Limited Clinical Data Impact Cannabis Integration Into Standard Care | ASHP Midyear 2025

As cannabis products steadily move into mainstream clinical conversations, many pharmacists remain caught between patient expectations and an evolving, often incomplete evidence base. Although public perception has surged ahead—fueled by state-level legalization, aggressive marketing, and widespread anecdotal reports—health care professionals are still working to ground their decisions in data rather than hype.

For certain conditions, that data is clear. Cannabidiol (CBD) already has an FDA-approved role in treating several severe, often pediatric-onset epilepsies characterized by dozens of seizures a day. These products act on the endocannabinoid system and have undergone rigorous clinical trials, giving clinicians a rare island of certainty in a sea of speculation around medical cannabis.

Tetrahydrocannabinol (THC), by contrast, has a longer but narrower clinical history. FDA-approved THC-containing products—available in liquid and capsule formulations—have been used for decades to manage chemotherapy-induced nausea and vomiting and to stimulate appetite in patients with cancer or AIDS. Outside those indications, however, the picture becomes murkier. Pain, in particular, has become the trillion-dollar question: patients, policymakers, and even some clinicians are eager to know whether cannabinoids can meaningfully and safely reduce suffering in acute, chronic, or neuropathic pain.

To answer that question, researchers and agencies are racing to keep pace. Major reviews, including work by organizations such as the American Heart Association, have tried to map the landscape of cannabis-related evidence. The Agency for Healthcare Research and Quality (AHRQ) now maintains a living review of cannabis and cannabinoids for pain—regularly updated to reflect new trials and analyses—underscoring just how fast the field is changing.

Mark Garofoli, PharmD, MBA, BCGP, CPE, director of experiential learning at West Virginia University, urges pharmacists to move beyond opinion and toward open, nonjudgmental dialogue with patients about what they are actually using—cannabis included—so that care decisions are informed by both evidence and reality at the bedside.

"We were just talking about pain, but really, [with] just any cannabinoid utilization, a lot of times the ship has already sailed," Garofoli said. "If you don't know what somebody is actually utilizing and they're too scared or anxious to tell you, it is all for naught."

READ MORE: ASHP Midyear Clinical Meeting and Exhibition

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