Physicians should counsel patients considering whether to start treatment for chronic noncancer pain about benefits and harms of cannabis or cannabinoids
By Elana Gotkine HealthDay Reporter
MONDAY, April 7, 2025 (HealthDay News) — In a best practice guideline issued by the American College of Physicians and published online April 4 in the Annals of Internal Medicine, advice is presented for clinicians regarding the benefits and harms of cannabis or cannabinoids for the management of chronic noncancer pain. The guideline was published to coincide with the Internal Medicine Meeting, the annual meeting of the American College of Physicians, held from April 3 to 5 in New Orleans.
Devan Kansagara, M.D., from the Oregon Health & Science University in Portland, and colleagues developed best practice advice to inform clinicians about the benefits and harms of cannabis or cannabinoids in the management of chronic noncancer pain.
According to the guideline, when patients are considering whether to start or continue to use cannabis or cannabinoids to manage their chronic noncancer pain, clinicians should counsel patients about the benefits and harms of such use. Young adult and adolescent patients, patients with current or past substance use disorder, patients with serious mental illness, and frail patients and those at risk for falling should be counseled that the harms of cannabis or cannabinoid use for chronic noncancer pain are likely to outweigh the benefits. In patients who are pregnant, breastfeeding, or actively trying to conceive, clinicians should advise against starting or continuing to use cannabis or cannabinoids to manage chronic noncancer pain. Patients should also be advised against use of inhaled cannabis to manage chronic noncancer pain.
“Clinicians are best positioned to provide evidence-based information about the benefits and harms most relevant to an individual patient’s needs and comorbidities to enable patients to make informed decisions about starting or continuing cannabis or cannabinoid use for chronic noncancer pain,” the authors write.
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