The Canadian Pain Society has advanced cannabinoid therapy from a fourth-line (2007) to the third-line (2014) recommendation, citing the following evidence:
- Since 2006, seven high quality studies investigated cannabinoid therapy in neuropathic pain, and all but one of these studies had positive results.
- Mucosal spray of 50/50 mixture of THC/CBD provided significant pain relief for patients with multiple sclerosis.
- One trial found that nabilone was effective for pain relief in patients with painful diabetic neuropathy, with improved sleep and overall quality of life.
- There is increasing evidence of the benefits of cannabinoid therapy in managing neuropathic pain: overall NNT of 3.4.