Characteristics, outcomes and conclusions of noncontrolled studies
| Study type; study | Characteristic | Pain outcomes and conclusions* | ||||||
|---|---|---|---|---|---|---|---|---|
| Drug | Dose | Route of administration | Frequency of administration | Population | Control | Duration | ||
| Case series/case reports | ||||||||
| Aggarwal et al. 2009 (30) | Unspecified | Unspecified | Various | Unspecified | 139 pain clinic patients (72 back pain, 43 arthritis pain) | None | Retrospective 11 d – 8.3 yr | McGill pain (+) |
| Barbosa-Hernandez et al. 2013 (31)† | Dronabinol | 2.5 mg | Oral | Twice per d | 1 25-yr-old male, posttrauma pain, opioid-tolerant | None | 6 d | VAS (+) |
| Gofeld et al. 2005 (36) | Nabilone | 1 mg, 2 mg | Oral | Twice per d | 1 29-yr-old male, postsurgical pain resistant to standard analgesia | None | 4 d | PCA morphine consumption (+) |
| Haroutiunian et al. 2011 (52)† | Unspecified | NR | NR | NR | 42 pain clinic patients (19% back pain) | None | 3–6 mo | BPI, pain symptoms (+) |
| Haroutiunian et al. 2008 (31) | Cannabis extract | 5 mg | Sublingual | 2–3 times/d | 13 pain clinic patients (5 back pain, 1 joint pain, 1 unspecified bone pain) | None | 5 d – 36 mo | TOPS (=) |
| Haroutiunian et al. 2016 (37) | Herbal cannabis, cannabis extract | 1 puff or drop | Oral drops, edibles or smoked | 1–3 times/d | 206 pain clinic patients | None | 6 mo | TOPS (+) |
| Hornby et al. 200958 | Herbal cannabis | Various | Smoked, oral capsules, and oral tincture | Various | 1 33--yr-old male, uncontrolled posttrauma pain | None | 15 mo | Unspecified pain score (+) |
| Ware et al. 2002 (39) | Herbal cannabis | 2–8 puffs | Smoked | Various, median 4 times daily | 15 pain clinic patients (3 back pain, 2 arthritis pain, 1 unspecified MSK) | None | Cross-sectional | Perceived effectiveness (+) |
| Surveys | ||||||||
| Harris et al. 2000 (53) | Unspecified | NR | NR | At least once/wk | 100 adults legally using medical cannabis | None | Cross-sectional | Perceived effectiveness (+) |
| Hazekamp et al. 2013 (25) | Dronabinol, nabilone, nabiximols, vapourized THC, herbal cannabis | Various | Smoked, vapourized, sublingual or oral tincture | Various | 953 adults using cannabis as medicine (135 back pain, 59 trauma pain, 19 arthritis pain) | None | Cross-sectional | None |
| Piper et al. 2017 (54) | Unspecified | Various | Various including smoked, vapourized, edibles and tinctures | Various | 1513 medical dispensary members (176 trauma pain, 798 back/neck pain, 200 postsurgical pain) | None | Cross-sectional | Perceived effectiveness (+) |
| Ste-Marie et al. 2016 (26) | Herbal cannabis | Mean 1.4 g, max 5 g | Smoked, vapourized, oral and topical | Various | 1000 rheumatology patients (most arthritis pain) | 28 cannabis users v. 972 nonusers‡ | Cross-sectional | None (only baseline pain measured; VAS) |
| Swift et al. 2005 (27) | Unspecified | NR | Edibles, tea, smoked vapourized | Various | 128 (14 back pain) | None | Cross-sectional | Perceived effectiveness (+) |
| Walsh et al. 2013 (28) | Unspecified | Various | Smoked, vapourized oral | Various | 628 medical cannabis users (unclear number of patients with back pain and arthritis pain) | None | Cross-sectional | None |
| Qualitative study | ||||||||
| Peters 2013 (55) | Unspecified | Various | Various, mostly smoked and oral | Various | 28 pain patients (6 postsurgical pain, 2 back pain, 6 arthritis pain, 6 hip or knee pain) | None | Cross-sectional | Patient- reported (qualitative) (+) |
BPI = brief pain inventory; MSK = musculoskeletal; NR = not reported; PCA = patient-controlled analgesia; THC = tetrahydrocannabinol; TOPS = treatment outcomes of pain survey; VAS = visual analogue scale.
↵* (+) = cannabis performed significantly better than comparator for pain outcomes; (=) = no difference for pain outcomes.
↵† Abstract only.
↵‡ This study technically had a control group; however, we included it with the noncontrolled studies because it assessed only the demographic characteristics of cannabis users versus nonusers; there was no comparison of pain outcomes across groups.