Patient Decision Aid

Medical cannabis for chronic pain

Deciding whether to use medical cannabis for chronic pain

1

Introduction

Who and why?
2

Priorities

Clarification exercise
3

Options

Explore the options
4

Decision

Make an informed choice
5

Profile

Summary of my process

Introduction

Who and why?

Chronic pain

This decision box focuses on chronic non-cancer pain. This tool should be used within discussions between patients and their healthcare providers.
Chronic pain is pain that has persisted for more than three months (e.g., knee pain, back pain, and headaches).

Drug treatments for chronic pain
Find out more

There are several drug treatments available for
chronic non-cancer pain: analgesic or antispasmodic drugs, opioids and a number of other types of drugs.

There are several non-drug treatments available, such as physiotherapy, occupational therapy, and chiropractic treatments.

However, not all of these treatments are effective in controlling chronic non-cancer pain.

Medical cannabis can be used for its therapeutic properties. It can be used in contexts such as palliative care, nausea, and vomiting induced by chemotherapy, or for the treatment of various types of pain. While medical cannabis appears to be an interesting avenue for the treatment of chronic pain, the evidence to this effect is limited.

Under supervision

  • Safer: the care team starts with the smallest dose and gradually increases according to tolerance.
  • The care team ensures that there is no interaction with current medication. Doses of current medications can be adjusted.
  • Allows for better acceptance by those around you.

Self-medication

  • Access is easier and dose adjustment is faster.
  • The patient's file is not analyzed by the care team.
  • The treatment is less safe.

Consult your pharmacist or doctor before using

cannabis if you have any of the following conditions:

  • Known sensitivity to THC, CBD, or any other cannabinoid, including Nabilone® or Nabiximols® .
  • Respiratory disease (e.g., asthma or chronic obstructive pulmonary disease)
  • Severe liver impairment or liver failure in patients with chronic hepatitis C
  • Personal history of psychiatric disorders (e.g., psychosis, schizophrenia, anxiety and mood disorders) or a family history of schizophrenia
  • History of drug or alcohol abuse
  • People receiving treatment with sedative-hypnotics or other psychoactive drugs
  • Pregnant or breastfeeding women
  • Cannabis, especially smoked or vaporized cannabis, containing primarily THC should not be used in people under 25 years of age.

Medical cannabis may interfere with operation of a motor vehicle. Use caution and inquire fully about the effects of your prescribed cannabis on driving. If you plan to travel outside of Canada or by air, it will probably not be possible to take your medical cannabis with you.

There are two medications approved in Canada that contain cannabis ingredients: Nabilone® and Nabiximols®. In addition to these two drugs, medical cannabis can be smoked, vaporized, and consumed in edible form. It can also be found in creams that are applied to the skin. Cannabis oil can be consumed in capsules or by dropper.

Depending on your priorities, you can choose whether or not to treat your chronic pain. You can also choose how to treat it.

These choices are up to you because :

  • Different treatments are available
  • There is a lack of knowledge and consensus among healthcare personnel about the efficacy of medical cannabis
  • These different treatments can have positive or negative effects, and it is impossible to predict their effects on you
  • It is easier to implement a treatment that you chose yourself
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We recommend that :

- The decision takes into account the values and priorities of the individual

- The decision is shared between the health care professional and the individual, and, if applicable, with his or her caregiver.


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Version: 1.0

Publication Date: Décembre 2023 - Evidence Update: Décembre 2023 - Next Update: Décembre 2023
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