New research published in the Journal of Pain Research found that full spectrum cannabidiol (CBD)-dominant marijuana extracts provide stronger pain relief and fewer side effects than dronabinol (synthetic THC) in older adults.

The study was conducted using data from the German Pain e-Registry, analyzing 968 patients aged 65 and older who were dealing with chronic or treatment-resistant pain. Researchers compared two groups: one using CBD-dominant full-spectrum extracts, and another using dronabinol, a medication made with synthetic THC. Each group included 484 patients and was tracked for at least 24 weeks.

Both treatments were linked to improvements in pain and related symptoms, but CBD-dominant extracts consistently outperformed THC across all measured categories. These included reductions in overall pain intensity, improvements in daily functioning, better sleep, and enhanced overall well-being. The differences were statistically significant across every major outcome.

The gap in effectiveness was particularly notable when looking at the study’s primary composite endpoint, which required both meaningful symptom improvement and no discontinuation due to side effects. This benchmark was met by 85.7% of patients using CBD-dominant extracts, compared to just 21.9% of those using THC-based treatments.

Safety and tolerability also strongly favored CBD. Adverse drug reactions were reported in 15.5% of patients in the CBD group, compared to 35.7% in the THC group. Additionally, discontinuation rates were significantly lower among CBD users, with just 5.6% stopping treatment due to side effects, versus 19.2% in the THC group.

Researchers concluded that CBD-dominant extracts were associated with more favorable outcomes across multiple dimensions of chronic pain management in older adults. However, they caution that the findings are exploratory and should be confirmed through randomized controlled trials.