Twenty cannabis experts from across the globe have reached a consensus on how medical cannabis may be used to treat chronic pain. The study was published in the Journal of Cannabis Research.
Cannabis legalization has become more commonplace in recent years. Despite this though, there have been few randomized control trials studying how to dose and administer medical cannabis to patients safely and effectively. This is the case even though more and more clinicians and patients alike are looking to cannabinoids, such as cannabidiol (CBD) and tetrahydrocannabinol (THC), to treat various conditions including chronic pain.
To change this, 20 leading cannabis experts came together to reach a consensus on dosing medical cannabis for neuropathic, inflammatory, nociplastic, and mixed pain. They used a multistage modified Delphi process, a decision-making process used to arrive at a group consensus. As a part of the process, experts respond to several rounds of questionnaires which are shared with the group after each round until a consensus is made.
In the end, the experts developed three treatment protocols- a routine protocol, a conservative protocol, and a rapid protocol. For the routine and conservative protocols, clinicians begin patients on a CBD-predominant strain of cannabis at a dose of 5mg CBD once or twice daily. The dosage can be incrementally increased until patients either reach their goals or 40mg/ day of CBD.
If goals are still not achieved after maximum CBD dosage, clinicians may also begin patients on THC at 2.5mg, and steadily increase the dosage until they reach their goals or 40mg/day of THC.
For the rapid protocol, clinicians begin patients on a balanced THC: CBD variety of cannabis at 2.5-5mg of each cannabinoid once or twice daily. Levels of both cannabinoids may be increased incrementally until 40mg/day or until the patient reaches their goals.
While there was a consensus for no minimum or maximum age for CBD treatment, the experts did not reach a consensus on what age THC should be recommended due to its potential effects on the developing human nervous system. As such, they recommended age limits for THC treatment to fall in line with local government regulations.