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Long-term and serious harms of medical cannabis and cannabinoids for chronic pain: a systematic review of non-randomised studies

Dena Zeraatkar, Matthew Adam Cooper, Arnav Agarwal, Robin W M Vernooij, Gareth Leung, Kevin Loniewski, Jared E Dookie, Muhammad Muneeb Ahmed, Brian Y Hong, Chris Hong, Patrick Hong, Rachel Couban, Thomas Agoritsas, Jason W Busse. BMJ Open. 2022 Aug 4;12(8):e054282.

Meta-analysisHumans

Design
Meta-analysis
Subjects
39 non-randomised studies enrolling 12,143 adults with chronic pain
Dose used in the study
Not stated in the abstract
Duration
Studies with at least 4 weeks of follow-up
What was measured
Prevalence of adverse events, serious adverse events, psychiatric and cognitive events, discontinuation, dependence and withdrawal among users of medical cannabis or cannabinoids for chronic pain

What the authors reported

The review found:

  • Very low certainty evidence that adverse events are common (26.0%, 95% CI 13.2% to 41.2%), including psychiatric events (13.5%).
  • Serious adverse events and other listed harms each occurred in fewer than 1 in 20 patients.
  • Longer use went with more reported adverse events.
  • Palmitoylethanolamide was usually associated with few to no adverse events.

Limits of this study

A review of non-randomised studies with very low certainty evidence. Palmitoylethanolamide was one of many cannabinoid-related agents; the abstract gives no separate PEA numbers. Insufficient evidence compared cannabis harms with other pain treatments. Competing interests: none declared.

Source

PubMed 35926992 · doi:10.1136/bmjopen-2021-054282

Entry checked against the abstract on PubMed on 2026-09-22. The dose shown is the dose the researchers used. It is not a recommendation. How to read this page.