The use of medicinal cannabis in Australia is on the rise, especially among those suffering from chronic pain. Medicinal cannabis includes legal cannabis products prescribed by health professionals, which can be the plant itself or extracts containing cannabinoids like THC (tetrahydrocannabinol) and CBD (cannabidiol). These products are available in various forms, including oils, capsules, dried flower for vaporizers, sprays, and edibles like gummies.
Since 2016, when regulatory changes improved access to medicinal cannabis, Australia has seen over 700,000 approvals for its use. Approximately half of these approvals are for chronic pain not related to cancer, affecting about one in five Australians aged 45 and over.
Current evidence regarding the effectiveness of medicinal cannabis for chronic pain is mixed. A 2021 review of 32 randomized controlled trials involving nearly 5,200 participants found that medicinal cannabis led to slight improvements in pain and physical functioning compared to a placebo. However, the review indicated that treating 24 patients with medicinal cannabis is necessary to achieve a 30% reduction in pain for just one individual. Additionally, while some participants reported better sleep, the studies did not show consistent improvements in overall quality of life.
Pain specialists express concerns about the sufficiency of evidence supporting medicinal cannabis for pain management. The Faculty of Pain Medicine recommends that its use should primarily occur within clinical trials due to the uncertainties surrounding its effectiveness.
The Therapeutic Goods Administration (TGA), Australia’s regulatory body, echoes these concerns. It states that evidence of clinically significant pain relief from medicinal cannabis is limited, and suggests that it should only be considered for patients who have not found relief with standard therapies. The TGA also emphasizes the preference for pharmaceutical-grade products over inhaled cannabis due to safety concerns.
Despite the research findings, many individuals report relief from medicinal cannabis, leading to varying responses based on personal health conditions and beliefs. This variability suggests that while some patients may benefit, the average results are modest. Moreover, medicinal cannabis is not recommended as a sole treatment for chronic pain.
The side effects of medicinal cannabis can include drowsiness, dizziness, dry mouth, nausea, and cognitive impairment. These effects can be more pronounced with higher-potency THC products, which have become increasingly common. Studies indicate that more individuals experience side effects than report benefits, and there is a risk of drug interactions, particularly with medications that cause sedation.
Concerns also exist regarding the potential for developing cannabis use disorder, with a 2024 study indicating that one in four medical cannabis users may develop this condition. Withdrawal symptoms can occur with regular use, and tolerance may develop, necessitating higher doses to achieve the same effects.
Alternative treatments for chronic pain, such as exercise, cognitive behavioral therapy, and pain management education, have proven effective and carry fewer risks than medicinal cannabis. However, accessibility and affordability of these treatments can vary, particularly in rural areas.
The growing trend of using medicinal cannabis highlights the high incidence of chronic pain in Australia and the gaps in access to effective treatment options. While some patients find relief, the evidence suggests that benefits are limited for most. For those considering medicinal cannabis, discussing options with a healthcare provider familiar with their medical history is crucial for effective pain management.
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