{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:04:00Z","timestamp":1788314640481,"version":"build-2803163510"},"reference-count":117,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Cannabinoids have gained increasing attention as potential therapeutic agents in chronic pain management. Their mechanisms of action, mediated through CB1 and CB2 receptors, provide a pharmacological alternative to conventional analgesics. The evidence is strongest for neuropathic pain and multiple sclerosis-related spasticity, while the results for fibromyalgia, osteoarthritis, and musculoskeletal pain remain inconsistent. The average pain reduction is modest, often not exceeding 0.5\u20131.0 points on a 10-point scale, and therapeutic gains are offset by safety concerns. Quantitative data show that discontinuation rates range from 4.3% at low-dose CBD to 12.9% at high-dose CBD, compared with 3.5% on placebo, while nabiximols (THC + CBD spray) are associated with dizziness in 25% of patients, somnolence in 8%, and treatment discontinuation in 12%. High-dose CBD also carries a measurable risk of hepatotoxicity. Regulatory heterogeneity further constrains trial feasibility, scalability, and patient access, with disparities evident across the United States, Europe, Canada, and Australia. Overall, cannabinoids provide modest, condition-specific analgesia and should be considered adjunctive rather than first-line options, reserved for patients unresponsive to conventional therapy. Future progress requires standardized formulations, harmonized international regulations, long-term safety data, and large-scale randomized controlled trials to clarify their role in evidence-based pain management.<\/jats:p>","DOI":"10.3390\/neurolint17090141","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T08:22:34Z","timestamp":1757406154000},"page":"141","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Cannabinoids in Chronic Pain: Clinical Outcomes, Adverse Effects and Legal Challenges"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9093-6998","authenticated-orcid":false,"given":"Aleksandar","family":"Sic","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conor","family":"George","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA"},{"name":"Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Ferrer","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5651-7082","authenticated-orcid":false,"given":"Vasilis-Spyridon","family":"Tseriotis","sequence":"additional","affiliation":[{"name":"Department of Neurology, Agios Pavlos General Hospital of Thessaloniki, Leoforos Ethnikis Antistaseos 161, Kalamaria, 55134 Thessaloniki, Greece"},{"name":"Laboratory of Clinical Pharmacology, Aristotle University Campus, Aristotle University of Thessaloniki, 4124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8028-1495","authenticated-orcid":false,"given":"Nebojsa Nick","family":"Knezevic","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA"},{"name":"Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA"},{"name":"Department of Surgery, University of Illinois, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"379","DOI":"10.15585\/mmwr.mm7215a1","article-title":"Chronic Pain Among Adults\u2014United States, 2019\u20132021","volume":"72","author":"Rikard","year":"2023","journal-title":"Morb. 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