Chronic pain
Pain lasting more than three months. The single indication with the strongest evidence base for cannabis in adults.
What the evidence says
NASEM 2017: conclusive or substantial evidence that cannabis is effective for the treatment of chronic pain in adults.
Chronic pain is the one thing NASEM concluded, without qualification, that cannabis helps with in adults. That conclusion sat in the highest evidence category alongside only two other findings.
The practical shape of the benefit matters. Cannabis tends to change the relationship with pain — reducing how much it intrudes — more reliably than it reduces pain intensity on a numeric scale. People often describe the pain as still present but less commanding.
Published dosing consensus for chronic pain starts far lower than most people expect. The 2021 Delphi process recommended beginning with 5 mg CBD twice daily and only adding THC at 2.5 mg after reaching a CBD plateau, titrating by 2.5 mg every 2 to 7 days.
What to ask for
This is a starting point, not a prescription. Take it to a licensed dispensary and ask to see the batch certificate of analysis.
- Suggested ratio
- Balanced 1:1 THC:CBD to start; shift toward THC only if needed
- Starting THC dose
- 2.5 mg
- Commonly chosen profile
- Balanced hybrid
- Time of day
- either
Cannabinoids
- THC
The main intoxicating compound in cannabis. It drives most of what people mean by "high," and it is also the cannabinoid behind most documented therapeutic effects.
- CBD
Non-intoxicating. The only cannabis-derived compound with an FDA-approved medicine behind it, and the cannabinoid most often used to soften THC.
Terpenes to look for
Commonly present in products people choose for this. Terpene effect claims are preclinical — this is a way to find a product again, not a promise about how it will feel.
- Beta-caryophyllene
Peppery, woody, spicy
- Myrcene
Earthy, musky, faintly sweet
- Limonene
Bright citrus, lemon and orange rind
Formats
- TinctureOnset 15–90 min · lasts 4–8 h
Liquid extract dosed by dropper. The most precise way to titrate an oral dose in small increments.
- CapsuleOnset 30–120 min · lasts 6–8 h
Swallowed softgel or capsule. Behaves like an edible with pharmacy-style consistency.
- FlowerOnset 1–10 min · lasts 2–4 h
Dried cannabis, smoked or dry-herb vaporised. Fast onset makes it the easiest format to titrate.
- TopicalOnset 15–60 min · lasts 2–6 h
Creams, balms, and patches applied to skin. Non-transdermal topicals do not produce intoxication.
Get a personalised starting point
Answer four questions and we will adjust the dose for your experience level and find licensed dispensaries near you.
Get guidanceTalk to a doctor if
- • The pain is new, sudden, or severe
- • You have unexplained weight loss, fever, or night sweats alongside the pain
- • You take warfarin, an immunosuppressant, or clobazam
- • Pain follows an injury you have not had assessed
Related conditions
- FibromyalgiaWidespread pain with fatigue and sleep disruption. Covered indirectly by the chronic pain and sleep findings.
- Neuropathic painPain from nerve damage — burning, shooting, or electric in quality. Covered by the chronic pain finding.
- ArthritisJoint pain and inflammation. Covered by the chronic pain finding.
- MigraineRecurrent severe headache. Insufficient evidence specifically for migraine, despite widespread claims.
Sources
- NASEM 2017, Committee Conclusions (summary PDF of all evidence-tier conclusions).Accessed 2026-08-15.
- Bhaskar A, Bell A, Boivin M, et al. Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: results of a modified Delphi process. Journal of Cannabis Research. 2021;3(1):22.(DOI 10.1186/s42238-021-00073-1 / PMID 34215346)Accessed 2026-08-15.
- MacCallum CA, Russo EB. Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine. 2018;49:12-19.Accessed 2026-08-15.