Medical marijuana has “genuine therapeutic effects for pain management,” and the degree of relief provided by cannabis can be predicted by their specific chemical profile—including not only cannabinoids but also, crucially, terpenoids—according to a newly published study employing machine learning methods.

It’s a conclusion that researchers say provides “evidence for compound-specific therapeutic effects.”

“These results highlight the importance of considering the full range of cannabis compounds when developing more precise and effective cannabis-based therapies for pain management,” says the report, published in the journal Communications Medicine.

It also furthers the notion that at least some combinations of the many compounds in cannabis work in concert to provide heightened relief—a concept known as the entourage effect.

An underlying goal of the research was contribute to the ongoing scientific debate “whether cannabis truly reduces pain or if patients feel better simply because they expect it to work (placebo effect),” authors explained. To do that, they looked at 329 medical marijuana patients and analyzed the chemical makeup of the products they used.

“We found that patients’ pain improvement could be predicted from the chemical content of their cannabis, even though patients didn’t know what chemicals they were receiving,” the team wrote. “This suggests that cannabis provides real pain relief beyond just patient expectations.”

“Pain relief can be predicted from cannabis chemical profiles that are unknown to patients, providing evidence for compound-specific therapeutic effects.”

One notable finding in the new research is that primary cannabinoids THC and CBD offered only “limited predictive value” of a product’s pain relieving effects. Other minor compounds, specifically alpha-Bisabolol and eucalyptol, instead emerged as “key predictors of treatment response.”

“An unexpected finding was the relatively minimal impact of well-known cannabinoids such as THC and CBD on pain relief outcomes, which stands in contrast to popular belief and previous reports,” the study says. “While THC and CBD are often highlighted for their therapeutic potential, our analysis revealed other compounds, including α-Bisabolol and eucalyptol, as more influential in the context of pain relief.”

As for the entourage effect, the report suggests that “specific combinations of compounds” work better at managing pain than individual chemical components.

“These findings show that medical cannabis has genuine therapeutic effects for pain management.”

“The complex relationship we observed between cannabis composition and pain relief helps explain why previous studies focusing on individual compounds have often shown mixed results,” the study says. “Our analysis suggests that therapeutic effects emerge from specific combinations of compounds working in concert, rather than from any single component.”

“This complexity in [medical cannabis’s] mechanism of action emphasizes the importance of considering the full chemical profile when investigating cannabis therapeutic properties,” it adds.

Overall, researchers—a six-person team from Technion-Israel Institute of Technology, in Haifa, Israel—said the findings also provide further evidence of medical marijuana’s analgesic properties.

“The fact that treatment outcomes were predictable from chemical composition supports the growing body of evidence for genuine pharmacological analgesia,” they wrote, “while acknowledging that expectation and context effects also contribute to therapeutic outcomes in clinical practice.”

“Our study provides compelling evidence that the efficacy of [medical cannabis] in pain relief is not merely a placebo response but is strongly influenced by its diverse chemical composition.”

The new paper contributes to a growing body of research supporting the use of marijuana as treatment for pain.

For example, a study published recently in the journal Pharmacy found that patients with chronic pain who used marijuana for at least one year “exhibited significantly lower healthcare utilization” compared to non-users, reporting fewer visits to urgent care and emergency departments (EDs) as well as a higher quality of life.

Hospitalization rates were also lower among chronic pain patients who used medical marijuana, the report found, though not enough to be statistically significant.

“Exposure [to cannabis] was associated with a 2.0 percentage point reduction in urgent care visits, a 3.2 percentage point reduction in ED visits and fewer unhealthy days per month,” said the report, authored by researchers at the Miami-based cannabis telehealth company Leafwell and George Mason University in Virginia.

“The findings of this study suggest, in line with existing research, that medical cannabis is likely an effective treatment option for patients with chronic pain,” authors wrote. “This underscores the potential for not only [quality of life] gains associated with medical cannabis use, but also positive downstream effects on the healthcare system resulting from treatment.”

Another study published earlier this year found that more than 8 in 10 patients who used medical marijuana reported it to be a useful tool for pain management.

Published in May in the journal Cureus, the report stemmed from a survey of 129 people who were medical marijuana patients in Pennsylvania between October 2022 and December 2024. It said it “provides important insights into the real-world patterns, perceived efficacy, and cognitive effects of medical cannabis use among individuals with chronic musculoskeletal pain who employ cannabis regularly over extended periods.”

“Over 80 percent of patients who turned to medical cannabis found it effective for managing their pain,” co-author Mohammad Khak, a researcher at the Rothman Opioid Foundation, said in a press release at the time.

Past research has suggested that a variety of cannabinoids—including CBD and others—may help ease pain symptoms. A study published in February, for example, found that marijuana and its cannabinoid components may be useful treatments for various types of chronic pain, in some cases helping to reduce the use of other medications

The paper also said select mixtures of cannabinoids—such as cannabichromene (CBC) and cannabigerol (CBG)—could have other benefits, including minimizing undesirable effects like the psychoactivity of THC.

All told, more than 180 different cannabinoids have now been isolated from the cannabis plant, the report noted, often interacting with different parts of the body. CBD and THC, for example, “have a wide potential for therapeutic effects based on their multiple molecular targets including ion channels, receptors, transporters and enzymes.”

“The two most abundant and studied cannabinoids, THC and CBD, along with an understudied cannabinoid, cannabigerol (CBG), have been shown, in our laboratories, to reduce neuropathic pain in animal models,” authors wrote, recommending that further study “into cannabinoids like THC, CBD and CBG should focus on the optimal therapeutic doses and the effects these cannabinoids can have on the management of chronic neuropathic pain in humans.”

Separate research published earlier this year in the journal Pain found that marijuana was “comparatively more effective than prescription medications” for treating chronic pain after a three-month period, and that many patients reduced their use of opioid painkillers while using cannabis.

The analysis “was able to determine, using causal inference techniques, that use of medical marijuana for chronic pain under medical supervision is at least as effective and potentially more effective in relationship to patients with chronic pain treated by prescription medications (nonopioid or opioid),” said the report, by authors at the University of Pittsburgh, Harvard Medical School and the National Cancer Institute.

A recent federally funded study, meanwhile, found that legalization of marijuana in U.S. states is associated with reduced prescriptions for opioid pain medications among commercially insured adults—indicating a possible substitution effect where patients are choosing to use cannabis instead of prescription drugs to treat pain.

“These results suggest that substitution of cannabis for traditional pain medications increases as the availability of recreational cannabis increases,” authors of that report wrote, noting that there “appears to be a small shift once recreational cannabis becomes legal, but we see stronger results once users can purchase cannabis at recreational dispensaries.”

“Reductions in opioid prescription fills stemming from recreational cannabis legalization may prevent exposure to opioids in patients with pain,” the paper, published in the journal Cannabis, continues, “and lead to decreases in the number of new opioid users, rates of opioid use disorder, and related harms.”

Other recent research also showed a decline in fatal opioid overdoses in jurisdictions where marijuana was legalized for adults. That study found a “consistent negative relationship” between legalization and fatal overdoses, with more significant effects in states that legalized cannabis earlier in the opioid crisis. Authors estimated that recreational marijuana legalization “is associated with a decrease of approximately 3.5 deaths per 100,000 individuals.”

“Our findings suggest that broadening recreational marijuana access could help address the opioid epidemic,” that report said. “Previous research largely indicates that marijuana (primarily for medical use) can reduce opioid prescriptions, and we find it may also successfully reduce overdose deaths.”

“Further, this effect increases with earlier implementation of [recreational marijuana legalization],” it added, “indicating this relationship is relatively consistent over time.”

Another recently published report into prescription opioid use in Utah following the state’s legalization of medical marijuana found that the availability of legal cannabis both reduced opioid use by patients with chronic pain and helped drive down prescription overdose deaths statewide. Overall, results of the study indicated that “cannabis has a substantial role to play in pain management and the reduction of opioid use,” it said.

Yet another study, published in 2023, linked medical marijuana use to lower pain levels and reduced dependence on opioids and other prescription medications. And another, published by the American Medical Association (AMA) last February, found that chronic pain patients who received medical marijuana for longer than a month saw significant reductions in prescribed opioids.

About one in three chronic pain patients reported using cannabis as a treatment option, according to a 2023 AMA-published report. Most of that group said they used cannabis as a substitute for other pain medications, including opioids.

Other research published that year found that letting people buy CBD legally significantly reduced opioid prescription rates, leading to 6.6 percent to 8.1 percent fewer opioid prescriptions.

A 2022 research paper that analyzed Medicaid data on prescription drugs, meanwhile, found that legalizing marijuana for adult use was associated with “significant reductions” in the use of prescription drugs for the treatment of multiple conditions.

A 2023 report linked state-level medical marijuana legalization to reduced opioid payouts to doctors—another datapoint suggesting that patients use cannabis as an alternative to prescription drugs when given legal access.

Researchers in another study, published last year, looked at opioid prescription and mortality rates in Oregon, finding that nearby access to retail marijuana moderately reduced opioid prescriptions, though they observed no corresponding drop in opioid-related deaths.

Other recent research also indicates that cannabis may be an effective substitute for opioids in terms of pain management.

A report published recently in the journal BMJ Open, for instance, compared medical marijuana and opioids for chronic non-cancer pain and found that cannabis “may be similarly effective and result in fewer discontinuations than opioids,” potentially offering comparable relief with a lower likelihood of adverse effects.

Separate research published found that more than half (57 percent) of patients with chronic musculoskeletal pain said cannabis was more effective than other analgesic medications, while 40 percent reported reducing their use of other painkillers since they began using marijuana.

In Minnesota, meanwhile, a state government report this year on chronic pain patients enrolled in the state’s medical marijuana program said recently that participants “are finding a noticeable change in pain relief” within a few months of starting cannabis treatment.

The large-scale study of nearly 10,000 patients also shows that nearly a quarter who were taking other pain relievers reduced the use of those drugs after using medical marijuana.

Another new study on the use of medical marijuana by older patients—age 50 and above—concluded that “cannabis seemed to be a safe and effective treatment” for pain and other conditions.

A separate presentation reviewing research on student athletes’ use of cannabis recently found that marijuana “has demonstrated positive findings as an alternative for pain management among NCAA athletes.”

Yet another study found that 40 percent of military veterans suffering from chronic pain reported using marijuana to treat their symptoms.

Most of them said they use cannabis to deal with pain, mobility and sleep issues, while substantial numbers of veterans also said it helps with PTSD, anxiety and stress. Nearly all participants (98 percent) said healthcare providers should discuss the use of natural products with their patients.