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Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain

Surveillance Report


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.

A systematic review assessing the effectiveness and harms of plant-based treatments for chronic pain conditions is underway. The review will be "living" in the sense that it will identify and synthesize recently published literature on an ongoing basis. 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.

The quarterly progress reports present the accumulating evidence and are updated on a regular basis. They include a description of the available studies and an appraisal of study quality. 

January 2021 Update


This is the first progress report for an ongoing living systematic review on plant-based treatments for chronic pain. The systematic review will synthesize evidence on the benefits and harms of plant-based compounds (PBCs) such as cannabinoids and kratom used to treat chronic pain, addressing concerns about severe adverse effects, abuse, misuse, dependence, and addiction.

The purpose of this progress report is to describe the body of literature identified thus far. This report will be periodically updated with new studies as they are published and identified, culminating in a systematic review that provides a synthesis of the accumulated evidence.

This report is available in digital format only: (Living Systematic Review—January 2021 [PDF, 493 KB]; Appendix Tables F-1 to F-4 [XLSX, 74 KB]; Appendix Table F-5: Cohort Studies [XLSX, 14 KB]; Appendix G: Risk of Bias Assessment [XLSX, 14 KB]).


McDonagh MS, Wagner J, Ahmed AY, Morasco B, Kansagara D, Chou R. Living Systematic Review on Plant-Based Treatments for Chronic Pain—Quarterly Progress Report: December 2020 (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 75Q80120D00006.) AHRQ Publication No. 21-EHC013. Rockville, MD: Agency for Healthcare Research and Quality; January 2021. DOI: 10.23970/AHRQEPCCERPLANTPAIN1. Posted final reports are located on the Effective Health Care Program search page.