A recent systematic review and network meta-analysis of randomized clinical trials have shed light on the comparative benefits and risks of using opioids and cannabis for medical purposes in managing chronic non-cancer pain. The study aimed to evaluate the efficacy and potential adverse effects of these treatments, providing valuable insights into their respective impacts.
- Objective: To assess the benefits and harms of opioids and medical cannabis for chronic non-cancer pain.
- Design: Systematic review and network meta-analysis.
- Data Sources: The study drew data from various sources, including EMBASE, MEDLINE, CINAHL, AMED, PsycINFO, PubMed, Web of Science, Cannabis-Med, Epistemonikos, and the Cochrane Library (CENTRAL), spanning from inception to March 2021.
- Study Selection: Randomized trials were included if they compared any type of medical cannabis or opioids against each other or a placebo, with a minimum patient follow-up period of four weeks.
- Trial Inclusion: A total of 90 trials involving 22,028 patients were eligible for review.
- Length of Follow-up: Follow-up durations ranged from 28 to 180 days.
- Pain Relief: Both opioids and cannabis for medical use showed low to moderate certainty evidence of providing small improvements in pain compared to a placebo.
- Functionality: Opioids demonstrated moderate certainty evidence of slight improvements in pain, physical functioning, and sleep quality. Cannabis, on the other hand, exhibited similar effects, with neither surpassing the efficacy of a placebo for role, social, or emotional functioning.
- Comparison between Cannabis and Opioids: Moderate certainty evidence suggested little to no difference between cannabis and opioids regarding physical functioning. Cannabis resulted in fewer discontinuations due to adverse events compared to opioids.
- Pain and Sleep Quality: Low certainty evidence indicated little to no difference between cannabis and opioids in terms of pain relief and sleep quality.
The study concludes that cannabis for medical use may be similarly effective for chronic non-cancer pain as opioids while potentially leading to fewer discontinuations due to adverse events. These findings provide valuable insights into the ongoing discussion surrounding alternative treatments for chronic pain and contribute to the growing body of evidence guiding medical decision-making.