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Opioid use disorder is a chronic disease characterized by a maladaptive pattern of opioid use despite negative consequences. In the US, nearly 75 000 overdose deaths occurred in 2023, a 10-fold increase from 1999.1 However, only 1 in 4 US adults eligible for MOUD received it in 2022.2 The 2024 CRISM guideline outlines evidence-based OUD management that can be implemented by clinicians with or without specialized MOUD training for patients aged 18 years or older.3 It does not address withdrawal induction protocols, scheduling of opioid agonist therapies, or urine drug testing.
In an effort to address the opioid epidemic, a prominent goal of current research is to identify alternative treatments with equal or better benefits for pain while avoiding potential unintended consequences that could result in harms.
This 'living' systematic review assesses the effectiveness and harms of cannabis and other plant-based treatments for chronic pain conditions. For the purposes of this review, plant-based compounds (PBCs) included are those that are similar to opioids in effect and that have the potential for addiction, misuse, and serious adverse effects; other PBCs such as herbal treatments are not included. The intended audience includes policy and decision makers, funders and researchers of treatments for chronic pain, and clinicians who treat chronic pain.
