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HSR&D Investigators on Annals of Internal Medicine’s Best of 2017 Articles List

December 19, 2017

VA’s Health Services Research & Development Service (HSR&D) and Quality Enhancement Research Initiative (QUERI) investigators produced two articles that were chosen by Annals of Internal Medicine as among the Best of 2017: “The Effects of Cannabis among Adults With Chronic Pain and an Overview of General Harms: A Systematic Review” (Nugent, et al.) and “Benefits and Harms of Plant-Based Cannabis for Posttraumatic Stress Disorder: A Systematic Review” (O’Neil, et al.). These reviews found that the scientific evidence is too limited to make firm conclusions about the effectiveness and safety of cannabis and cannabinoid products in treating chronic pain or post-traumatic stress disorder (PTSD).

Cannabis is increasingly available for the treatment of chronic pain, yet its efficacy remains uncertain. Nugent and colleagues, part of HSR&D/QUERI’s Evidence-Based Synthesis Program (ESP) Center in Portland, OR, reviewed the benefits of cannabis for treating chronic pain in adults – and the harms of cannabis use in chronic pain and general adult populations. After reviewing the literature from database inception through March 2017, they found limited evidence suggesting that cannabis may alleviate neuropathic pain in some patients, but there was insufficient evidence to suggest that cannabis helps with other types of chronic pain. There also was limited evidence suggesting that cannabis is associated with an increased risk for adverse mental health effects. In addition, cannabis is now available from medical dispensaries for treating PTSD in many states, yet its efficacy remains uncertain. O’Neil and colleagues, also part of the ESP Center in Portland, reviewed the literature from database inception through March 2017 to identify ongoing studies and to review the existing evidence regarding the benefits and harms of cannabis in treating PTSD. They found insufficient evidence to draw any conclusions; however, several ongoing studies may soon provide important results.

The Best of 2017 articles will be freely accessible on the Annals website through February 14, 2018. A cyberseminar session titled “Benefits and Harms of Cannabis in Chronic Pain or Post-Traumatic Stress Disorder: A Systematic Review” also is available with 24/7 access on the HSR&D website.

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