An Integrated Review of Cannabis and Cannabinoids in Adult Oncologic Pain Management

Objective: The objective of this paper is to review the available literature regarding the use of cannabis and cannabinoids in adult oncologic pain management. Design and Data Sources: A integrative review was conducted on March 1, 2018 using PubMed, MEDLINE, CINAHL, Embase, and Scopus. A snowball method was used to extract studies included in systematic reviews that were not included in the primary literature search. Review Method: Articles reviewed address the use of cannabinoids or cannabis for pain management in oncology patients, either as stand-alone or adjuvant therapy. Results: The final number of articles included is nine articles. Of the nine studies reviewed, eight reviewed the effect of the cannabinoid THC on cancer pain, and one study reviewed the use of medicinally available whole plant cannabis. The following study types were included: multiple multi-center, randomized, placebo- controlled trials and two prospective observational survey studies. Results and Conclusions: Of the eight studies that reviewed the effect of the cannabinoid THC, five found THC to be more effective than placebo, one found THC to be more effective than placebo in American patients but ineffective in patients from other countries, and two found THC to be no more effective than placebo. The study that reviewed the effect of the whole plant cannabis found that there was a significant decrease in pain among those patients smoking cannabis. Nursing Practice Implications: The lack of evidence in this field of research suggests a need to change policy surrounding cannabis research. (C) 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.