Cannabis and Opioids in Chronic Pain Management

Background: Many adults suffer from chronic pain. Opioids are commonly prescribed to treat chronic pain, though they can produce adverse side effects and carry the potential for abuse and addiction. The introduction of cannabis in medicine has provided a possible alternative to opioids in chronic pain management. Objective: This systematic literature review aims to synthesize evidence from published studies to answer the following research question in the PICOT format: In adults over the age of 18 with chronic pain (P), how does prescribed cannabis therapy (I) compare with prescribed opioid therapy (C) in affecting perceived pain levels and quality of life (O) within six months of treatment (T). Methods: Electronic searches were conducted through KSU Library, Pubmed, Cochrane, CINAHL, and Pain Management Nursing databases. Fourteen studies were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses as a guide. Results: The majority of the reviewed studies provided evidence of improvement in pain and quality of life in patients prescribed cannabis. However, some studies reported that cannabis had no effect on pain management. Few studies directly compared the efficacy of cannabis to opioids, but a few studies indicated that opioid use and prescription rates were reduced in states where medical cannabis was legal. Conclusion: The benefits of medical cannabis in treating chronic pain among adults differed across the studies. There was a lack of high-quality evidence to determine the effectiveness of cannabis compared to opioids appropriately. Thus, there is a need for more comparative research studies. Keywords: chronic pain, medicinal cannabis, opioid, quality of lif