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Medical Cannabis A Focus on Use in Chronic Pain

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Cannabis has been legalized, decriminalized or approved for medical use in every US state except Alabama, Idaho, Kansas, South Carolina, Tennessee, Wisconsin,and Wyoming. The number of medical Cannabis users in the US is somewhere between 3 and 9 million. A review of individual states’ registries shows that the overwhelming majority of medical cannabis users are managing pain. Because most registries are designed to access and track tetrahydrocannabinol (THC)-type Cannabis products, the reasons for using cannabidiol (CBD) products are less clear. An online survey of 2,409 patients found that CBD was used for a variety of medical conditions, most frequently chronic pain, arthritis/joint pain, and anxiety.

Although medical Cannabis may not be an item offered in most pharmacies, the American Pharmacy Association (APhA) released a policy statement in 2015 advocating for pharmacists to “collect and document information in the pharmacy patient profile about the use of Cannabis and its various components and provide appropriate patient counseling.” Many health care providers feel there isn’t enough information about Cannabis available to support evidence-based decision making. While that may be true, health care providers can participate in the collection of practice-based evidence and patient experience, as suggested by the APhA. This facilitates shared decision making and supports the effort to achieve optimal health care. This issue provides an overview of the physiological and clinical effects of Cannabis-based compounds and dosage forms. It is intended to help providers counsel patients about the potential benefit, or lack of benefit, of Cannabis for various types of chronic pain, and discuss safety considerations.


Publication Date: 11/23/2020
Expiration Date: 11/23/2023
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.


Kari L. Franson, PharmD,PhD, BCPP is Assoicate Dean for Academic and Student Affairs and a Professor of Clinical Pharmacy, University of Southern California, School of Pharmacy in los Angeles,California. She has guided professional, legislative, media and commercial groups on the wise study and use of cannabis.

Heesoo I. Kim, PharmD is a post-graduate year 2 Psychiatric Pharmacy Resident at the University of Southern California, School of Pharmacy in Los Angeles, California.

Disclosure Statement

Dr. Franson and Dr. Kim report no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in this issue

Target Audience

This accredited program is targeted to pharmacists .

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Discuss the rationale for use of the cannabinoids THC and CBD in various chronic pain syndromes. Interpret clinical study results of these compounds for effectiveness in chronic pain.
    2. Discuss the impact of Cannabis use on opioid use in patients with chronic, refractory pain.
    3. Describe the acute and long-term risks of Cannabis.
    4. Review various administration methods for Cannabis and the pharmacokinetic differences among them.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

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Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

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Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-20-011-H01-P

Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator

Terry M. Baker, PharmD

Managing Editor

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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