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Study: A Quarter of People With Chronic Pain Use Cannabis

The number of people who are turning to medical marijuana for treatment of chronic pain has also increased with legalization in most states.

Researchers at Michigan have published this finding in a study. JAMA Network Open This week. 

One thousand and twenty-four adults were surveyed by the researchers. Of these, ninety-six percent (1,661) answered all questions. 

Among them, “31.0%…of adults with chronic pain reported having ever used cannabis to manage their pain; 25.9%… reported using cannabis to manage their chronic pain in the past 12 months, and 23.2%… reported using cannabis in the past 30 days,” the researchers wrote. 

The researchers said that “more than half of adults who used cannabis to manage their chronic pain reported that use of cannabis led them to decrease use of prescription opioid, prescription nonopioid, and over-the-counter pain medications, and less than 1% reported that use of cannabis increased their use of these medications.” 

“Fewer than half of respondents reported that cannabis use changed their use of nonpharmacologic pain treatments,” they wrote in their findings. “Among adults with chronic pain in this study, 38.7% reported that their used of cannabis led to decreased use of physical therapy (5.9% reported it led to increased use), 19.1% reported it led to decreased use of meditation (23.7% reported it led to increased use), and 26.0% reported it led to decreased used of cognitive behavioral therapy (17.1% reported it led to increased use).” 

The U.S. has 37 states with medical cannabis programs. Among adults living with chronic pain in those states, “3 in 10 persons reported using cannabis to manage their pain,” according to the new study.

“Most persons who used cannabis as a treatment for chronic pain reported substituting cannabis in place of other pain medications including prescription opioids. The high degree of substitution of cannabis with both opioid and nonopioid treatment emphasizes the importance of research to clarify the effectiveness and potential adverse consequences of cannabis for chronic pain,” the researchers wrote. “Our results suggest that state cannabis laws have enabled access to cannabis as an analgesic treatment despite knowledge gaps in use as a medical treatment for pain. Limitations include the possibility of sampling and self-reporting biases, although NORC AmeriSpeak uses best-practice probability-based recruitment, and changes in pain treatment from other factors (eg, forced opioid tapering).” 

These findings are encouraging for cannabis advocates, who want patients to continue using it as a treatment option rather than highly addictive prescription medications. 

According to the Center for Disease Control and Prevention, “more than 564,000 people died from overdoses involving any opioid, including prescription and illicit opioids, from 1999-2020.”

The CDC says that the “rise in opioid overdose deaths can be outlined in three distinct waves.”

“The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) increasing since at least 1999,” according to the CDC. “The second wave began in 2010, with rapid increases in overdose deaths involving heroin. In 2013, the third wave was initiated by significant rises in deaths from overdoses involving synthetic opioids. This included illicitly produced fentanyl. The market for illicitly manufactured fentanyl continues to change, and it can be found in combination with heroin, counterfeit pills, and cocaine.”

Mark Bicket, one of the authors of the new study who also serves as assistant professor in the Department of Anesthesiology and co-director of the Michigan Opioid Prescribing Engagement Network, said that the “fact that patients report substituting cannabis for pain medications so much underscores the need for research on the benefits and risk of using cannabis for chronic pain.”