Cannabis-based medicines for cancer pain management

Nabiximols and tetrahydrocannabinol (THC) did not differ from placebo in reducing pain, sleep problems, and opioid maintenance and breakthrough dosages. There was no clinically relevant benefit of nabiximols for the number of participants who reported they were much or very much improved (number needed to treat for an additional beneficial outcome = 16; 95% confidence interval 6–100).

There was no difference between nabiximols and THC versus placebo with regard to the dropout rates due to adverse events and the frequency of psychiatric disorders as adverse events. There was clinically relevant harm by nabiximols and THC in the frequency of nervous system adverse events compared with placebo (number needed to treat for an additional harmful outcome = 9; 95% CI 6–20).

This review found that nabilone did not reduce pain associated with chemotherapy or radiochemotherapy in people with head and neck cancer or non-small cell lung cancer.

This review also found that synthetic THC analogue was superior to placebo and not superior to codeine in reducing moderate to severe cancer pain after cessation of previous analgesic treatment for 3 to 4.5 hours.