Goals and outcomes
The right pain treatment for the right person at the right time at the right cost and without side effects
Cannabis for Pain Disorders
Cannabis has been used for medical purposes across the world for centuries. As states and countries implement medical and recreational cannabis policies, increasing numbers of people are using cannabis pharmacotherapy for pain. There is a theoretical rationale for cannabis’ efficacy for pain management, although the subjective pain relief from cannabis may not match objective measurements of analgesia. As more patients turn to cannabis for pain relief, there is a need for additional scientific evidence to evaluate this increase.
Content will be in various forms including articles, infographs, interviews, links to other websites, video and other media forms.
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Cannabis Overview
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Cannabis for pain disorders
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How to use cannabis most effectively
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Legal issues
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Research
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Resources
About chronic pain and its treatment
Cannabis Rx Basics
Role of cannabis in the treatment of pain
Overview
The Pain Module
The Pain Treatment Checklist
Monitoring Pain and its Treatment
Integrated Care
Resources
Academic Articles
Cannabis and Pain: A Clinical Review
Specific Medical Conditions
Headache
Joint pain
Fibromylgia
Cancer related pain
Cannabis for Pain Disorder
Initial Treatment
Initial visit checklist (regular pdf)
Medicinal Cannabis for Chronic Pain Provider Decision Tree
Citizen Brief
My treatment
Ecosystem
Policy
Research of Cannabis and Pain
Rothman Institute in Philly will study medical marijuana for pain
Complications of Cannabis Use
The Marijuana Problem Scale (MPS) (form AS5), developed by Stephens and colleagues (1994a), is a self-report assessment that helps the client identify areas in his or her life affected by marijuana use.
Medical Professional Checklist
CHECKLIST: When considering Cannabis Treatment
Checklist for prescribing cannabis for chronic pain. For primary care providers treating adults (18+) with chronic pain ≥ 3 months, excluding cancer, palliative, and end-of-life care
When CONSIDERING cannabis therapy
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Set realistic goals for pain and function based on diagnosis (eg, walk around the block). Check that non-opioid therapies tried and optimized.
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Discuss benefits and risks (eg, addiction, overdose) with patient. Evaluate risk of harm or misuse.
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Discuss risk factors with patient.
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Check PDMP
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Check urine drug screen.
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Set criteria for stopping or continuing cannabis. Assess baseline pain and function (eg, PEG scale).
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Schedule initial reassessment within 1– 4 weeks.
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Prescribe cannabis using lowest dosage on product labeling; match duration to scheduled reassessment.
If RENEWING without patient visit
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Check that return visit is scheduled ≤ 3 months from last visit.
When REASSESSING at return visit
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Continue cannabis only after confirming clinically meaningful improvements in pain and function without significant risks or harm.
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Assess pain and function (eg, PEG); compare results to baseline.
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Evaluate risk of harm or misuse: (Addiction Behaviors Checklist (ABC) (Google DOC )
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Designed to track behaviors characteristic of addiction related to cannabis medications in chronic pain patients. Items are focused on observable behaviors noted both during and between visits. ABC is focused on longitudinal assessment and tracking of problematic behaviors.
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Observe patient for signs of over-sedation or overdose risk. – If yes: Taper dose.
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Check PDMP.
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Check for cannabis use disorder if indicated (eg, difficulty controlling use).
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If yes: Refer for treatment.
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If you suspect your patient has a substance abuse issue, refer them to SAMHSA’s National Helpline at 1-800-662-HELP (4357) or SAMHSA’s Behavioral Health Treatment Services Locator.
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Check that pain management therapies optimized.
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Determine whether to continue, adjust, taper, or stop cannabis.
Schedule reassessment at regular intervals (≤ 3 months).