Nabilone

Cannabis products with higher THC levels may slightly reduce chronic pain, particularly nerve pain, according to a review of multiple clinical trials. The improvement was small and short-lived, while side effects were more common. Products with little or no THC, including CBD-only formulations, showed no clear benefit. Researchers say more long-term studies are needed.A large review of medical studies examined whether cannabis-based products can help people living with chronic pain, a condition defined as pain that lasts for months or even years. The analysis included data from more than 2,300 adults and focused on products containing different amounts of two well-known cannabis compounds: tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the compound responsible for the "high" associated with marijuana, while CBD does not cause intoxication and is often marketed for wellness and pain relief. The review found that cannabis products with higher levels of THC compared to CBD may offer small, short-term improvements in pain levels and physical functioning. These modest benefits were most noticeable among people with nerve-related pain, also known as neuropathic pain, which can cause burning, tingling, or shooting sensations. However, the potential benefits came with drawbacks. Products higher in THC were also linked to a greater risk of common side effects. In contrast, products with low THC content, including CBD-only formulations, did not appear to meaningfully reduce pain. The findings were published in Annals of Internal Medicine. How the Research Was Conducted The review was led by researchers from Oregon Health & Science University working with other experts in the field. They analyzed 25 short-term, placebo-controlled randomized trials, which are considered one of the strongest types of clinical studies because they compare an active treatment to an inactive placebo. The goal was to update earlier evidence on how effective cannabis-based products are for chronic pain and how often they cause harm. To better compare results across studies, the researchers grouped cannabis products in several ways. They classified cannabinoids based on the ratio of THC to CBD (high, comparable, low). They also noted whether the products were synthetic, meaning made in a laboratory, purified, or extracted directly from a cannabis plant. In addition, they examined how the products were taken, including oral forms such as pills, oromucosal sprays applied inside the mouth, and topical products applied to the skin. The team then measured changes in pain severity, physical function, and the occurrence of adverse events. What the Results Showed The data suggested that oral products containing only THC likely led to a slight reduction in pain severity. Among these, nabilone showed a moderate benefit, while dronabinol produced little or no meaningful improvement. Nabiximols, a product that contains both THC and CBD, slightly reduced pain but did not improve physical function, which includes activities such as walking, working, or completing daily tasks. Across the studies, products with high or comparable THC levels were consistently associated with higher rates of side effects. These adverse events included dizziness, sedation, and nausea, with increases described as moderate to large. Because most of the trials were short in duration, the authors emphasized that there is still limited information about long-term safety and effectiveness. They also noted that many types of cannabis products commonly used by the public have not yet been well studied. Expert Perspective and What Comes Next An accompanying editorial from the UCLA Center for Cannabis and Cannabinoids explains that the findings highlight both the potential and the limitations of cannabinoids for treating chronic pain. The editorial notes that while THC-based products may provide modest relief for some patients, the results across studies were inconsistent and safety concerns remain. The authors of the editorial stress that more high-quality research is needed to better understand long-term outcomes and to help guide decisions made by patients, clinicians, and policymakers. Until stronger evidence is available, the role of cannabis-based products in chronic pain treatment remains limited and uncertain.

MONDAY, Dec. 29, 2025 — CBD and other cannabis derivatives are a bust when it comes to pain relief, a new evidence review has concluded. Products containing mainly or only cannabidiol (CBD) demonstrated almost no ability to manage a person’s pain, according to a review of recent clinical trials. “This may be surprising to people,” said lead researcher Dr. Roger Chou , senior adviser for the Pacific Northwest Evidence-based Practice Center at Oregon Health & Science University in Portland. “Conventional wisdom was that CBD was promising because it doesn’t have euphoric effects like THC and it was thought to have medicinal properties,” Chou said in a news relase. “But, at least in our analysis, it didn’t have an effect on pain.” Weed products carrying relatively high levels of THC — the compound that causes intoxication — showed some potential to provide short-term improvements in pain and function, the review found. But they also come with an increased risk of side effects like dizziness, sleepiness and nausea, researchers concluded in their Dec. 23 paper in the Annals of Internal Medicine . Both THC and CBD act on a system of neurotransmitters within the body that play a role in modulating a person’s pain. Because of that, many people have turned to cannabis to treat conditions like pain, anxiety and sleep, researchers said in background notes. Weed is legal for medical use in 40 states and the District of Columbia and for recreational use in 24 states and the District of Columbia. On Dec. 18, President Donald Trump signed an executive order calling for marijuana to be reclassified from a Schedule I to a Schedule III drug, on par with substances like ketamine, testosterone and anabolic steroids. For the new evidence review, researchers analyzed data from 25 clinical trials testing cannabis products’ ability to treat chronic pain . Researchers looked at the trials based on the THC-to-CBD ratio of the products being tested. Results showed some evidence of pain relief for two U.S. Food and Drug Administration-approved products, dronabinol and nabilone , which are made of 100% THC. Those drugs are approved for treatment of nausea and vomiting during chemotherapy. However, the pain relief was relatively small. Compared to placebo, it was on the order of a half-point to a point on a 10-point scale, researchers noted. Those slight benefits were accompanied by moderate-to-large increases in dizziness, sedation and nausea, the trial results showed. “It’s complicated because cannabis products are complicated,” Chou said. “It’s not like taking a standardized dose of ibuprofen, for example," he said. "Cannabis is derived from a plant and has multiple chemicals in addition to THC and CBD that may have additional properties depending on where it’s grown, how it’s cultivated and ultimately prepared for sale.” Researchers noted that the medical profession is divided on the potential medical benefits of cannabis. The American College of Physicians recently declined to recommend smoking weed to treat chronic pain, but previously experts have issued a soft recommendation for people with chronic pain when standard treatments fail. The results regarding CBD are particularly discouraging, researchers said. “CBD-based products are widely available in dispensaries. Many people use these products and they think it helps,” Chou said. “Our goal is to provide some scientific basis to help people make their decisions.” Sources Oregon Health & Science University, news release, Dec. 22, 2025