title: The Effect of Medicinal Cannabis on Pain and Quality-of-Life Outcomes in Chronic Pain: A Prospective Open-label Study.
abstract: The objective of this prospective, open-label study was to determine the long-term effect of medicinal cannabis treatment on pain and functional outcomes in participants with treatment-resistant chronic pain.
  
  
  
  The primary outcome was the change in the pain symptom score on the S-TOPS (Treatment Outcomes in Pain Survey-Short Form) questionnaire at the 6-month follow-up in an intent-to-treat population. Secondary outcomes included the change in S-TOPS physical, social, and emotional disability scales, the pain severity, and pain interference on the Brief Pain Inventory, sleep problems, and the change in opioid consumption.
  
  
  
  A total of 274 participants were approved for treatment; complete baseline data were available for 206 (intent-to-treat), and complete follow-up data for 176 participants. At follow-up, the pain symptom score improved from median 83.3 (95% confidence interval [CI], 79.2-87.5) to 75.0 (95% CI, 70.8-79.2) (P<0.001). The pain severity score (7.50 [95% CI, 6.75-7.75] to 6.25 [95% CI, 5.75-6.75]) and the pain interference score (8.14 [95% CI, 7.28-8.43] to 6.71 [95% CI, 6.14-7.14]) improved (both P<0.001), together with most social and emotional disability scores. Opioid consumption at follow-up decreased by 44% (P<0.001). Serious adverse effects led to treatment discontinuation in 2 participants.
  
  
  
  The treatment of chronic pain with medicinal cannabis in this open-label, prospective cohort resulted in improved pain and functional outcomes, and a significant reduction in opioid use. Results suggest long-term benefit of cannabis treatment in this group of patients, but the study's noncontrolled nature should be considered when extrapolating the results.
authors.affiliation: *Pain Relief Unit ‡Department of Anesthesia and Critical Care Medicine, Hadassah-Hebrew University Medical Center §Hadassah School of Dental Medicine, Hebrew University, Jerusalem, Israel †Department of Anesthesiology, Division of Clinical and Translational Research, Washington University School of Medicine, Saint Louis, MO.
authors.forename: Simon
authors.initials: S
authors.lastname: Haroutounian
authors.forename: Yael
authors.initials: Y
authors.lastname: Ratz
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Ginosar
authors.forename: Karina
authors.initials: K
authors.lastname: Furmanov
authors.forename: Fayez
authors.initials: F
authors.lastname: Saifi
authors.forename: Ronit
authors.initials: R
authors.lastname: Meidan
authors.forename: Elyad
authors.initials: E
authors.lastname: Davidson
mesh_terms: D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D064086:Medical Marijuana / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D059408:Pain Management; D010147:Pain Measurement; D011446:Prospective Studies; D012890:Sleep / Q000187:drug effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D064086:Medical Marijuana