Medicinal cannabis caution urged

Using medicinal cannabis to relieve chronic pain in people who don't have cancer is likely to be far more risky than beneficial, say specialists.

The evidence supporting its use by those sufferers is weak and based more on anecdote than sound clinical science and practice, they say.

The Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists on Wednesday urged caution in the face of ongoing calls for cannabinoids to be used to treat chronic non-cancer pain.

Faculty director of professional affairs, Professor Milton Cohen, referred to a lack of any sound evidence showing the treatments were effective saying its efficacy needed to be rigorously demonstrated.

"At this stage we are concerned that the risks of medicinal cannabis are likely to greatly outweigh any benefit in patients with chronic non-cancer pain," he said.

Those risks included adding another drug to a condition where patients are often over-prescribed, and the effects of cannabis-based preparations on motivation and cognitive function.

Medicines were only one aspect of their pain management which also looked at psychological and social initiatives, Prof Cohen said.

But, he told AAP, there may be a case for the use of cannabis-based preparations for cancer end-of-life patients after appropriate trials.

Faculty vice-dean, Dr Chris Hayes, said drugs were no longer the front line of chronic non-cancer pain treatment.

"We spend a vast amount of time trying to get people off a cocktail of pain drugs, such as opioids, and not introduce new ones," he said.

NSW premier Mike Baird has announced three separate trials to examine the use of cannabis in treating children with epilepsy, the terminally ill and people suffering nausea as a result of chemotherapy.

Prof Cohen told AAP those categories were not germane to those involved in pain management, but were for the professionals involved in those groups.