Super Speedy Summary: Medical Cannabis Trials for Pain

Join Dr. Goldenberg for this super speedy summary, which takes a peak into the evolving role of medical cannabis in chronic pain management, as discussed by Dr. Jamie Caroon, a prominent figure in CBD and cannabis research. Focusing on a recent BMJ clinical practice guideline, Dr. Caroon's insights challenge conventional views, emphasizing the need for cautious consideration of medical cannabis trials. Despite varied recommendations, the guideline highlights modest yet significant benefits in high-quality evidence. This discussion underscores the importance of evidence-based approaches in navigating the complexities of pain management and medical cannabis usage.

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Episode Transcript

Introducer (00:02):
Welcome to the Dr Journal Club podcast, the show
that goes under the hood ofevidence-based integrative
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We review recent researcharticles, interview
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(00:23):
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Josh (00:31):
Please bear in mind that this is for educational and
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pod.
Hello and welcome to another DrJournal Club.
Super speedy summary.
This one is on a very excellentclinical practice guideline that

(01:16):
just came out in the BMJ by areally stellar research group.
Bousset has done someincredible work with chronic
pain, really cutting edgemethodology, and he attached
himself with the Guyatt Group atMcMaster just a sort of a
superstar lineup ofmethodologists and researchers
on this study and really usefulpractice guide.

(01:39):
So the problem, of course, ischronic pain.
Of course, course is extremelycommon.
People are using medicalcannabis, especially these days
as more and more states in theUnited States are legalizing it,
but the current clinicalpractice recommendations are
inconsistent.
So the question for thisguideline was what is the role

(01:59):
of medical cannabis orcannabinoids for people living
with chronic pain due to canceror non-cancer causes.
So again, this was a clinicalpractice guideline.
It was based on four reallyexcellent systematic reviews
with state-of-the-artmethodology.
They built an internationalguideline development panel
including patients, clinicianswith content, expertise and

(02:21):
methodologists and of course,they used the great approach
which is really the standard nowand they framed everything
within an individual patientperspective, which I think is
excellent, but as opposed tosort of a societal perspective
and there can be differentconclusions based on your
perspective.
But that's the perspective thatthey took and their summary was
they offered a weakrecommendation to offer a trial

(02:45):
of non-inhaled medical cannabisor cannabinoids in addition to
standard of care and standardmanagement if it's not
sufficient.
So in other words, you dostandard of care for the chronic
pain.
If that's not sufficient, theclinician can offer a trial of
medical cannabis for peopleliving with chronic cancer or
non-cancer pain.
And it was a weakrecommendation, not because the

(03:06):
quality of the evidence wasparticularly low there's
actually a surprisingly highlevel of evidence on a lot of
the aspects here but it was aweak recommendation because the
actual magnitude of effect was,at least to me, somewhat
surprisingly small.
So they had pretty decentevidence that it was effective,
but that the effect was quitesmall and for that reason they

(03:27):
made a weak recommendation.
Dr Jamie Caroon, our expert inCBD and cannabis methodology,
goes into great detail on thispaper in both a basic and also
in-depth level video we have onthis.
So go ahead and please watchhis more detailed explanations

(03:59):
as well, and review us on ApplePodcast or any other distributor
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It would be greatly appreciated.
It would mean a lot to us andhelp get the word out to other
people that would really enjoyour content.
Thank you.
Hey all this is Josh, you knowwe talked about some really
interesting stuff today.
I think one of the things we'regoing to do that's relevant.
There is a course we have on DrJournal Club called the EBM
Boot Camp.

(04:20):
That's really meant forclinicians to sort of help them
understand how to criticallyevaluate the literature, etc,
etc.
Some of the things that we'vebeen talking about today.
Go ahead and check out the shownotes link.
We're going to link to itdirectly.
I think it might be of interest.
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us to cover on the pod, pleaselet us know as well.

Introducer (05:03):
Thank you for listening to the Doctor Journal
Club podcast, the show that goesunder the hood of
evidence-based integrativemedicine.
We review recent researcharticles, interview
evidence-based medicine thoughtleaders and discuss the
challenges and opportunities ofintegrating evidence-based and
integrative medicine.
Be sure to visit www.
d rjournalclub.
com to learn more.