A large review led byUCLAHealth reports that medicalcannabisdoes not have strong scientific evidence for most of the conditions it is commonly used to treat, including chronic pain, anxiety, and insomnia.

The analysis, published inJAMAexamined than 2,500 studies released between January 2010 and September 2025. These included randomized clinical trials, meta-analyses, and clinical guidelines. Researchers gave special attention to than 120 studies that stood out for their large sample sizes, recent publication dates, relevance, and range of topics.

The findings arrive as cannabis andcannabinoidssuch as CBD continue to gain popularity. A 2018 survey found that 27% of people in the U.S. and Canada reported using cannabis for issues like pain relief, anxiety, and sleep difficulties.

Public Perception and Scientific Evidence Do Not Align

Dr. Michael Hsu of UCLA Health, the review’s first author, said many people believe cannabis provides broad medical benefits, even though the latest research often does not support those beliefs.

“While many people turn to cannabis seeking relief, our review highlights significant gaps between public perception and scientific evidence regarding its effectiveness for most medical conditions,” said Hsu, health sciences clinical assistant professor at the UCLA Health Department of Psychiatry and Biobehavioral Sciences. “Clear guidance from clinicians is essential to support safe, evidence-based decision-making when discussing medical cannabis with their patients.”

Proven Benefits Are Limited to Specific Conditions

The review found that pharmaceutical-grade cannabinoid products approved by the U.S. Food and Drug Administration do show clear benefits, but only for a small number of conditions. These include treatments for HIV/AIDS-related appetite loss, chemotherapy-induced nausea and vomiting, and certain severe pediatric seizure disorders such as Dravet syndrome and Lennox-Gastaut syndrome.

Outside of these uses, evidence supporting cannabis-based treatments remains unclear or insufficient. Even though than half of medical cannabis users report using it to manage chronic pain, current clinical guidelines advise against cannabis-based medicines as a first-line option for chronic pain treatment.

Mental Health and Cardiovascular Risks Highlighted

The researchers also examined potential health risks linked to cannabis use. Long-term data from adolescents suggested that high-potency cannabis may be associated with higher rates of psychotic symptoms (12.4% versus 7.1% for low-potency) as well as generalized anxiety disorder (19.1% versus 11.6%).

The review also found that about 29% of people using medical cannabis met the criteria for cannabis use disorder. Daily use, especially involving inhaled and/or high-potency products, may be tied to increased cardiovascular risks. These include higher rates of coronary heart disease, heart attack, and stroke when compared with non-daily use.

Guidance for Clinical Decision-Making

Based on these findings, the authors stress that clinicians should screen patients forcardiovascular diseaseand psychotic disorders, review possible drug interactions, and carefully weigh potential risks against benefits before recommending THC-containing products for medical use.

“Patients deserve honest conversations about what the science does and doesn’t tell us about medical cannabis,” Hsu said.

Study Limitations and Need for Further Research

The authors also outlined several limitations of their work. The analysis was not a systemic review and did not include a formal risk of bias assessment.

Some of the studies reviewed were observational, which means their results could be influenced by confounding factors. In addition, conclusions drawn from clinical trials may not apply to all patients because of differences in study design, patient populations, and the cannabis products tested.

“Further research is crucial to better understand the potential benefits and risks of medical cannabis. By supporting rigorous studies, we can provide clearer guidance and improve clinical care for patients,” said Dr. Hsu.

Reference: “Therapeutic Use of Cannabis and Cannabinoids: A Review” by Michael Hsu, Arya Shah, Ayana Jordan, Mark S. Gold and Kevin P. Hill, 26 November 2025,JAMA.
DOI: 10.1001/jama.2025.19433

Researchers from Harvard, UC San Francisco, Washington University School of Medicine, andNew York Universitycontributed to the study.

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