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Cannabis for Pain Management in Rheumatology

Joanna Zeiger, PhD, & Kaleb Michaud, PhD  |  Issue: March 2025  |  March 7, 2025

Kaleb Michaud, PhD.

University of Nebraska Medical Center portrait taken on Thursday, September 15, 2022.

Kaleb Michaud, PhD, is a professor in the Division of Rheumatology and Immunology, University of Nebraska Medical Center, Omaha, and the director of FORWARD, The National Databank for Rheumatic Diseases. He is also the ARP secretary.

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Disclosure

Dr. Michaud has received Innovative Research Award funding from the Rheumatology Research Foundation.

References

  1. Habib G, Artul S. Medical cannabis for the treatment of fibromyalgia. Clin Rheumatol. 2018 Aug;24(5):255–258.
  2. Katz-Talmor D, Katz I, Porat-Katz BS, Shoenfeld Y. Cannabinoids for the treatment of rheumatic diseases—where do we stand? Nat Rev Rheumatol. 2018 Aug;14(8):488–498.
  3. Wipfler K, Simon TA, Katz P, Wolfe F, Michaud K. Increase in cannabis use among adults with rheumatic diseases: Results from a 2014–2019 United States observational study. Arthritis Care Res (Hoboken). 2022 Dec;74(12):2091–2099.
  4. Boehnke KF, Scott JR, Martel MO, et al. Substituting medical cannabis for medications among patients with rheumatic conditions in the United States and Canada. ACR Open Rheumatol. 2024 Dec;6(12):826–835.
  5. Zeiger JS, Silvers WS, Naimi DR, et al. Impact of cannabis knowledge and attitudes on real-world practice. Ann Allergy Asthma Immunol. 2022 Oct;129(4):441–450.
  6. Fitzcharles MA, Niaki OZ, Hauser W, Hazlewood G. Position statement: A pragmatic approach for medical cannabis and patients with rheumatic diseases. J Rheumatol. 2019 May;46(5):532–538.
  7. Gonen T, Amital H. Cannabis and cannabinoids in the treatment of rheumatic diseases. Rambam Maimonides Med J. 2020 Jan 1;11(1):e0007.
  8. Fitzcharles M-A, Rampakakis E, Sampalis J, et al. Medical cannabis use by rheumatology patients following recreational legalization: A prospective observational study of 1000 patients in Canada. ACR Open Rheumatol. 2020 May;2(5):286–293.
  9. Barrie N, Manolios N. The endocannabinoid system in pain and inflammation: Its relevance to rheumatic disease. Eur J Rheumatol. 2017 Sep 15;4(3):210–218.
  10. Zeiger JS, Silvers WS, Fleegler EM, Zeiger RS. Cannabis use for pain in a large population-based survey of adult athletes (abstract 5C). Institute of Cannabis Research, Pueblo. 2019.
  11. Zeiger JS, Silvers WS, Winders TA, et al. Cannabis attitudes and patterns of use among followers of the Allergy & Asthma Network. Ann Allergy Asthma Immunol. 2021 Apr;126(4):401–410.e1.
  12. Zeiger J, Katz P, Fitzcharles M, et al. Knowledge and attitudes about delta-9-tetrahydrocannabinol (THC) impact real-world practice in an international group of rheumatologists [abstract]. Arthritis Rheumatol. 2024;76(suppl 9).
  13. van den Hoogen NJ, Harding EK, Davidson CED, Trang T. Cannabinoids in chronic pain: Therapeutic potential through microglia modulation. Front Neural Circuits. 2022 Jan 7;15:816747.
  14. Kendall DA, Yudowski GA. Cannabinoid receptors in the central nervous system: Their signaling and roles in disease. Front Cell Neurosci. 2017 Jan 4;10:294.
  15. Zou S, Kumar U. Cannabinoid receptors and the endocannabinoid system: Signaling and function in the central nervous system. Int J Mol Sci. 2018 Mar 13;19(3):833.
  16. Rabgay K, Waranuch N, Chaiyakunapruk N, et al. The effects of cannabis, cannabinoids, and their administration routes on pain control efficacy and safety: A systematic review and network meta-analysis. J Am Pharm Assoc. 2020 Jan–Feb;60(1):225–234.e6.
  17. Sheikh NK, Dua A. Cannabinoids. StatPearls. 2023 Feb 27.
  18. Wilson-Morkeh H, Al-Abdulla A, Sien L, et al. Important drug interactions exist between cannabidiol oil and commonly prescribed drugs in rheumatology practice. Rheumatology (Oxford). 2020 Jan 1;59(1):249–251.
  19. Busse JW, Vankrunkelsven P, Zeng L, et al. Medical cannabis or cannabinoids for chronic pain: A clinical practice guideline. BMJ. 2021 Sep 9;374.
  20. Bhaskar A, Bell A, Boivin M, et al. Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: Results of a modified Delphi process. J Cannabis Res. 2021 Dec 1;3(1):1–12.

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Filed under:ConditionsDrug UpdatesPain SyndromesPatient Perspective Tagged with:Editor's PickJoanna ZeigerKaleb MichaudPhD

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