The use of medicinal cannabis in Australia is on the rise, with a significant number of prescriptions being issued for chronic pain management. Medicinal cannabis consists of legally prescribed products derived from the cannabis plant, including ingredients like THC (tetrahydrocannabinol) and CBD (cannabidiol). These cannabinoids can be found in various formats such as oils, capsules, dried flowers for vaporization, sprays, and edibles like gummies.
Since the regulatory changes in 2016, more than 700,000 approvals for medicinal cannabis have been granted, although the actual number of patients is likely lower, as one patient can receive multiple approvals. Approximately half of these approvals are for chronic pain unrelated to cancer. In Australia, chronic pain affects about 20% of people aged 45 and older, significantly impacting their quality of life.
A 2021 review analyzed 32 randomized controlled trials involving nearly 5,200 participants with chronic pain. The findings indicated that while there was a slight improvement in pain and physical functioning compared to a placebo, the benefits were modest. Specifically, to see a 30% reduction in pain for one person, 24 individuals would need to be treated with medicinal cannabis. Minimal enhancements in sleep were also reported, but there were no consistent improvements in overall quality of life.
Many pain specialists question whether the evidence supports the widespread use of medicinal cannabis for pain management. The Faculty of Pain Medicine suggests that it should be limited to clinical trials due to the uncertainties surrounding its efficacy.
Australia’s Therapeutic Goods Administration (TGA) reflects these doubts, stating that there is limited evidence of clinically significant pain relief from medicinal cannabis for various pain conditions. The TGA recommends that medicinal cannabis be considered only after standard therapies have been tried and failed to provide sufficient relief. Pharmaceutical-grade products, such as nabiximols or THC and/or CBD extracts, are deemed safer than inhaled cannabis due to safety concerns.
Despite the clinical evidence, many patients report positive outcomes from medicinal cannabis. Individual responses can vary significantly, influenced by health conditions, personal beliefs, and other factors. While research provides a general understanding of outcomes, some individuals may find relief in pain, sleep disturbances, or overall well-being, particularly when other treatments have not been effective.
However, medicinal cannabis is not without risks. Common side effects include drowsiness, dizziness, dry mouth, nausea, and cognitive slowing. These side effects are generally more pronounced with high-potency THC products, which have become increasingly prevalent in the Australian market. A study projected that over 50% of approvals in 2025 would involve high-potency THC. Notably, more participants in clinical studies reported side effects than those who experienced benefits from medicinal cannabis.
Interactions with other medications pose additional risks, particularly with drugs that cause drowsiness, such as opioids, as well as mental health medications, blood thinners, and immunosuppressants. Even CBD, which is non-intoxicating, has been associated with serious drug interactions. Risks may be heightened when cannabis is prescribed by a doctor unfamiliar with the patient’s complete medical history, especially since many prescriptions occur through separate telehealth clinics, leading to fragmented care.
Another concern is the development of cannabis use disorder. A recent study found that approximately 25% of individuals using medical cannabis may develop this condition, with withdrawal symptoms like irritability and sleep disturbances occurring in regular users. Tolerance may also develop, requiring higher doses to achieve the same effect, further increasing the risk of disorder.
When compared to other chronic pain treatments, the effectiveness of medicinal cannabis is modest, and it is not recommended as a standalone treatment. Evidence supports alternative interventions, such as exercise, cognitive behavioral therapy, and self-management education, which may offer more effective results and lower risks.
The increasing use of medicinal cannabis for chronic pain reflects both a high prevalence of pain in the population and barriers to accessing effective treatments. While some patients may experience benefits, the current evidence indicates that these benefits are limited for most individuals and must be weighed against potential risks. Patients considering medicinal cannabis should consult their primary healthcare providers, particularly those familiar with their medical history, to determine the most suitable pain management approach.
German 
English 
Spanish 
Czech