Cancer-Associated Pain

High-doses of THC significantly reduced pain compared with placebo or codeine, but also caused more sedation.1 Another study demonstrated that a combination of THC and CBD provided pain relief, but not THC alone, compared with placebo. An observational study found that patients using CBM for pain relief required less opioids. Nabiximol was also shown to provided pain relief more effectively compared with placebo.

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Anorexia and Cachexia

Though dronabinol is approved for the treatment of cancer-related anorexia, only a few studies have been published for this indication. Megestrol acetate, for example, was more effective than dronabinol for anorexia. A phase 3 trial demonstrated no significant increase in survival, body weight, or nutritional variables among patients with cancer who received THC or THC plus CBD compared with placebo.

Adverse Effects

In many studies, cannabis results in a greater rate of adverse effects compared with the comparator, even active comparators.1 Common adverse effects for cannabis include somnolence, dizziness, disorientation, anxiety, euphoria, hallucination, and dry mouth.

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Treatment of Cancer

In vitro and animal model data suggest that some cannabinoids have anticancer properties for multiple cancer types.1,3 Cannabis inhibited tumor growth, vascularization, migration, and metastasis in animal models.1 Early in-human studies demonstrated that cannabis is safe, but data regarding efficacy has not yet been reported.