Is Cannabis A Useful Medication to Relieve Pain?

Is there a therapeutic use for cannabis that merits its legalization?  Should it be an over-the-counter drug or by prescription only?  Should its medical use be covered by insurance?  Political push has surfaced in Virginia for legalization of the sale of cannabis.  I would guess you already have strong opinions on these issues, but there is  uncertainty about this topic.  A recent article in JAMA helps to un-muddy the waters a little bit.

For recreational users, their answer is a slam-dunk - “yes!”, bring it all on.  For those of us holding the opinion that it still has much potential for diversion, abuse and misuse, this article reinforces that control of its use remains warranted.  Approximately 27% of adults in the US and Canada report ever having used cannabis for medical purposes and another 10.5% report using cannabidiol (CBD), a chemical extracted from cannabis that does not have the psychoactive effects.  That’s one out of three people seeking relief of their medical condition.  Having a psychoactive spell is favored >2:1.

Cannabinoids have approval from the FDA for HIV/AIDS-related loss of appetite, chemotherapy nausea and vomiting, and certain seizure disorders of children.  Research has shown a small, but significant reduction in nausea/vomiting and a moderate effect on increased body weight for HIV/AIDS patients.  The seizure disorder use is diagnosis-dependent.  Evidence-based guidelines do not recommend highpotency cannabis for medical purposes due to associated risk for psychotic symptoms (12.4%) and anxiety disorders (19.1%).  Increased risk for cardiovascular disease (heart attack, stroke, coronary artery symptoms) was associated with daily inhaled cannabis use.  I guess sudden death would relieve your pain, but good evidence from randomized trials does not exist for most of the medical conditions it is promoted, i.e., acute pain and sleep disorders.

I do not find evidence for legalization of cannabis for over-the-counter sales.  It remains a drug of potential abuse and a “catalyst” for entering into the use of more addictive psychoactive drugs.  Until further benefits can be proven, proper use would still mandate a physician’s evaluation and clear guidance for safe use by prescription.

Medical Tip from Charles Driscoll, VASSAR State Surgeon

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References:  1.  Hsu M, Shah A, Jordan A, Gold MS, Hill KP. Therapeutic Use of Cannabis and Cannabinoids: A Review. JAMA. Published online November 26, 2025. doi:10.1001/ jama.2025.19433