National Academies Report: What Cannabis Actually Treats
What Researchers Found About Chronic Pain and Cannabis
The Study at a Glance
Published
European Journal of Internal Medicine, 2018
Researchers
National Academies of Sciences, Engineering and Medicine (USA)
Study Type
Systematic ReviewDuration
N/A (comprehensive review)
Key Finding
There is conclusive or substantial evidence that cannabis or cannabinoids are effective for chronic pain in adults, chemotherapy-induced nausea and vomiting, and spasticity associated with multiple sclerosis. Evidence for most other conditions is limited, insufficient, or absent.
Key Finding: There is conclusive or substantial evidence that cannabis or cannabinoids are effective for chronic pain in adults, chemotherapy-induced nausea and vomiting, and spasticity associated with multiple sclerosis. Evidence for most other conditions is limited, insufficient, or absent.
What Researchers Studied About Chronic Pain and Cannabis
The National Academies of Sciences, Engineering and Medicine (NASEM) conducted a comprehensive rapid-turnaround review of "The Health Effects of Cannabis and Cannabinoids."
A 16-member committee adopted systematic review features, conducting an extensive database search and considering 10,000 recent abstracts.
Primacy was given to recently published systematic reviews and primary research studying 11 prioritized health endpoints.
How This Systematic Review Was Conducted
The committee developed standard language to categorize the weight of evidence: - Conclusive or substantial evidence - Moderate evidence - Limited evidence - Insufficient evidence - No or absent evidence
Evidence was evaluated for therapeutic effects, cancer incidence, cardiometabolic risk, respiratory disease, immune function, injury and death, prenatal/perinatal outcomes, psychosocial outcomes, mental health, problem cannabis use, and abuse of other substances.
Chronic Pain Treatment Results
The Main Results:
- 1CONCLUSIVE/SUBSTANTIAL evidence for: Chronic pain in adults, chemotherapy-induced nausea/vomiting, MS spasticity
- 2MODERATE evidence for: Secondary sleep disturbances
- 3LIMITED/INSUFFICIENT/ABSENT evidence for: Appetite, Tourette syndrome, anxiety, PTSD, cancer treatment, IBS, epilepsy, neurodegenerative disorders
- 4Multiple barriers to conducting cannabis research in the US were identified
- 5These barriers may explain the paucity of positive therapeutic benefits in published literature
By the Numbers
| Statistic | What It Means |
|---|---|
| 10,000 abstracts | Number of abstracts considered by the 16-member committee |
| 3 conditions | Number with conclusive/substantial evidence: pain, nausea/vomiting, spasticity |
| 1 condition | Number with moderate evidence: secondary sleep disturbances |
| 11 endpoints | Total health endpoints prioritized for evaluation |
Number of abstracts considered by the 16-member committee
Number with conclusive/substantial evidence: pain, nausea/vomiting, spasticity
Number with moderate evidence: secondary sleep disturbances
Total health endpoints prioritized for evaluation
What This Means for Chronic Pain Patients
This is the most authoritative summary of what cannabis actually treats, from the National Academies of Sciences.
PROVEN EFFECTIVE (strong evidence): - Chronic pain in adults - Nausea and vomiting from chemotherapy - Muscle spasticity in multiple sclerosis
PROBABLY HELPS (moderate evidence): - Sleep problems (secondary to other conditions)
NOT PROVEN (limited or no evidence): - Appetite/weight gain - Tourette syndrome - Anxiety - PTSD - Cancer treatment - Irritable bowel syndrome - Epilepsy (note: this review was before large CBD trials) - Neurodegenerative disorders
The report also noted significant barriers to cannabis research in the US, which may explain why many claimed benefits lack evidence. If a condition is not in the "proven" category, evidence simply does not yet support using cannabis for it.
Quick Answers: Chronic Pain and Cannabis
Direct answers based on the findings of this study:
Research Summary: Answers are based on published peer-reviewed studies and represent research findings, not medical recommendations. Individual results may vary. Always consult a healthcare provider before making treatment decisions.
What does the National Academies say about medical marijuana?
Conclusive evidence for 3 conditions. The 2018 NASEM report found conclusive/substantial evidence for chronic pain, chemotherapy nausea/vomiting, and MS spasticity. Evidence for most other conditions is limited or absent.
Source: Abrams DI, European Journal of Internal Medicine, 2018 (PMID: 29325791)
What conditions have strong evidence for cannabis treatment?
Per NASEM: Chronic pain in adults, chemotherapy-induced nausea and vomiting, and spasticity from multiple sclerosis have conclusive or substantial evidence. Only sleep disturbances have moderate evidence. Most other claims lack support.
Source: Abrams DI, European Journal of Internal Medicine, 2018 (PMID: 29325791)
Why is there limited cannabis research?
Multiple research barriers in the US. The NASEM report documented "multiple barriers to conducting research on Cannabis in the US" including scheduling restrictions, which may explain why many therapeutic claims lack rigorous evidence.
Source: Abrams DI, European Journal of Internal Medicine, 2018 (PMID: 29325791)
This is educational content, not medical advice
The research summarized here is for informational purposes only. Individual results may vary, and what works in studies may not work the same way for everyone. Always consult with a qualified healthcare provider before making changes to your treatment plan or starting medical cannabis therapy.
Important Limitations
This study has some caveats to keep in mind when interpreting the results:
- Review conducted before major CBD epilepsy trials
- Research barriers limit available evidence
- Evidence absence does not mean cannabis is ineffective
- Individual responses may vary
- US-focused research landscape
The Bottom Line on Cannabis for Chronic Pain
The authoritative NASEM report found conclusive/substantial evidence that cannabis effectively treats: chronic pain, chemotherapy nausea/vomiting, and MS spasticity. Moderate evidence supports use for sleep problems. For most other conditions (anxiety, PTSD, appetite, Tourette, cancer treatment, IBS, epilepsy), evidence is limited, insufficient, or absent. Research barriers in the US may explain this.
Do You Qualify for Medical Marijuana?
If you're living with Chronic Pain, you may qualify for a medical marijuana card. Our licensed physicians can evaluate you from home via telehealth.
Related Research & Resources
Related Research
- Which Cannabinoid Works for What? The Definitive Review of 152 Trials
- What We Really Know About Medical Cannabis: A Review of Reviews
- What Does Science Actually Know About Medical Cannabis?
- Medical Cannabis for Cancer Patients: Real-World Results
- Smoked Cannabis Reduces MS Spasticity but Impairs Cognition
Get Your Card
This condition qualifies for medical marijuana in:
Source
Abrams DI "The therapeutic effects of Cannabis and cannabinoids: An update from the National Academies of Sciences, Engineering and Medicine report" European Journal of Internal Medicine. 2018. DOI: 10.1016/j.ejim.2018.01.003
Important Information
Study Age: This study was published 8 years ago. Newer research may have updated or refined these findings.
Not Medical Advice: This research summary is for educational purposes only. It should not be used to diagnose, treat, cure, or prevent any disease or medical condition. Always consult a qualified healthcare provider before starting or changing any treatment.
Individual Variation: Research findings represent group averages. Your individual response to cannabis may differ based on genetics, other medications, underlying conditions, and many other factors.
Last reviewed: January 25, 2026
Important Notices
Research Summary Disclaimer
This content represents our interpretation of published scientific research for educational purposes. It should not be used to make treatment decisions without consulting a qualified healthcare provider. Individual results may vary from study findings.
FDA Notice
These statements have not been evaluated by the FDA. Cannabis is not intended to diagnose, treat, cure, or prevent any disease. The FDA has not approved cannabis for any medical condition except specific prescription medications.
Copyright & Fair Use
Research summaries are provided under fair use (17 U.S.C. § 107) for educational purposes. We provide brief summaries with attribution, not full reproductions. All studies remain the intellectual property of their respective authors and publishers.
Data Sources
Study information sourced from PubMed®, U.S. National Library of Medicine. Inclusion does not imply endorsement by NLM, NIH, or the federal government.
For complete information, see our Terms of Use and Research Content Policy.
FAQs: Cannabis for Chronic Pain
What conditions has cannabis been proven to treat?
Conclusive evidence for chronic pain, chemo nausea, MS spasticity. According to NASEM, these have the strongest evidence. Moderate evidence supports use for sleep disturbances.
Does cannabis help anxiety or PTSD?
Evidence is limited or insufficient according to the National Academies report. While people use cannabis for these conditions, rigorous evidence supporting effectiveness is lacking.
Why is cannabis research so limited?
Multiple research barriers exist in the US. The NASEM report identified barriers that may explain why positive therapeutic benefits are not well-documented in published literature.