placebo-Controlled, Crossover Pilot Trial With Extension Using an Oral Mucosal Cannabinoid Extract for Treatment of Chemotherapy-Induced Neuropathic Pain
Lynch, M. E., Cesar-Rittenberg, P., & Hohmann, A. G. (2014) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2013.02.018 · Cited by 266 · see citing works
Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS)
Ware, M. A., Wang, T., Shapiro, S., Collet, J., Boulanger, A., Esdaile, J. M., GORDON, A. S., Lynch, M. E., Moulin, D. E., & O’Connell, C. M. (2015) · Journal of Pain · doi:10.1016/j.jpain.2015.07.014 · Cited by 249 · see citing works
Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial
Corey-Bloom, J., Wolfson, T., Gamst, A., Jin, S., Marcotte, T. D., Bentley, H., & Gouaux, B. (2012) · Canadian Medical Association Journal · doi:10.1503/cmaj.110837 · Cited by 235 · see citing works
The Effect of Medicinal Cannabis on Pain and Quality-of-Life Outcomes in Chronic Pain: A Prospective Open-label Study
Haroutounian, S., Ratz, Y., Ginosar, Y., Furmanov, K., Saifi, F., Meidan, R., & Davidson, E. (2016) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000364 · Cited by 234 · see citing works
Association Between Marijuana Exposure and Pulmonary Function Over 20 Years
Pletcher, M. J., Vittinghoff, E., Kalhan, R., Richman, J., Safford, M. M., Sidney, S. S., Lin, F., & Kertesz, S. G. (2012) · JAMA · doi:10.1001/jama.2011.1961 · Cited by 230 · see citing works
Cannabis use and mania symptoms: A systematic review and meta-analysis
Gibbs, M., Winsper, C., Marwaha, S., Gilbert, E., Broome, M. R., & Singh, S. P. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.09.016 · Cited by 216 · see citing works
A literature review and meta-analyses of cannabis use and suicidality
Borges, G., Bagge, C. L., & Orozco, R. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.02.007 · Cited by 214 · see citing works
Cannabis Use Provides Symptom Relief in Patients with Inflammatory Bowel Disease but Is Associated with Worse Disease Prognosis in Patients with Crohnʼs Disease
Storr, M., Devlin, S. M., Kaplan, G. G., Panaccione, R., & Andrews, C. N. (2014) · Inflammatory Bowel Diseases · doi:10.1097/01.mib.0000440982.79036.d6 · Cited by 207 · see citing works
A double‐blind, randomized, placebo‐controlled, parallel group study of <scp>THC</scp>/<scp>CBD</scp> spray in peripheral neuropathic pain treatment
Serpell, M., Ratcliffe, S., Hovorka, J., Schofield, M., Taylor, L., Lauder, H., & Ehler, E. (2014) · European Journal of Pain · doi:10.1002/j.1532-2149.2013.00445.x · Cited by 197 · see citing works
Randomized Placebo-Controlled Double-Blind Clinical Trial of Cannabis-Based Medicinal Product (Sativex) in Painful Diabetic Neuropathy
Selvarajah, D., Gandhi, R. A., Emery, C., & Tesfaye, S. H. (2009) · Diabetes Care · doi:10.2337/dc09-1029 · Cited by 190 · see citing works
Marijuana use and risk of lung cancer: a 40-year cohort study
Callaghan, R. C., Allebeck, P., & Sidorchuk, A. (2013) · Cancer Causes & Control · doi:10.1007/s10552-013-0259-0 · Cited by 189 · see citing works
Early Expression of Negative/Disorganized Symptoms Predicting Psychotic Experiences and Subsequent Clinical Psychosis: A 10-Year Study
Dominguez, M.-D.-G., Saka, M. C., Lieb, R., Wïttchen, H., & van Os, J. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.09060883 · Cited by 189 · see citing works
Effects of cannabis on lung function: a population-based cohort study
Hancox, R. J., Poulton, R., Ely, M., Welch, D., Taylor, D. R., McLachlan, C. R., Greene, J., Moffitt, T. E., Caspi, A., & Sears, M. R. (2009) · European Respiratory Journal · doi:10.1183/09031936.00065009 · Cited by 177 · see citing works
Cannabis smoking and lung cancer risk: Pooled analysis in the I nternational L ung C ancer C onsortium
Zhang, L. R., Morgenstern, H., Greenland, S., Chang, S., Lazarus, P. J., Teare, M. D., Woll, P. J., Orlow, I., Cox, B., Brhane, Y., et al. (2014) · International Journal of Cancer · doi:10.1002/ijc.29036 · Cited by 164 · see citing works
Characteristics of adults seeking medical marijuana certification
Ilgen, M. A., Bohnert, K. M., Kleinberg, F., Jannausch, M. L., Bohnert, A. M., Walton, M. A., & Blow, F. C. (2013) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2013.04.019 · Cited by 139 · see citing works
Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis
Gurney, J., Shaw, C., Stanley, J., Signal, V., & Sarfati, D. (2015) · BMC Cancer · doi:10.1186/s12885-015-1905-6 · Cited by 137 · cited 2× · see citing works
“Testicular cancer Meta-analysis (60) of 3 high-ROB case–control studies; combined N = 719 Increased cancer risk for weekly users compared with never-users seen with nonseminoma cancer but not seminoma cancer (OR, 1.”
Background
Cannabis Use in Patients with Fibromyalgia: Effect on Symptoms Relief and Health-Related Quality of Life
Fiz, J., Durán, M., Capellà, D., Abelló, J. C., & Farré, M. (2011) · PLoS ONE · doi:10.1371/journal.pone.0018440 · Cited by 132 · see citing works
Weighing the Evidence: A Systematic Review on Long-Term Neurocognitive Effects of Cannabis Use in Abstinent Adolescents and Adults
Ganzer, F., Bröning, S., Kraft, S., Sack, P., & Thomasius, R. (2016) · Neuropsychology Review · doi:10.1007/s11065-016-9316-2 · Cited by 127 · see citing works
Successfully treated invasive pulmonary aspergillosis associated with smoking marijuana in a renal transplant recipient
Marks, W. H., Florence, L., Lieberman, J., Chapman, P., Howard, D., Roberts, P., & Perkinson, D. (1996) · Transplantation · doi:10.1097/00007890-199606270-00018 · Cited by 125 · see citing works
Experience of adjunctive cannabis use for chronic non-cancer pain: Findings from the Pain and Opioids IN Treatment (POINT) study
Degenhardt, L. J., Lintzeris, N., Campbell, G., Bruno, R., Cohen, M. L., Farrell, M., & Hall, W. (2014) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2014.11.031 · Cited by 117 · see citing works
A cluster of tuberculosis associated with use of a marijuana water pipe.
Munckhof, W., Konstantinos, A., Wamsley, M., Mortlock, M., & Gilpin, C. M. (2003) · PubMed · Cited by 112 · see citing works
The Cannabis Hyperemesis Syndrome Characterized by Persistent Nausea and Vomiting, Abdominal Pain, and Compulsive Bathing Associated with Chronic Marijuana Use: A Report of Eight Cases in the United States
Soriano-Co, M., Batke, M., & Cappell, M. S. (2010) · Digestive Diseases and Sciences · doi:10.1007/s10620-010-1131-7 · Cited by 102 · see citing works
Marijuana use and long-term mortality among survivors of acute myocardial infarction
Frost, L. E., Mostofsky, E., Rosenbloom, J. I., Mukamal, K. J., & Mittleman, M. A. (2012) · American Heart Journal · doi:10.1016/j.ahj.2012.11.007 · Cited by 100 · see citing works
An Exploratory Human Laboratory Experiment Evaluating Vaporized Cannabis in the Treatment of Neuropathic Pain From Spinal Cord Injury and Disease
Wilsey, B. L., Marcotte, T. D., Deutsch, R., Zhao, H. H., Prasad, H., & Phan, A. T. (2016) · Journal of Pain · doi:10.1016/j.jpain.2016.05.010 · Cited by 100 · see citing works
The effects of marijuana on human physical aggression.
Myerscough, R. P., & Taylor, S. P. (1985) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.49.6.1541 · Cited by 93 · see citing works
Tetrahydrocannabinol Does Not Reduce Pain in Patients With Chronic Abdominal Pain in a Phase 2 Placebo-controlled Study
de Vries, M., van Rijckevorsel, D. C., Vissers, K. C. P., Wilder‐Smith, O. H. G., & van Goor, H. (2016) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2016.09.147 · Cited by 93 · see citing works
Medicinal Use of Marijuana — Polling Results
Adler, J. N., & Colbert, J. A. (2013) · New England Journal of Medicine · doi:10.1056/nejmclde1305159 · Cited by 92 · see citing works
Effects on Spasticity and Neuropathic Pain of an Oral Formulation of Δ9-tetrahydrocannabinol in Patients With Progressive Multiple Sclerosis
van Amerongen, G., Kanhai, K., Baakman, A. C., Heuberger, J., Klaassen, E., Beumer, T. L., Strijers, R. L. M., Killestein, J., van Gerven, J., Cohen, A., et al. (2018) · Clinical Therapeutics · doi:10.1016/j.clinthera.2017.01.016 · Cited by 86 · see citing works
Pulmonary Aspergillosis, Inhalation of Contaminated Marijuana Smoke, Chronic Granulomatous Disease
Chusid, M. J., Gelfand, J. A., NUTTER, C., & Fauci, A. S. (1975) · Annals of Internal Medicine · doi:10.7326/0003-4819-82-5-682 · Cited by 84 · see citing works
Invasive Pulmonary Aspergillosis Associated With Marijuana Use in a Man With Colorectal Cancer
Cescon, D. W., Page, A. V., Richardson, S. E., Moore, M. J., Boerner, S. L., & Gold, W. L. (2008) · Journal of Clinical Oncology · doi:10.1200/jco.2007.15.2777 · Cited by 81 · see citing works
Prevalence of medical marijuana use in C alifornia, 2012
Ryan‐Ibarra, S., Induni, M., & Ewing, D. (2014) · Drug and Alcohol Review · doi:10.1111/dar.12207 · Cited by 74 · see citing works
Acute cannabis use causes increased psychotomimetic experiences in individuals prone to psychosis
Mason, O. J., Morgan, C. J. A., Dhiman, S. K., Patel, A., Parti, N., Patel, A., & Curran, H. V. (2008) · Psychological Medicine · doi:10.1017/s0033291708004741 · Cited by 71 · see citing works
Association between marijuana use and transitional cell carcinoma
Chacko, J. A., Heiner, J. G., Siu, W., Macy, M., & Terris, M. K. (2006) · Urology · doi:10.1016/j.urology.2005.07.005 · Cited by 71 · see citing works
The Prevalence and Significance of Cannabis Use in Patients Prescribed Chronic Opioid Therapy: A Review of the Extant Literature
Reisfield, G. M., Wasan, A. D., & Jamison, R. N. (2009) · Pain Medicine · doi:10.1111/j.1526-4637.2009.00726.x · Cited by 67 · see citing works
Linking substance use with symptoms of subclinical psychosis in a community cohort over 30 years
Rössler, W., Hengartner, M. P., Angst, J., & Ajdacic‐Gross, V. (2012) · Addiction · doi:10.1111/j.1360-0443.2011.03760.x · Cited by 67 · see citing works
Tuberculosis Outbreak in Marijuana Users, Seattle, Washington, 2004
Oeltmann, J. E., Oren, E., Haddad, M. B., Lake, L. K., Harrington, T. A., Ijaz, K., & Narita, M. (2006) · Emerging infectious diseases · doi:10.3201/eid1207.051436 · Cited by 59 · see citing works
Head and neck cancer among marijuana users: A meta-analysis of matched case–control studies
de Carvalho, M. F. F., Dourado, M. R., Fernandes, I. B., de Araújo, C. T. P., Mesquita, A. T. M., & Ramos‐Jorge, M. L. (2015) · Archives of Oral Biology · doi:10.1016/j.archoralbio.2015.09.009 · Cited by 39 · see citing works
Evidence That Transition from Health to Psychotic Disorder Can Be Traced to Semi-Ubiquitous Environmental Effects Operating against Background Genetic Risk
van Nierop, M. M., Janssens, M., Genetic Risk OUtcome of Psychosis (GROUP) Investigators, Bruggeman, R., Cahn, W., de Haan, L., Kahn, R. S., Meijer, C. J., Myin‐Germeys, I., van Os, J., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0076690 · Cited by 38 · see citing works
Acute Psychotropic Effects of Oral Cannabis Extract with a Defined Content of Δ9-Tetrahydrocannabinol (THC) in Healthy Volunteers
Kaufmann, R. M., Kraft, B., Frey, R., Winkler, D., Weiszenbichler, S., Bäcker, C., Kasper, S. F., & Kress, H. G. (2009) · Pharmacopsychiatry · doi:10.1055/s-0029-1237397 · Cited by 34 · see citing works
Concomitant cannabis abuse/dependence in patients treated with opioids for non‐cancer pain
Hefner, K. R., Sofuoglu, M., & Rosenheck, R. A. (2015) · American Journal on Addictions · doi:10.1111/ajad.12260 · Cited by 26 · see citing works
Characteristics of substance use disorder treatment patients using medical cannabis for pain
Ashrafioun, L., Bohnert, K. M., Jannausch, M. L., & Ilgen, M. A. (2014) · Addictive Behaviors · doi:10.1016/j.addbeh.2014.11.024 · Cited by 25 · see citing works
Cannabinoid Hyperemesis Syndrome
Woods, J. A., Wright, N. J. D., Gee, J., & Scobey, M. (2014) · American Journal of Therapeutics · doi:10.1097/mjt.0000000000000034 · Cited by 25 · see citing works
Cannabis use and violent behaviour: a psychiatric patients cohort study in Southern Italy
Carabellese, F., Candelli, C., Martinelli, D., Tegola, D. L., & Catanesi, R. (2013) · Rivista di psichiatria · doi:10.1708/1228.13614 · Cited by 22 · see citing works
Effects of Marijuana Smoking on Pulmonary Function and Respiratory Complications: A Systematic Review
Tetrault, J. M. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.3.221 · Cited by 4 · see citing works
Cannabinoid hyperemesis syndrome – case report
Vujasinović, M., Ivartnik, M., & Tretjak, M. (2011) · Slovenian Medical Journal · Cited by 3 · see citing works
A Prescription for Song
Pérez, M. T. (2011) · Journal of General Internal Medicine · doi:10.1007/s11606-011-1865-8 · Cited by 1 · see citing works
Med-Sci 2013 Poster Presenter Abstracts
(2013) · Journal of Addiction Medicine · doi:10.1097/adm.0b013e3182a3b16f · Cited by 1 · see citing works

Flagged first, then by citations

Sorted by citations

Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies
Stockings, E., Campbell, G., Hall, W. D., Nielsen, S., Zagic, D., Rahman, R., Murnion, B., Farrell, M., Weier, M., & Degenhardt, L. (2018) · Pain · doi:10.1097/j.pain.0000000000001293 · Cited by 460 · see citing works
The therapeutic effects of Cannabis and cannabinoids: An update from the National Academies of Sciences, Engineering and Medicine report
Abrams, D. I. (2018) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2018.01.003 · Cited by 296 · see citing works
Cannabinoid Delivery Systems for Pain and Inflammation Treatment
Bruni, N., Pepa, C. D., Oliaro‐Bosso, S., Pessione, E., Gastaldi, D., & Dosio, F. (2018) · Molecules · doi:10.3390/molecules23102478 · Cited by 305 · see citing works
Patient-reported use of medical cannabis for pain, anxiety, and depression symptoms: Systematic review and meta-analysis
Kosiba, J. D., Maisto, S. A., & Ditre, J. W. (2019) · Social Science & Medicine · doi:10.1016/j.socscimed.2019.06.005 · Cited by 238 · see citing works
Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study
Campbell, G., Hall, W., Peacock, A., Lintzeris, N., Bruno, R., Larance, B., Nielsen, S., Cohen, M. L., Chan, G., Mattick, R. P., et al. (2018) · The Lancet Public Health · doi:10.1016/s2468-2667(18)30110-5 · Cited by 232 · see citing works
Knowledge Mapping of Drug-Induced Liver Injury: A Scientometric Investigation (2010–2019)
Ke, L., Lu, C., Shen, R., Lu, T., Ma, B., & Hua, Y. (2020) · Frontiers in Pharmacology · doi:10.3389/fphar.2020.00842 · Cited by 206 · see citing works
European Pain Federation ( EFIC ) position paper on appropriate use of cannabis‐based medicines and medical cannabis for chronic pain management
Häuser, W., Finn, D. P., Kalso, E. A., Krcevski‐Škvarč, N., Kress, H. G., Morlion, B. J., Perrot, S., Schäfer, M., Wells, C., & Brill, S. (2018) · European Journal of Pain · doi:10.1002/ejp.1297 · Cited by 201 · see citing works
Benefits and harms of medical cannabis: a scoping review of systematic reviews
Pratt, M., Stevens, A., Thuku, M., Butler, C., Skidmore, B., Wieland, L. S., Clemons, M. J., Kanji, S., & Hutton, B. (2019) · Systematic Reviews · doi:10.1186/s13643-019-1243-x · Cited by 164 · see citing works
Prescription of Controlled Substances: Benefits and Risks
Preuss, C. V., Kalava, A., & King, K. C. (2019) · StatPearls · Cited by 156 · see citing works
Risks and Benefits of Marijuana Use
Keyhani, S., Steigerwald, S., Ishida, J. H., Vali, M., Cerdá, M., Hasin, D. S., Dollinger, C., Yoo, S. R., & Cohen, B. E. (2018) · Annals of Internal Medicine · doi:10.7326/m18-0810 · Cited by 152 · see citing works
Knowledge and attitudes of Australian general practitioners towards medicinal cannabis: a cross-sectional survey
Karanges, E. A., Suraev, A. S., Elias, N. V., Manocha, R., & McGregor, I. S. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-022101 · Cited by 151 · see citing works
Impact of co-administration of oxycodone and smoked cannabis on analgesia and abuse liability
Cooper, Z. D., Bedi, G., Ramesh, D., Balter, R. E., Comer, S. D., & Haney, M. (2018) · Neuropsychopharmacology · doi:10.1038/s41386-018-0011-2 · Cited by 145 · see citing works
Pills to Pot: Observational Analyses of Cannabis Substitution Among Medical Cannabis Users With Chronic Pain
Boehnke, K. F., Scott, J. R., Litinas, E., Sisley, S., Williams, D. A., & Clauw, D. J. (2019) · Journal of Pain · doi:10.1016/j.jpain.2019.01.010 · Cited by 138 · see citing works
Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits
Hoch, E., Volkow, N. D., Friemel, C. M., Lorenzetti, V., Freeman, T. P., & Hall, W. (2025) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-024-01880-2 · Cited by 139 · see citing works
The blind men and the elephant: Systematic review of systematic reviews of cannabis use related health harms
Campeny, E., López-Pelayo, H., Nutt, D., Blithikioti, C., Oliveras, C., Nuño, L., Maldonado, R., Florez, G., Arias, F., Fernández-Artamendi, S., et al. (2020) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2020.02.003 · Cited by 127 · see citing works
The pharmacokinetics, efficacy, and safety of a novel selective‐dose cannabis inhaler in patients with chronic pain: A randomized, double‐blinded, placebo‐controlled trial
Almog, S., Aharon‐Peretz, J., Vulfsons, S., Ogintz, M., Abalia, H., Lupo, T., Hayon, Y., & Eisenberg, E. (2020) · European Journal of Pain · doi:10.1002/ejp.1605 · Cited by 121 · see citing works
Multi-ancestry genome-wide association study of cannabis use disorder yields insight into disease biology and public health implications
Levey, D. F., Galimberti, M., Deak, J. D., Wendt, F. R., Bhattacharya, A., Koller, D., Harrington, K. M., Quaden, R. M., Johnson, E. C., Gupta, P., et al. (2023) · Nature Genetics · doi:10.1038/s41588-023-01563-z · Cited by 111 · see citing works
A National Survey of Marijuana Use Among US Adults With Medical Conditions, 2016-2017
Dai, H. D., & Richter, K. P. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.11936 · Cited by 115 · see citing works
Interaction between warfarin and cannabis
Damkier, P., Lassen, D., Christensen, M. M. H., Madsen, K. G., Hellfritzsch, M., & Pottegård, A. (2018) · Basic & Clinical Pharmacology & Toxicology · doi:10.1111/bcpt.13152 · Cited by 115 · see citing works
Medical Cannabis for Older Patients
Minerbi, A., Häuser, W., & Fitzcharles, M. (2018) · Drugs & Aging · doi:10.1007/s40266-018-0616-5 · Cited by 103 · see citing works
Cannabis Use Preferences and Decision-making Among a Cross-sectional Cohort of Medical Cannabis Patients with Chronic Pain
Boehnke, K. F., Scott, J. R., Litinas, E., Sisley, S., Clauw, D. J., Goesling, J., & Williams, D. A. (2019) · Journal of Pain · doi:10.1016/j.jpain.2019.05.009 · Cited by 101 · see citing works
Associations Between Marijuana Use and Cardiovascular Risk Factors and Outcomes: A Systematic Review
Ravi, D., Ghasemiesfe, M., Korenstein, D., Cascino, T., & Keyhani, S. (2018) · Annals of Internal Medicine · doi:10.7326/m17-1548 · Cited by 98 · see citing works
Medical cannabis treatment for chronic pain: Outcomes and prediction of response
Aviram, J., Pud, D., Gershoni, T., Schiff‐Keren, B., Ogintz, M., Vulfsons, S., Yashar, T., Adahan, H., Brill, S., Amital, H., et al. (2020) · European Journal of Pain · doi:10.1002/ejp.1675 · Cited by 98 · see citing works
The use of cannabis in response to the opioid crisis: A review of the literature
Vyas, M. B., LeBaron, V. T., & Gilson, A. M. (2017) · Nursing Outlook · doi:10.1016/j.outlook.2017.08.012 · Cited by 94 · see citing works
Efficacy, tolerability and safety of cannabis-based medicines for cancer pain
Häuser, W., Welsch, P., Klose, P., Radbruch, L., & Fitzcharles, M. (2019) · Der Schmerz · doi:10.1007/s00482-019-0373-3 · Cited by 94 · see citing works
Clinical uses of cannabis and cannabinoids in the United States
Levinsohn, E. A., & Hill, K. P. (2020) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2020.116717 · Cited by 92 · see citing works
Risks and Benefits of Cannabis and Cannabinoids in Psychiatry
Hill, K. P., Gold, M. S., Nemeroff, C. B., McDonald, W. M., Grzenda, A. L., Widge, A. S., Rodríguez, C. I., Kraguljac, N. V., Krystal, J. H., & Carpenter, L. L. (2021) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2021.21030320 · Cited by 91 · see citing works
Association of Cannabinoid Administration With Experimental Pain in Healthy Adults
Víta, M., Moskal, D., Maisto, S. A., & Ansell, E. B. (2018) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.2503 · Cited by 86 · see citing works
Pain management in hidradenitis suppurativa and a proposed treatment algorithm
Savage, K. T., Singh, V., Patel, Z. S., Yannuzzi, C. A., McKenzie-Brown, A. M., Lowes, M. A., & Orenstein, L. A. V. (2020) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2020.09.039 · Cited by 86 · see citing works
Long-term and serious harms of medical cannabis and cannabinoids for chronic pain: a systematic review of non-randomised studies
Zeraatkar, D., Cooper, M. A., Agarwal, A., Vernooij, R. W. M., Leung, G., Loniewski, K., Dookie, J., Ahmed, M. M., Hong, B. Y., Hong, C. J. H., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-054282 · Cited by 83 · see citing works
Clinical Practice Guidelines for Cannabis and Cannabinoid-Based Medicines in the Management of Chronic Pain and Co-Occurring Conditions
Bell, A. D., MacCallum, C., Margolese, S., Walsh, Z., Wright, P., Daeninck, P. J., Mandarino, E., Lacasse, G., Kaur Deol, J., de Freitas, L., et al. (2024) · Cannabis & Cannabinoid Research · doi:10.1089/can.2021.0156 · Cited by 78 · see citing works
Benefits and Harms of Plant-Based Cannabis for Posttraumatic Stress Disorder
O'Neil, M. E., Nugent, S. M., Morasco, B. J., Freeman, M., Low, A., Kondo, K. K., Zakher, B., Elven, C., Motu’apuaka, M. L., Paynter, R. A., et al. (2017) · Annals of Internal Medicine · doi:10.7326/m17-0477 · Cited by 76 · see citing works
Self-citation
Should Physicians Recommend Replacing Opioids With Cannabis?
Humphreys, K. N., & Saitz, R. (2019) · JAMA · doi:10.1001/jama.2019.0077 · Cited by 76 · see citing works
Cannabinoids, cannabis, and cannabis-based medicines for pain management: an overview of systematic reviews
Moore, A., Fisher, E., Finn, D. P., Finnerup, N. B., Gilron, I., Haroutounian, S., Krane, E. J., Rice, A. S. C., Rowbotham, M. C., Wallace, M. S., et al. (2020) · Pain · doi:10.1097/j.pain.0000000000001941 · Cited by 73 · see citing works
Cannabinoids: Current and Future Options to Treat Chronic and Chemotherapy-Induced Neuropathic Pain
Blanton, H. L., Brelsfoard, J., Deturk, N., Pruitt, K., Narasimhan, M., Morgan, D. J., & Guindon, J. (2019) · Drugs · doi:10.1007/s40265-019-01132-x · Cited by 70 · see citing works
Cannabis and pain: a scoping review
Pantoja‐Ruiz, C., Restrepo-Jiménez, P., Castañeda‐Cardona, C., Ferreirós, A., & Rosselli, D. (2021) · Brazilian Journal of Anesthesiology (English Edition) · doi:10.1016/j.bjane.2021.06.018 · Cited by 76 · see citing works
Impacts of medical and non-medical cannabis on the health of older adults: Findings from a scoping review of the literature
Wolfe, D. M., Corace, K., Butler, C., Rice, D. B., Skidmore, B., Patel, Y., Thayaparan, P., Michaud, A., Hamel, C., Smith, A., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0281826 · Cited by 70 · see citing works
Rational Urine Drug Monitoring in Patients Receiving Opioids for Chronic Pain: Consensus Recommendations
Argoff, C. E., Alford, D. P., Fudin, J., Adler, J. A., Bair, M. J., Dart, R. C., Gandolfi, R., McCarberg, B. H., Stanos, S. P., Gudin, J. A., et al. (2017) · Pain Medicine · doi:10.1093/pm/pnx285 · Cited by 68 · see citing works
Substitution of marijuana for opioids in a national survey of US adults
Ishida, J. H., Wong, P. O., Cohen, B. E., Vali, M., Steigerwald, S., & Keyhani, S. (2019) · PLoS ONE · doi:10.1371/journal.pone.0222577 · Cited by 67 · see citing works
Exploring the use of cannabis as a substitute for prescription drugs in a convenience sample
Kvamme, S. L., Pedersen, M. M., Thomsen, K. R., & Thylstrup, B. (2021) · Harm Reduction Journal · doi:10.1186/s12954-021-00520-5 · Cited by 62 · see citing works
Integrative Therapies in Cancer Care: An Update on the Guidelines
Gowin, K. L., Muminovic, M., Zick, S. M., Lee, R. T., Lacchetti, C., & Mehta, A. (2024) · American Society of Clinical Oncology Educational Book · doi:10.1200/edbk_431554 · Cited by 63 · see citing works
The Form and Content of Cannabis Products in the United States
Steigerwald, S., Wong, P. O., Khorasani, A., & Keyhani, S. (2018) · Journal of General Internal Medicine · doi:10.1007/s11606-018-4480-0 · Cited by 62 · see citing works
Cannabis for cancer – illusion or the tip of an iceberg: a review of the evidence for the use of Cannabis and synthetic cannabinoids in oncology
Turgeman, I., & Bar‐Sela, G. (2018) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2019.1561859 · Cited by 61 · see citing works
Joints for joints: cannabinoids in the treatment of rheumatoid arthritis
Lowin, T., Schneider, M., & Pongratz, G. (2019) · Current Opinion in Rheumatology · doi:10.1097/bor.0000000000000590 · Cited by 55 · see citing works
Patients’ and clinicians’ perspectives of co-use of cannabis and opioids for chronic non-cancer pain management in primary care
Cooke, A. C., Knight, K. R., & Miaskowski, C. A. (2018) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2018.09.002 · Cited by 54 · see citing works
Medical Cannabis for Older Patients—Treatment Protocol and Initial Results
Abuhasira, R., Ron, A., Sikorin, I., & Novack, V. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8111819 · Cited by 53 · see citing works
Association of Marijuana Use With Psychosocial and Quality of Life Outcomes Among Patients With Head and Neck Cancer
Zhang, H., Xie, M., Archibald, S. D., Jackson, B. S., & Gupta, M. K. (2018) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2018.0486 · Cited by 52 · see citing works
Understanding the evidence for medical cannabis and cannabis-based medicines for the treatment of chronic non-cancer pain
Campbell, G., Stockings, E., & Nielsen, S. (2019) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-018-0960-9 · Cited by 53 · see citing works
The nephrologistʼs guide to cannabis and cannabinoids
Rein, J. L. (2020) · Current Opinion in Nephrology & Hypertension · doi:10.1097/mnh.0000000000000590 · Cited by 52 · see citing works
State marijuana laws and opioid overdose mortality
Chihuri, S. T., & Li, G. (2019) · Injury Epidemiology · doi:10.1186/s40621-019-0213-z · Cited by 51 · see citing works
Cannabidiol in the Treatment of Epilepsy: A Focused Review of Evidence and Gaps
Silva, G. D., Guerra, F. B. D., Lelis, M. D. O., & Pinto, L. F. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.531939 · Cited by 50 · see citing works
A Review of Cannabis in Chronic Kidney Disease Symptom Management
Ho, C., Martinusen, D. J., & Lo, C. (2019) · Canadian Journal of Kidney Health and Disease · doi:10.1177/2054358119828391 · Cited by 50 · see citing works
A Mapping Literature Review of Medical Cannabis Clinical Outcomes and Quality of Evidence in Approved Conditions in the USA from 2016 to 2019
Jugl, S., Okpeku, A., Costales, B., Morris, E. J., Alipour‐Haris, G., Hincapie‐Castillo, J. M., Stetten, N. E., Sajdeya, R., Keshwani, S., Joseph, V. W., et al. (2021) · Medical Cannabis and Cannabinoids · doi:10.1159/000515069 · Cited by 49 · see citing works
Differences in Opinions About Marijuana Use and Prevalence of Use by State Legalization Status
Steigerwald, S., Cohen, B. E., Vali, M., Hasin, D. S., Cerdá, M., & Keyhani, S. (2019) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000593 · Cited by 48 · see citing works
THC and gabapentin interactions in a mouse neuropathic pain model
Atwal, N., Casey, S. L., Mitchell, V. A., & Vaughan, C. W. (2018) · Neuropharmacology · doi:10.1016/j.neuropharm.2018.10.006 · Cited by 47 · see citing works
Identification of a New Family of Prenylated Volatile Sulfur Compounds in Cannabis Revealed by Comprehensive Two-Dimensional Gas Chromatography
Oswald, I. W. H., Ojeda, M. A., Pobanz, R. J., Koby, K. A., Buchanan, A. J., Rosso, J. D., Guzmán, M., & Martin, T. J. (2021) · ACS Omega · doi:10.1021/acsomega.1c04196 · Cited by 49 · see citing works
High-Frequency Medical Cannabis Use Is Associated With Worse Pain Among Individuals With Chronic Pain
Boehnke, K. F., Scott, J. R., Litinas, E., Sisley, S., Williams, D. A., & Clauw, D. J. (2019) · Journal of Pain · doi:10.1016/j.jpain.2019.09.006 · Cited by 47 · see citing works
The Role of Cannabis in the Management of Inflammatory Bowel Disease: A Review of Clinical, Scientific, and Regulatory Information
Swaminath, A. C., Berlin, E. P., Cheifetz, A. S., Hoffenberg, E. J., Kinnucan, J. A. R., Wingate, L., Buchanan, S., Zmeter, N., & Rubin, D. T. (2018) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izy319 · Cited by 45 · see citing works
The effectiveness of self-directed medical cannabis treatment for pain
Li, X., Vigil, J. M., Stith, S. S., Brockelman, F., Keeling, K., & Hall, B. (2019) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2019.07.022 · Cited by 45 · see citing works
Trends in emergency department visits associated with cannabis use among older adults in California, 2005–2019
Han, B. H., Brennan, J. J., Orozco, M. A., Moore, A. A., & Castillo, E. M. (2023) · Journal of the American Geriatrics Society · doi:10.1111/jgs.18180 · Cited by 44 · see citing works
Medical cannabis for chronic pain: can it make a difference in pain management?
Maharajan, M. K., Yong, Y. J., Yip, H. Y., Woon, S. S., Yeap, K. M., Yap, K. Y., Yip, S. C., & Yap, K. X. (2019) · Journal of Anesthesia · doi:10.1007/s00540-019-02680-y · Cited by 45 · see citing works
Perspectives on Cannabis as a Substitute for Opioid Analgesics
Khan, S. P., Pickens, T. A., & Berlau, D. J. (2019) · Pain Management · doi:10.2217/pmt-2018-0051 · Cited by 43 · see citing works
MASCC guideline: cannabis for cancer-related pain and risk of harms and adverse events
To, J., Davis, M. P., Sbrana, A., Alderman, B., Hui, D., Mukhopadhyay, S., Bouleuc, C., Case, A. A., Amano, K., Crawford, G. B., et al. (2023) · Supportive Care in Cancer · doi:10.1007/s00520-023-07662-1 · Cited by 44 · see citing works
It is premature to expand access to medicinal cannabis in hopes of solving the US opioid crisis
Hall, W., West, R., Marsden, J., Humphreys, K. N., Neale, J., & Petry, N. M. (2018) · Addiction · doi:10.1111/add.14139 · Cited by 42 · see citing works
Clinician Knowledge, Attitudes, and Practice Regarding Cannabis: Results from a National Veterans Health Administration Survey
Kansagara, D. L., Morasco, B. J., Iacocca, M. O., Bair, M. J., Hooker, E. R., & Becker, W. C. (2019) · Pain Medicine · doi:10.1093/pm/pnz322 · Cited by 41 · see citing works
Self-citation
Is Cannabis being used as a substitute for non‐medical opioids by adults with problem substance use in the United States? A within‐person analysis
Gorfinkel, L., Stohl, M., Greenstein, E., Aharonovich, E., Olfson, M., & Hasin, D. S. (2020) · Addiction · doi:10.1111/add.15228 · Cited by 41 · see citing works
Medical cannabis: A forward vision for the clinician
Fitzcharles, M., & Eisenberg, E. (2018) · European Journal of Pain · doi:10.1002/ejp.1185 · Cited by 39 · see citing works
Patterns and correlates of medical cannabis use for pain among patients prescribed long-term opioid therapy
Nugent, S. M., Yarborough, B. J. H., Smith, N. X., Dobscha, S. K., Deyo, R. A., Green, C. A., & Morasco, B. J. (2017) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2017.11.001 · Cited by 38 · see citing works
Self-citation
Cancer-Related Neuropathic Pain
Davis, M. P. (2018) · Hematology/Oncology Clinics of North America · doi:10.1016/j.hoc.2018.01.005 · Cited by 37 · see citing works
Tuberculosis. Captain of all these men of death.
Rubin, S. A. (1995) · PubMed · Cited by 38 · see citing works
Histone methyltransferase G9a diminishes expression of cannabinoid CB1 receptors in primary sensory neurons in neuropathic pain
Luo, Y., Zhang, J., Chen, L., Chen, S.-R., Chen, H., Zhang, G.-F., & Pan, H. (2020) · Journal of Biological Chemistry · doi:10.1074/jbc.ra119.011053 · Cited by 37 · see citing works
Cancer Initiation, Progression and Resistance: Are Phytocannabinoids from Cannabis sativa L. Promising Compounds?
Nigro, E., Formato, M., Crescente, G., & Daniele, A. (2021) · Molecules · doi:10.3390/molecules26092668 · Cited by 53 · see citing works
Increasing risk of cannabis use disorder among U.S. veterans with chronic pain: 2005-2019
Mannes, Z. L., Malte, C. A., Olfson, M., Wall, M. M., Keyes, K. M., Martins, S. S., Cerdá, M., Gradus, J. L., Saxon, A. J., Keyhani, S., et al. (2023) · Pain · doi:10.1097/j.pain.0000000000002920 · Cited by 35 · see citing works
Cannabinoids and the Coronavirus
Hill, K. P. (2020) · Cannabis and Cannabinoid Research · doi:10.1089/can.2020.0035 · Cited by 34 · see citing works
Lack of Communication about Medical Marijuana Use between Doctors and Their Patients
Kondrad, E. C., Reed, A. J., Simpson, M., & Nease, D. E. (2018) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2018.05.170462 · Cited by 33 · see citing works
What does the ecological and epidemiological evidence indicate about the potential for cannabinoids to reduce opioid use and harms? A comprehensive review
Campbell, G., Hall, W., & Nielsen, S. (2018) · International Review of Psychiatry · doi:10.1080/09540261.2018.1509842 · Cited by 33 · see citing works
Cannabis Use in Older Adults: A Perspective
Solomon, H. V., Greenstein, A. P., & DeLisi, L. E. (2021) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000289 · Cited by 33 · see citing works
Cannabinoids for fibromyalgia pain: a critical review of recent studies (2015–2019)
Cameron, E. C., & Hemingway, S. L. (2020) · Journal of Cannabis Research · doi:10.1186/s42238-020-00024-2 · Cited by 36 · see citing works
The Role of the Cannabinoid System in Pain Control: Basic and Clinical Implications
Wolf, J., Urits, I., Orhurhu, V., Peck, J., Orhurhu, M. S., Giacomazzi, S., Smoots, D., Piermarini, C., Manchikanti, L., Kaye, A. D., et al. (2020) · Current Pain and Headache Reports · doi:10.1007/s11916-020-00873-9 · Cited by 31 · see citing works
Cannabis use among military veterans: A great deal to gain or lose?
Turna, J., & MacKillop, J. M. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.101958 · Cited by 32 · see citing works
Insomnia symptoms, cannabis protective behavioral strategies, and hazardous cannabis use among U.S. college students.
Wong, M. M.-H., The Protective Strategies Study Team, Craun, E. A., Bravo, A. J., & Pearson, M. R. (2019) · Experimental and Clinical Psychopharmacology · doi:10.1037/pha0000273 · Cited by 32 · see citing works
Priority Considerations for Medicinal Cannabis-Related Research
Bonn‐Miller, M. O., Pollack, C. V., Casarett, D., Dart, R. C., ElSohly, M. A., Good, L. I., Guzmán, M., Hanuš, L., Hill, K. P., Huestis, M. A., et al. (2019) · Cannabis and Cannabinoid Research · doi:10.1089/can.2019.0045 · Cited by 32 · see citing works
Cannabis use frequency, route of administration, and co-use with alcohol among older adults in Washington state
Subbaraman, M. S., & Kerr, W. C. (2021) · Journal of Cannabis Research · doi:10.1186/s42238-021-00071-3 · Cited by 31 · see citing works
Adverse events following cannabis for medical use in Tuscany: An analysis of the Italian Phytovigilance database
Crescioli, G., Lombardi, N., Bettiol, A., Menniti‐Ippolito, F., Cas, R. D., Parrilli, M., Lungo, M. D., Gallo, E. R., Mugelli, A., Maggini, V., et al. (2019) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.14140 · Cited by 30 · see citing works
The effectiveness of inhaled Cannabis flower for the treatment of agitation/irritability, anxiety, and common stress
Stith, S., Li, X., Diviant, J. P., Brockelman, F., Keeling, K., Hall, B., & Vigil, J. (2020) · Journal of Cannabis Research · doi:10.1186/s42238-020-00051-z · Cited by 28 · see citing works
Healthcare professionals' perspectives on the use of medicinal cannabis to manage chronic pain: A systematic search and narrative review
Cheng, K. Y. C., Harnett, J., Davis, S., Eassey, D., Law, S., & Smith, L. D. (2022) · Pain Practice · doi:10.1111/papr.13161 · Cited by 29 · see citing works
Benefit of Tetrahydrocannabinol versus Cannabidiol for Common Palliative Care Symptoms
Casarett, D., Beliveau, J., & Arbus, M. S. (2019) · Journal of Palliative Medicine · doi:10.1089/jpm.2018.0658 · Cited by 29 · see citing works
Management of headache and chronic pain in POTS
Cook, G. A., & Sandroni, P. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.06.004 · Cited by 28 · see citing works
Cannabis against chronic musculoskeletal pain: a scoping review on users and their perceptions
Furrer, D., Kröger, E., Marcotte, M., Jauvin, N., Bélanger, R. E., Ware, M. A., Foldes‐Busque, G., Aubin, M., Pluye, P., & Dionne, C. E. (2021) · Journal of Cannabis Research · doi:10.1186/s42238-021-00096-8 · Cited by 28 · see citing works
Cannabinoid Profiles in Medical Cannabis Users: Effects of Age, Gender, Symptoms, and Duration of Use
Kalaba, M., & Ware, M. A. (2021) · Cannabis and Cannabinoid Research · doi:10.1089/can.2020.0120 · Cited by 28 · see citing works
Effect of preoperative cannabis use on perioperative outcomes: a retrospective cohort study
Zhang, B. H., Saud, H., Sengupta, N., Chen, M., Bakshi, D., Richardson, L., Wang, L., & Shanthanna, H. (2021) · Regional Anesthesia & Pain Medicine · doi:10.1136/rapm-2021-102479 · Cited by 28 · see citing works
Topical Cannabinoids for Treating Chemotherapy-Induced Neuropathy: A Case Series
D’Andre, S. D., McAllister, S. D., Nagi, J., Giridhar, K. V., Ruiz-Macias, E., & Loprinzi, C. L. (2021) · Integrative Cancer Therapies · doi:10.1177/15347354211061739 · Cited by 27 · see citing works
Should Oncologists Recommend Cannabis?
Abrams, D. (2019) · Current Treatment Options in Oncology · doi:10.1007/s11864-019-0659-9 · Cited by 22 · see citing works
Societal Costs and Outcomes of Medical and Recreational Marijuana Policies in the United States: A Systematic Review
French, M. T., Zukerberg, J., Lewandowski, T. E., Piccolo, K. B., & Mortensen, K. (2022) · Medical Care Research and Review · doi:10.1177/10775587211067315 · Cited by 26 · see citing works
Panic Disorder: A Review of Treatment Options
Ziffra, M. (2021) · Annals of Clinical Psychiatry · doi:10.12788/acp.0014 · Cited by 26 · see citing works
SPME as a green sample-preparation technique for the monitoring of phytocannabinoids and endocannabinoids in complex matrices
Woźniczka, K., Konieczyński, P., Plenis, A., Bączek, T., & Roszkowska, A. (2023) · Journal of Pharmaceutical Analysis · doi:10.1016/j.jpha.2023.06.014 · Cited by 26 · see citing works
Cannabis for peripheral neuropathy: The good, the bad, and the unknown
Modesto‐Lowe, V., Bojka, R., & Alvarado, C. (2018) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.85a.17115 · Cited by 26 · see citing works
Medical and non‐medical cannabis use and risk of prescription opioid use disorder: Findings from propensity score matching
Liang, D., Wallace, M. S., & Shi, Y. (2019) · Drug and Alcohol Review · doi:10.1111/dar.12964 · Cited by 25 · see citing works
Ein Positionspapier zu medizinischem Cannabis und cannabisbasierten Medikamenten in der Schmerzmedizin
der Medizin“, A.-H.-K. D. D. S. „. I., Petzke, F. W., Karst, M., Gastmeier, K., Radbruch, L., Steffen, E., & Häuser, W. (2019) · Der Schmerz · doi:10.1007/s00482-019-00407-2 · Cited by 25 · see citing works
Efficacy and safety of paediatric medicinal cannabis use: A scoping review
Pawliuk, C., Chau, B., Rassekh, S. R., McKellar, T., & Siden, H. B. (2020) · Paediatrics & Child Health · doi:10.1093/pch/pxaa031 · Cited by 25 · see citing works

Review: Weak evidence of benefits of cannabis for chronic neuropathic pain; moderate to weak evidence of adverse effects
Murff, H. J. (2017) · Annals of Internal Medicine · doi:10.7326/acpjc-2017-167-12-062 · Cited by 6 · see citing works
Cannabis-based medicines for chronic neuropathic pain in adults
Ateş, G., Welsch, P., Klose, P., Phillips, T., Lambers, B., Häuser, W., & Radbruch, L. (2026) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012182.pub3 · Cited by 11 · see citing works
Systematic Review and Meta-analysis of Cannabis Treatment for Chronic Pain
Martín-Sánchez, E., Furukawa, T. A., Taylor, J., & Martín, J. L. R. (2009) · Pain Medicine · doi:10.1111/j.1526-4637.2009.00703.x · Cited by 227 · see citing works
Cannabis and pain: a scoping review
Pantoja‐Ruiz, C., Restrepo-Jiménez, P., Castañeda‐Cardona, C., Ferreirós, A., & Rosselli, D. (2021) · Brazilian Journal of Anesthesiology (English Edition) · doi:10.1016/j.bjane.2021.06.018 · Cited by 76 · see citing works
Cannabis for Chronic Pain: A Rapid Systematic Review of Randomized Control Trials
Longo, R., Oudshoorn, A., & Befus, D. (2021) · Pain Management Nursing · doi:10.1016/j.pmn.2020.11.006 · Cited by 39 · see citing works

Authors: Nugent, S. M., Morasco, B. J., O'Neil, M. E., Freeman, M., Low, A., Kondo, K., Elven, C., Zakher, B., Motu'apuaka, M., Paynter, R., & Kansagara, D.
Affiliations: Oregon Health & Science University (US)
From VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon.
ORCID: Nugent, Shannon M.
Morasco, Benjamin J.
O'Neil, Maya E.
Freeman, Michele
Low, Allison
Kondo, Karli
Paynter, Robin
Kansagara, Devan
Venue: Annals of Internal Medicine
Publisher: American College of Physicians
Published: 2017-09-05
Volume: 167
Issue: 5
Pages: 319-331
ISSN: 0003-4819 (ISSN-L)
1539-3704
DOI: 10.7326/m17-0155
OpenAlex: W2747833740
Cited by: 301
References: 86
Citations by year: 2026: 6 · 2025: 23 · 2024: 22 · 2023: 25 · 2022: 27 · 2021: 54 · 2020: 39 · 2019: 56 · 2018: 42 · 2017: 6
FWCI: 4.96
Type: journal article
Language: en
Open access: closed
Licence: www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations: Annals of Internal Medicine (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 › Physiology › Pain Mechanisms and Treatments
Keywords: cannabis, chronic pain, neuropathic pain, adverse effects, motor vehicle accidents, psychotic symptoms, cognitive impairment, pulmonary effects, quality of life
MeSH terms: Accidents, Traffic, Cancer Pain, Adult, Humans, Multiple Sclerosis, Neuralgia, Psychoses, Substance-Induced, Quality of Life, Chronic Pain, Medical Marijuana

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

The Effects of Cannabis Among Adults With Chronic Pain and an Overview of General Harms: A Systematic Review

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks