Cannabis como opção no tratamento da dor crônica: uma Revisão Sistemática de Ensaios Clínicos

Abstract

INTRODUCTION: The plant Cannabis sativa sp. is known for its therapeutic potential for 5,000 years. However, its active principles were described from the 1960s, amid its prohibitive context formulated in this period. In parallel, associated with the limitation of conventional therapies in the management of chronic pain, evidence- based medicine points to the plant as an important additional tool for the treatment of this pathology. HYPOTHESIS: The use of Cannabis is effective in relieving symptoms in patients diagnosed with chronic pain. OBJECTIVES: to review the scientific evidence available in the literature on the efficacy, safety and tolerability of Cannabis sativa sp. in the treatment of chronic pain. METHODS: following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020, the terms MeSH Cannabis and Chronic Pain were used to perform a Systematic Review from clinical trials published between 2002 and 2022 in English and Portuguese, in the MEDLINE/PubMed and TRIP Databases. Experience reports, editorials, studies and case series, letters to the editor, comments, observational studies (cross-sectional, cohort, case-control and nested) and reviews (narrative, integrative, scope and systematic) were excluded. Studies evaluating acute pain and those using synthetic cannabinoids were also excluded. Of the 48 articles found, 25 were included by the title, 10 of these were excluded due to inadequacy to the theme, resulting in 15 articles. DISCUSSION AND CONCLUSION: An important level of evidence associated with the efficacy, safety and tolerance of cannabis use in patients with chronic pain was identified. However, due to the lack of legislation that corroborates the development of clinical trials, there is still little sample of patients evaluated. This legal obstacle also limits the elaboration of comprehensive protocols, as well as access to pharmaceutical-quality medicines. It is suggested a legislative reformulation regarding access to the plant, with the intention of fostering scientific development, expanding its access to patients with chronic pain refractory to conventional therapies.