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European Pain Federation ( EFIC ) position paper on appropriate use of cannabis‐based medicines and medical cannabis for chronic pain management
Author(s) -
Häuser Winfried,
Finn David P.,
Kalso Eija,
KrcevskiSkvarc Nevenka,
Kress HansGeorg,
Morlion Bart,
Perrot Serge,
Schäfer Michael,
Wells Chris,
Brill Silviu
Publication year - 2018
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.1297
Subject(s) - cannabis , medicine , tolerability , chronic pain , neuropathic pain , guideline , adverse effect , clinical trial , alternative medicine , psychiatry , intensive care medicine , pharmacology , pathology
Cannabis‐based medicines are being approved for pain management in an increasing number of European countries. There are uncertainties and controversies on the role and appropriate use of cannabis‐based medicines for the management of chronic pain. EFIC convened a European group of experts, drawn from a diverse range of basic science and relevant clinical disciplines, to prepare a position paper to empower and inform specialist and nonspecialist prescribers on appropriate use of cannabis‐based medicines for chronic pain. The expert panel reviewed the available literature and harnessed the clinical experience to produce these series of recommendations. Therapy with cannabis‐based medicines should only be considered by experienced clinicians as part of a multidisciplinary treatment and preferably as adjunctive medication if guideline‐recommended first‐ and second‐line therapies have not provided sufficient efficacy or tolerability. The quantity and quality of evidence are such that cannabis‐based medicines may be reasonably considered for chronic neuropathic pain. For all other chronic pain conditions (cancer, non‐neuropathic noncancer pain), the use of cannabis‐based medicines should be regarded as an individual therapeutic trial. Realistic goals of therapy have to be defined. All patients must be kept under close clinical surveillance. As with any other medical therapy, if the treatment fails to reach the predefined goals and/or the patient is additionally burdened by an unacceptable level of adverse effects and/or there are signs of abuse and misuse of the drug by the patient, therapy with cannabis‐based medicines should be terminated. Significance This position paper provides expert recommendations for nonspecialist and specialist healthcare professionals in Europe, on the importance and the appropriate use of cannabis‐based medicines as part of a multidisciplinary approach to pain management, in properly selected and supervised patients.