Medical marijuana for chronic pain: the short answer
Medical marijuana may ease chronic pain for some patients, but it is not a cure and not a first-line treatment. Evidence is strongest for chronic neuropathic pain (nerve pain). Evidence is weaker for low back pain, osteoarthritis, and fibromyalgia. Use cannabis as part of a clinician-guided plan that includes proven care, such as physical therapy, exercise, and prescribed medicine. Do not stop a prescribed treatment on your own.
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What the evidence says
A 2017 review by the National Academies of Sciences, Engineering, and Medicine found substantial evidence that cannabis is effective for chronic pain in adults. Later reviews report modest average pain relief and wide variation between patients. Pain relief is not the same as restored function. Track sleep, mood, activity, and side effects along with pain scores.
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Prerequisites before you start
- You live in a state with a medical cannabis program.
- Your condition appears on that state's qualifying condition list.
- You have a clinician who can review your history and medicines.
- You can store cannabis where children and pets cannot reach it.
How to start medical marijuana for chronic pain
- Check your state health department's qualifying condition list.
- Ask a clinician to review your pain history, medicines, and mental health history.
- Get the written certification your state requires.
- Register with your state medical cannabis program.
- Pay the registration fee if your state charges one.
- Buy cannabis only from a licensed dispensary.
- Choose a product with a known THC to CBD ratio and a measured dose per unit.
- Start with a low THC dose, such as 1 to 2.5 mg.
- Wait at least two hours before you take more.
- Record the product, dose, route, time, pain score, and side effects in a log.
- Repeat the same dose for several days before you change it.
- Schedule a follow-up with your clinician.
Choose a route
Inhaled cannabis acts within minutes and lasts two to three hours. Oral oils and capsules take 30 to 120 minutes and last longer. Oral products are easier to dose but harder to stop if a dose feels too strong. Avoid smoked cannabis if you have lung disease. Vaporizing carries fewer combustion products than smoking but still irritates airways.
Safety and risks
- Do not drive or operate machinery after using cannabis.
- Common side effects include dizziness, dry mouth, fatigue, and anxiety.
- High THC doses can cause paranoia, rapid heart rate, and vomiting.
- Cannabis can interact with sedatives, blood thinners, and some seizure medicines.
- Regular use can lead to dependence, with early or daily high-THC use.
- Avoid cannabis during pregnancy and breastfeeding.
- Talk with a clinician before use if you have a history of psychosis or heart disease.
What to ask your clinician
- Which route and ratio fit my pain type and health history?
- How does cannabis interact with my current prescriptions?
- What dose should I start with, and when should I increase it?
- Which side effects should prompt a call or an emergency visit?