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J Pain: Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS)

Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS)

Journal of Pain:

Cannabis is widely used as a self-management strategy by patients with a wide range of
symptoms and diseases including chronic non-cancer pain. The safety of cannabis use for medical
purposes has not been systematically evaluated. We conducted a prospective cohort study to
describe safety issues among individuals with chronic non-cancer pain. A standardized herbal
cannabis product (12.5% tetrahydrocannabinol) was dispensed to eligible individuals for a 1-year
period; controls were individuals with chronic pain from the same clinics who were not cannabis
users. The primary outcome consisted of serious adverse events and non-serious adverse events.
Secondary safety outcomes included pulmonary and neurocognitive function and standard
hematology, biochemistry, renal, liver, and endocrine function. Secondary efficacy parameters
included pain and other symptoms, mood, and quality of life. Two hundred and fifteen individuals
with chronic pain were recruited to the cannabis group (141 current users and 58 ex-users) and
216 controls (chronic pain but no current cannabis use) from 7 clinics across Canada. The median daily
cannabis dose was 2.5 g/d. There was no difference in risk of serious adverse events (adjusted
incidence rate ratio = 1.08, 95% confidence interval = .57–2.04) between groups. Medical cannabis
users were at increased risk of non-serious adverse events (adjusted incidence rate ratio = 1.73,
95% confidence interval = 1.41–2.13); most were mild to moderate. There were no differences in
secondary safety assessments. Quality-controlled herbal cannabis, when used by patients with
experience of cannabis use as part of a monitored treatment program over 1 year, appears to have
a reasonable safety profile. Longer-term monitoring for functional outcomes is needed.

Source: Journal of Pain

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