Research Corner

COLLECTED BY MATT JACKSON, PHD

PILLS TO POT: OBSERVATIONAL ANALYSES OF CANNABIS SUBSTITUTION AMONG MEDICAL CANNABIS USERS WITH CHRONIC PAIN A survey of patients using medical cannabis to manage chronic pain and how medical use is changing prescription drug use, from the University of Michigan Medical School and published in The Journal of Pain in July 2019.

https://www.jpain.org/article/S1526-5900(18)30735-1/fulltext#sec0018

STUDY FACTS

SURVEY DESIGN:

● Dispensaries and cannabis certification clinics distributed an anonymous, online survey to medical cannabis patients through their databases and social media.

● Researchers asked patients with chronic pain about their health conditions and history using prescription drugs and cannabis.

● 1,321 medical cannabis patients from across the U.S. completed the survey, a nationwide expansion of a smaller 2016 study that surveyed 185 patients in Michigan. 1

DEMOGRAPHIC BREAKDOWN:

● On average, patients were 50 years of age, 59% were female, 86% had a college degree, and 49% were married.

● 63% had used medical cannabis for over 1 year, and 62% also used prescription pain medicines.

● 20% were from California, 18% from Maine, 10% from Arizona, and 9% from New Hampshire.

In 2016, researchers surveyed 185 medical cannabis patients with chronic pain who visited one dispensary in Michigan. These patients reported that after starting to use medical cannabis, they decreased their opioid use by 64%. 1 In 2019, the researchers expanded the study to a nationwide survey of more than 1,000 medical cannabis patients. They found that medical cannabis patients were decreasing prescription drug use or replacing their prescriptions with cannabis altogether. Patients also reported decreased pain levels and improved overall health.

ALL PATIENTS IN THE STUDY USED MEDICAL CANNABIS FOR CHRONIC PAIN.

● Back pain was most common (58% of patients), followed by migraines (21%), osteoarthritis (20%), and fibromyalgia (15%)

● Patients reported multiple health conditions (4.5 on average), which included conditions besides pain: anxiety (52%), depression (40%), and PTSD (25%).

62% OF MEDICAL CANNABIS PATIENTS ALSO REPORTED USING A PRESCRIPTION DRUG FOR PAIN MANAGEMENT.

● NSAIDs (nonsteroidal anti-inflammatory drugs, such as aspirin) were most common (31% of patients), then opioids (16%), benzodiazepines (13%), and gabapentanoids (12%).

● Patients also used SSRIs (12%) and SNRIs (9%), drugs generally used to treat depression and anxiety.

80% OF PATIENTS REPORTED USING MEDICAL CANNABIS TO REPLACE AN AVERAGE OF TWO PRESCRIPTION DRUGS.

● About 40% of patients stopped using NSAIDs, and another 40% decreased use “a lot.”

● 70–80% stopped using other drugs, including opioids, and 10–20% decreased use “a lot.”

● Patients said cannabis provided better symptom management with fewer side effects.

● Those who substituted prescriptions were also more likely to say that their pain levels decreased or that their overall health improved.

HOW DO THESE RESULTS STACK UP WITH THE REST OF THE SCIENTIFIC EVIDENCE?

● This survey closely matches at least seven surveys and clinical studies from the U.S., Canada, and Israel, all reporting that medical cannabis patients are reducing or stopping opioid use.

● The researchers pointed to additional scientific evidence that indicates that THC and opioids likely work together to increase pain tolerance and that CBD might help reduce opioid cravings.

● Patients can often achieve similar pain relief by supplementing smaller opioid doses with cannabis.

On the heels of the opioid epidemic, patients are reporting astounding success using medical cannabis to moderate or stop their opioid use, all while reporting improved pain management and overall better quality of life.