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The ACOEM Guidelines methodology was used to develop an evidence-based guideline on cannabis use. There is some evidence suggesting potential efficacy of cannabis for treatment of spasticity associated with multiple sclerosis. There is no quality evidence of efficacy for treatment of common and typical work-related disorders such as back pain, chronic radiculopathy, neuropathic pain, and other acute or chronic pain disorders. Quality evidence supports lack of efficacy for postoperative pain. There are many adverse effects, including cancers, cardiovascular diseases, psychotic disorders, and safety risks. There is a rising concern that cannabis may cause schizophrenia. Cannabis is not recommended for treatment of typical potentially work-related conditions. Cannabis use for any purpose is not recommended for those in safety-sensitive positions.