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Cannabinoid Buccal Spray for Chronic Non-Cancer or Neuropathic Pain: A Review of Clinical Effectiveness, Safety, and Guidelines

Last updated: September 21, 2016
Project Number: RC0768-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report


  1. What is the clinical effectiveness and safety of delta-9-tetrahydrocannabinol/cannabidiol for the treatment of adult patients with chronic non-cancer pain or neuropathic pain?
  2. What are the evidence-based guidelines relating to the use of delta-9-tetrahydrocannabinol/cannabidiol for adult patients with chronic non-cancer pain or neuropathic pain?

Key Message

Five systematic reviews, including two with meta-analyses, were identified relating to the clinical effectiveness of delta-9-tetrahydrocannabinol/cannabidiol (THC:CBD) buccal spray for the treatment of chronic neuropathic or non-cancer pain. Based on the identified published literature, THC:CBD buccal spray may be associated with favourable short-term patient outcomes, including reduced levels of perceived pain and a good tolerability, when compared with placebo therapy. However, sustained benefit of short-term clinical outcomes and safety over a longer term is unclear, and the clinical effectiveness of THC:CBD oral spray in comparison with other pharmacologic treatments is currently lacking.One evidence-based guideline was identified that recommends third-line use of THC:CBD buccal spray for patients uncontrolled on drug therapy in the management of chronic neuropathic pain.