The medicinal use of cannabinoids: a review of the current literature

Introduction: The medicinal use of cannabinoids is increasing in the United States, despite controversies over its efficacy and safety. Therefore, clinicians will encounter patients who desire or elect to use cannabinoids and should be able to advise them on cannabis-related clinical issues based on the current evidence. This article reviews the main areas of clinical cannabinoid use, discusses the quality and consistency of the evidence for these areas, and examines cannabinoid side effects. Methodology: The literature search for this review was carried out to identify papers published between 1995 and 2016 in in the following electronic databases: PubMed, and Cochrane Review. Several combinations of the following keywords were used: “Cannabinoids” OR “marijuana” AND “pain”, fibromyalgia”, “multiple sclerosis”, “huntingtons”, “treatment”, “cancer”, “dementia”, “nausea”, “vomiting”, “hepatitis”, “HIV”, “schizophrenia”, and “inflammatory bowel disease. The quality and consistency of the studies selected was evaluated according to the Strength of Recommendation Taxonomy (SORT) and key recommendations with each main clinical indication. Results: Cannabinoids do appear effective for multiple conditions including spasticity and neuropathic pain related to MS, fibromyalgia, chronic pain, and cancer-associated nausea and vomiting, there are significant side-effects related to their use. Conclusion: Despite efficacy, cannabinoids are best reserved for use as a second-line treatment, due to the multiple common side effects, withdrawal symptoms, and addiction potential.