Medical cannabis in chronic pain management

Kevin Hill, MD, MS, is an addiction psychiatrist and director of the Division of Addiction Psychiatry at Beth Israel Deaconess Medical Center and associate professor of psychiatry at Harvard Medical School, USA. His research interests include the development of medications to treat cannabis use disorder. He provides consultations to organizations seeking assistance with cannabis or opioid policy.

What is the role of medical cannabis in chronic pain management?

Kevin Hill, MD, MS: There is a role for medical cannabis in chronic pain management, I believe, as a third-line treatment. If a patient comes to me and they have chronic low back pain, for example, and they’ve tried multiple medications and perhaps some injections, then I’m willing to have a discussion with them about using medical cannabis, often as an adjunct treatment for their chronic pain.

We may talk about using, ideally, a United States Food and Drug Administration (FDA)–approved cannabinoid, like dronabinol, starting at a low dose, perhaps 2.5 mg or so, to see if it helps any of the pain that they may be experiencing.