Super Speedy Summary: Medical Cannabis Trials for Pain

Join Dr. Goldenberg for this super speedy summary, which takes a peak into the evolving role of medical cannabis in chronic pain management, as discussed by Dr. Jamie Caroon, a prominent figure in CBD and cannabis research. Focusing on a recent BMJ clinical practice guideline, Dr. Caroon's insights challenge conventional views, emphasizing the need for cautious consideration of medical cannabis trials. Despite varied recommendations, the guideline highlights modest yet significant benefits in high-quality evidence. This discussion underscores the importance of evidence-based approaches in navigating the complexities of pain management and medical cannabis usage.

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Transcript

Introducer: 0:02

Welcome to the Dr Journal Club podcast, the show that goes under the hood of evidence-based integrative medicine. We review recent research articles, interview evidence-based medicine thought leaders and discuss the challenges and opportunities of integrating evidence-based and integrative medicine. Continue your learning after the show at www. drjournal club. com.

Josh: 0:31

Please bear in mind that this is for educational and entertainment purposes only. Talk to your doctor before making any medical decisions, changes etc. Everything we're talking about that's to teach you guys stuff and have fun. We are not your doctors. Also, we would love to answer your specific questions on drjournalclub. com. You can post questions and comments for specific videos, but go ahead and email us directly at josh at drjournalclub. com. That's josh at drjournalclub. com. Send us your listener questions and we will discuss it on our pod. Hello and welcome to another Dr Journal Club. Super speedy summary.

Josh: 1:12

This one is on a very excellent clinical practice guideline that just came out in the BMJ by a really stellar research group. Bousset has done some incredible work with chronic pain, really cutting edge methodology, and he attached himself with the Guyatt Group at McMaster just a sort of a superstar lineup of methodologists and researchers on this study and really useful practice guide. So the problem, of course, is chronic pain. Of course, course is extremely common. People are using medical cannabis, especially these days as more and more states in the United States are legalizing it, but the current clinical practice recommendations are inconsistent. So the question for this guideline was what is the role of medical cannabis or cannabinoids for people living with chronic pain due to cancer or non-cancer causes. So again, this was a clinical practice guideline. It was based on four really excellent systematic reviews with state-of-the-art methodology. They built an international guideline development panel including patients, clinicians with content, expertise and methodologists and of course, they used the great approach which is really the standard now and they framed everything within an individual patient perspective, which I think is excellent, but as opposed to sort of a societal perspective and there can be different conclusions based on your perspective. But that's the perspective that they took and their summary was they offered a weak recommendation to offer a trial of non-inhaled medical cannabis or cannabinoids in addition to standard of care and standard management if it's not sufficient. So in other words, you do standard of care for the chronic pain. If that's not sufficient, the clinician can offer a trial of medical cannabis for people living with chronic cancer or non-cancer pain. And it was a weak recommendation, not because the quality of the evidence was particularly low there's actually a surprisingly high level of evidence on a lot of the aspects here but it was a weak recommendation because the actual magnitude of effect was, at least to me, somewhat surprisingly small. So they had pretty decent evidence that it was effective, but that the effect was quite small and for that reason they made a weak recommendation.

Josh: 3:29

Dr Jamie Caroon, our expert in CBD and cannabis methodology, goes into great detail on this paper in both a basic and also in-depth level video we have on this. So go ahead and please watch his more detailed explanations as well, and review us on Apple Podcast or any other distributor. It would be greatly appreciated. It would mean a lot to us and help get the word out to other people that would really enjoy our content. Thank you.

Josh: 4:10

Hey all this is Josh, you know we talked about some really interesting stuff today. I think one of the things we're going to do that's relevant. There is a course we have on Dr Journal Club called the EBM Boot Camp. That's really meant for clinicians to sort of help them understand how to critically evaluate the literature, etc, etc. Some of the things that we've been talking about today. Go ahead and check out the show notes link. We're going to link to it directly. I think it might be of interest. Don't forget to follow us on social and interact with us on social media at DrJournal Club. Dr Journal Club on Twitter. We're on Facebook, we're on LinkedIn, etc, etc. So please reach out to us. We always love to talk to our fans and our listeners. If you have any specific questions you'd like to ask us about research, evidence, being a clinician, etc. Don't hesitate to ask. And then, of course, if you have any topics that you'd like us to cover on the pod, please let us know as well.

Introducer: 5:03

Thank you for listening to the Doctor Journal Club podcast, the show that goes under the hood of evidence-based integrative medicine. We review recent research articles, interview evidence-based medicine thought leaders and discuss the challenges and opportunities of integrating evidence-based and integrative medicine. Be sure to visit www. d rjournalclub. com to learn more.