Research: Simplified guidelines for prescribing medical cannabinoids in primary care, Canadian Family Physician

The new 2018 guideline, published in the official journal of the College of Family Physicians of Canada, suggests that clinicians could consider medical cannabinoids only for refractory neuropathic pain and refractory pain in palliative care, chemotherapy-induced nausea and vomiting, and spasticity in multiple sclerosis and spinal cord injury after reasonable trials of standard therapies have failed. If considering medical cannabinoids and criteria are met, the guideline recommends nabilone or nabiximols be tried first. 

The researchers acknowledge that the evidence for medical cannabinoids is unfortunately sparse in many areas, limiting the ability to provide clear guidance beyond the conditions for which they saw improvements after initiating cannabinoid therapy (above). They hope that future high quality randomized controlled trials will clarify the evidence further and that that might lead to reevaluation of the recommendations. They also recommend long-term monitoring of medical cannabinoids to further assess potential individual and societal benefits and harms.