Session 08L2: Cannabinoids in pain management

Monday 30 November, 1115-1200H, Channel 3

The evidence around medicinal cannabis will be presented in this session by Prof Silviu Brill, Director of the Pain Institute Center and Center for Medicinal Cannabis Research and Treatment, Tel Aviv Medical Center, Israel.

He will discuss that cannabis has been used for medical purposes for thousands of years, and the medical-legal landscape surrounding its use has dramatically evolved over the past decade.

“Patients are turning to cannabis as a therapeutic option for several medical conditions,” says Prof Brill. “Given the surge in interest over the past decades, there exists a major gap in the literature with respect to understanding the products that are currently being consumed by patients.”

The current perspective highlights the lack of relevance within the current literature towards understanding the medical chemistry of the products being consumed. “The cannabis industry must rigorously invest into understanding what people are consuming from a chemical composition standpoint and what compounds in addition to THC and CBD may be producing physiologic/therapeutic effects from plant-based extracts. Longer-term monitoring for functional outcomes is needed,” explains Prof Brill.

The increased use of medical cannabis for pain has created a need for comprehensive risk-benefit discussions that take into account cannabis’ benefits and possible side effects. “As cannabis use dramatically increases in the context of medical and recreational cannabis policies, additional research to support or refute the current evidence base is essential to attempt to answer the questions that so many healthcare professionals and patients are asking.”

He will discuss that the endocannabinoid system is undoubtedly a new and exciting pharmaceutical target for chronic pain management, but the transition from preclinical to clinical studies has so far proved difficult. He concludes: “While it is reasonable to consider cannabinoids for otherwise unresponsive pain, care should be taken in frail clinical populations. As this has become a socioeconomic and political issue where agendas often take precedence over due diligence, there is a pressing need for unbiased empirical data and high-quality evidence to better inform prescribers and patients.”

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