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Chronic Pain Blog

Explore thoughts, experiences, and evidence-informed perspectives on chronic pain, pain science, pain rehabilitation, self-management, and living well despite persistent pain.

medical cannabis for chronic pain?

7/8/2022

 
Updated September 3, 2026

Some people with chronic pain find medical cannabis or cannabinoid-based products helpful, particularly for short-term symptom relief. However, questions remain about how effective these products are for chronic pain over the longer term, as well as their potential risks and side effects.

Cannabis wasn't recommended by the Mayo Clinic when I attended its Pain Rehabilitation Center in 2018. The International Association for the Study of Pain (IASP) also does not currently endorse the general use of cannabis or cannabinoids for pain because it considers the available high-quality evidence insufficient. Importantly, IASP does not dismiss the experiences of people with pain who report benefit from these products.

What does the research show?
A systematic review and meta-analysis published in JAMA Network Open in 2022 examined 20 randomized clinical trials involving 1,459 people with clinical pain. The researchers found a substantial reduction in pain among people receiving placebo and didn't find a statistically significant difference between cannabinoid and placebo groups.

This doesn't mean cannabis or cannabinoids can never help anyone. It means that, in the clinical trials included in this analysis, the evidence did not demonstrate a clear pain-relieving advantage over placebo.
The findings also highlight an important issue in chronic pain treatment: expectations and the context surrounding a treatment can influence pain outcomes. This is one reason rigorous placebo-controlled research is important when evaluating treatments for chronic pain.

The Problem With Passive Treatment
Medication can be an important part of pain management for some people. But relying primarily on passive treatments can have a downside.

When relief depends largely on a medication, procedure, or someone else providing the treatment, it can create dependence—not only on the medication itself, but also on the healthcare provider who prescribes it. Over time, this can reinforce the belief that pain relief depends primarily on something being done for you, rather than on your own ability to manage pain.

This doesn't mean medication is inherently bad or that people should never use it. It means that medication works best as part of a broader approach that also helps people develop the knowledge, skills, confidence, and ability to manage pain themselves.

Research on chronic pain self-management has identified an important distinction between passive and active approaches. Passive strategies, such as medication and rest, are common, while active strategies, such as exercise and behavioral or cognitive approaches, can help build self-management skills and self-efficacy.

My Experience
I have found that I don't need medication or supplements to manage my chronic pain.

Of course, your experience may differ. Mine certainly did earlier in my pain journey.
My relief came from changing how I think about, feel about, and behave around pain through pain rehabilitation and self-management.

Instead of continually looking for something or someone to take my pain away, I learned skills that put more of the day-to-day management of my pain back in my own hands.

That shift from passive treatment to active self-management was an important part of my recovery.

It doesn't mean I believe everyone should stop taking medication or that medication has no place in chronic pain management. Different treatments work differently for different people, and decisions about cannabis, medications, or other treatments should be made with a qualified healthcare professional who understands your individual circumstances.

The goal is not to eliminate every treatment that might help. The goal is to make sure that treatment supports your ability to manage your life rather than becoming the only way you believe you can manage your pain.

The Bottom Line
Medical cannabis and cannabinoid-based products remain an active area of research.

Some people report meaningful benefits, but evidence for chronic pain remains mixed, and important questions remain about effectiveness, safety, appropriate products, dosing, and which people are most likely to benefit. IASP continues to call for more rigorous research into both potential benefits and harms.
Rather than viewing cannabis as either a miracle treatment or something that can never help, it makes more sense to look at the evidence, understand the potential benefits and risks, and consider it as one possible component of an individualized treatment plan.

For people living with chronic pain, self-management doesn't mean refusing medication or other treatments. It means developing the knowledge, skills, and confidence to play an active role in managing your pain and your life.

That was an important part of my own pain rehabilitation—and ultimately helped me change the way I lived with chronic pain.

Learn More
  • Cannabinoid Non-technical Summary 2021 — International Association for the Study of Pain — IASP's plain-language summary of its position on cannabis and cannabinoids for pain.
  • IASP Position Statement on the Use of Cannabinoids to Treat Pain — IASP's full position and explanation of the evidence.
  • Cannabis Is No Better Than a Placebo for Treating Pain — New Research — An accessible discussion of the 2022 systematic review and meta-analysis.
  • Cannabis for Chronic Pain: New Research Questions Its Effectiveness
  • International Review Finds a Lack of Evidence to Endorse Clinical Use of Medical Cannabis for Pain
  • Cannabidiol (CBD) Products for Pain: Ineffective, Expensive, and With Potential Harms
  • What You Need to Know About Products Containing Cannabis or Cannabis-Derived Compounds, Including CBD — FDA
  • Labeling Accuracy of Cannabidiol Extracts Sold Online
  • Beware of Supplements — My blog post.
  • We Have a Chronic Pain Problem, Not a Prescription Opioid Problem — My article.
  • The Power of the Placebo Effect
  • How to Move Patients from Passive Management to Active Self-Management — My article.
 
Learn more
  • Cannabis is no better than a placebo for treating pain – new research
  • Cannabinoid Non-technical Summary 2021 (International Association for the Study of Pain)
  • Cannabis for chronic pain: New research questions its effectiveness
  • International Review finds a lack of evidence to endorse clinical use of medical cannabis for pain
  • Cannabis For Smart Consumers: What The Industry Does Not Want You To Know.
  • Cannabidiol (CBD) Products for Pain: Ineffective, Expensive, and With Potential Harms
  • What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD
  • Cannabis is no better than a placebo for treating pain – new research​
  • Labeling Accuracy of Cannabidiol Extracts Sold Online
  • Beware of supplements (my blog post)
  • We Have a Chronic Pain Problem, Not a Prescription Opioid Problem (my article)
  • The power of the placebo effect
  • How to Move Patients from Passive Management to Active Self-Management (my article)

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