It was 2021 The expert group decided that cannabis preparations should not be used for pain relief in healthcare. This is because the evidence for pain-relieving effects is minimal or completely absent – while the risks are high for serious long-term side effects, primarily psychosis and cognitive disorders.
The recommendation is now being reviewed. Karl Olaf Stiller, associate professor and chief physician at Karolinska University Hospital and leading the expert group, does not want to get ahead of events and reveal whether the expert group has changed its position since 2021.
However, he stresses that reviewing the document is not about answering the question of whether cannabis preparations can reduce pain in general.
– Such a question is too broad for us to care about getting an answer to it. “We intend to analyze specific pain conditions and each preparation individually,” says Karl Olaf Steller.
The expert team is now analyzing whether there is a well-defined pain condition, for example diabetic neuropathy or pain after stroke, where a specific dose of a particular cannabis preparation had a greater benefit than placebo and where the difference could be considered clinically important. .
Karl Olaf Steller, for example, points out that nerve pain varies, and that a study conducted on patients with multiple sclerosis, MS, cannot be transferred to all patients with nerve pain.
He also says that the expert group does not take a position on studies that have compared treatment with cannabis preparations with treatment with opioids in chronic pain conditions, because these pain conditions should not, as a general rule, be treated with opioids.
-We do not believe this question is relevant to our mission. In acute pain, cannabis was observed to have no better effect than placebo. The same applies to cancer-related pain. These are the main indications for opioid therapy.
The review is expected to be completed soon. However, before publication, the expert group is awaiting publication of the SBU review of the systematic review. It concerns “SBU Comments”, a type of publication where the quality of methodological overviews provided by other actors is checked by staff at the SBU and commented on from a Swedish perspective by subject matter experts and independent reviewers.
– We wait and see what the SBU will come up with, says Karl Olaf Steller.
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Discussion: Medical cannabis – it's time for Sweden to update its guidelines
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