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(CNN) --
People who suffer from chronic pain may find mild to moderate short-term relief when they use certain prescription medical cannabis products that have a higher ratio of THC to CBD, new research has found.
But, there are some worrying side effects, the study warns.
Tetrahydrocannabinol, or THC, is the chemical compound in the marijuana plant that produces the drug's psychoactive effect.
While cannabidiol, or CBD, is the second most prevalent active chemical compound in cannabis, it does not produce effects.
The two compounds have been associated with pain relief.
"The results are consistent with what we know," said Yasmin Hurd, a professor of pharmacological sciences, neuroscience and psychiatry at the Icahn School of Medicine at Mount Sinai in New York.
She did not participate in the study.
"There are some signs of mild to moderate pain relief depending on the THC/CBD ratio. But, there is an increase in side effects, such as dizziness and sedation," said Hurd, who is the director of the Addiction Institute. of Mount Sinai.
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However, no such benefits have been found in over-the-counter THC or CBD extracts from the whole marijuana plant.
"Unfortunately, the available evidence is largely inconclusive, due to the small number of studies and the variation in cannabinoid products between these studies," said Jodi Gilman, an associate professor at the Harvard University Center for Addiction Medicine, who did not participate in the study.
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"Large placebo-controlled trials in hundreds of patients taking the exact same product at the same doses are needed to understand the benefits and risks of cannabis for treating chronic pain," Gilman added.
There are no benefits of over-the-counter extracts
The review looked at 25 clinical trials and observational studies involving almost 15,000 people.
The researchers found that the prescription drugs dronabinol, a pure synthetic THC compound, and nabilone, which is almost pure THC, were linked to moderate pain relief but increased risk of drowsiness and dizziness.
Nabiximols, a drug with comparable amounts of THC and CBD designed to be sprayed under the tongue, improved pain relief and function to a lesser degree, but also carried a risk of sedation, dizziness and nausea, according to the study published this week. Monday in the academic journal
Annals of Internal Medicine
.
Nabiximols is a prescription drug that is not available in the United States.
Those side effects caused some patients to stop using the products, although "these are also common side effects of other pain medications," Gilman said.
Patients using cannabinoids for pain should be "closely monitored by their doctors to determine if these products are helpful," Gilman said, and to determine if any benefits outweigh possible side effects.
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"Although the amount of pain relief is not substantial, individuals suffering from chronic pain might think it is worth the risk. It is clear that CBD has a much higher safety profile than THC. So it is important that high-THC products are carefully controlled," Hurd said.
"It is critical that patients consider conventional clinically approved products before trying cannabis," he said.
"In addition, they have to be extremely careful about the cannabis products they use, as there are many products that do not have good quality control and may not even contain the amount of THC or CBD that they believe based on the packaging." .
Additionally, Hurd warned that "'recreational' cannabis smoking as a medicine is not appropriate."
Like tobacco, smoking marijuana can damage the lungs and increase the risk of respiratory illness.
Excessive cannabis use has been linked to an increased risk of heart attacks, she said.
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