Neuropathy is damage to peripheral nerves. Diabetes is the most common cause in the United States. Chemotherapy, heavy alcohol use, HIV, shingles, and injury also damage nerves. Symptoms include numbness, tingling, burning pain, and weakness in the feet and hands.

medical marijuana for neuropathy

Medical cannabis may reduce that pain for some people. The evidence is weak. No cannabis product is FDA-approved to treat neuropathy. This guide covers what trials found, how products are regulated, and which doses were studied.

Best Medical Cannabis Strains for Neuropathy

What clinical trials found

A 2018 Cochrane review pooled 16 randomized trials with about 1,750 participants. Cannabis-based medicines reduced neuropathic pain more than placebo. The number needed to treat for 30% pain relief was about 6. Reviewers rated the evidence low quality. Most trials ran less than 3 months.

Does Medical Cannabis Help Neuropathy

Nabiximols is an oral spray with THC and CBD in a 1:1 ratio. It is approved in Canada and several European countries. Trials in multiple sclerosis and cancer pain gave mixed results. Nabiximols is not approved in the United States.

does medical cannabis help neuropathy

Studies of CBD alone for neuropathy are small. No large trial has shown that CBD by itself reduces nerve pain.

FDA status

Epidiolex, a purified CBD drug, is FDA-approved for three rare seizure disorders. It is not approved for pain. THC remains a Schedule I controlled substance under federal law. Hemp-derived CBD with 0.3% THC or less is legal under the 2018 Farm Bill at the federal level. State law varies. The FDA has sent warning letters to companies that claimed CBD treats pain.

Routes of use

  • Inhaled: onset 1 to 10 minutes; effects last 1 to 3 hours.
  • Oral oil, capsule, or edible: onset 30 to 120 minutes; effects last 4 to 8 hours.
  • Topical: absorption into the bloodstream is low; evidence for nerve pain comes from small studies only.

Side effects and interactions

Common effects are drowsiness, dizziness, dry mouth, and nausea. THC can raise heart rate and cause anxiety or short-term memory problems. Risk of cannabis use disorder is about 9% among adults who use cannabis, and higher for people who start in their teens. CBD inhibits the CYP3A4 and CYP2C19 enzymes. It can raise blood levels of clobazam, warfarin, clopidogrel, and some statins. Tell your clinician about every product you take.

Doses used in studies

There is no standard dose. Trials of nabiximols used 1 to 12 sprays per day. Each spray contains 2.7 mg THC and 2.5 mg CBD. Epidiolex doses in trials ranged from 5 to 20 mg/kg per day, but that drug treats seizures, not pain. Common guidance is to start low and increase over days or weeks.

Legal access

38 states and the District of Columbia run medical cannabis programs. 24 states and DC allow adult use for any reason. Rules on qualifying conditions, possession limits, and lab testing differ by state. Neuropathy is a qualifying condition in some states and not in others.

Questions for a clinician

  • Is neuropathy the cause of my symptoms, or is another condition involved?
  • Which standard drugs have we tried, and at what doses?
  • Could cannabis interact with my current medicines?
  • Does my state list neuropathy as a qualifying condition?