Study: A quarter of people with chronic pain use cannabis

With medical cannabis being legal in most states across the country, the number of adults turning to chronic pain management has also increased.

That’s according to a new study by University of Michigan researchers published last week in the JAMA Network Open.

Researchers contacted 1,724 adults, of whom 96% (1,661) completed the full survey.

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

Researchers said that “more than half of adults who used cannabis to treat their chronic pain reported that cannabis use led them to reduce their use of prescription opioids, prescription non-opioids, and over-the-counter pain relievers, and less than 1% said cannabis use increased their use of these drugs.”

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

Thirty-seven states in the US have medicinal cannabis programs on their books. Among adults living with chronic pain in these states, “3 in 10 people reported using cannabis to manage their pain,” according to the new study.

“Most people who used cannabis to treat chronic pain reported using cannabis as a substitute for other pain medications, including prescription opioids. The high degree of substitution of cannabis by both opioid and non-opioid treatments underscores the importance of research to clarify the efficacy and possible adverse consequences of cannabis for chronic pain,” the researchers wrote. “Our results suggest that state cannabis laws have allowed access to cannabis as an analgesic treatment despite gaps in knowledge of its use as a medical treatment for pain. Limitations include the possibility of sampling and self-report bias, although NORC AmeriSpeak uses proven, probability-based recruitment and changes in pain management due to other factors (e.g., forced opioid taper).”

The results are another source of encouragement for advocates who hope patients continue to be treated with cannabis rather than highly addictive prescription drugs.

According to the Centers for Disease Control and Prevention, “More than 564,000 people died from opioid overdoses, including prescription and illicit opioids, between 1999 and 2020.”

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

“The first wave began with increased prescription opioid prescriptions in the 1990s, with overdose deaths from 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 a rapid increase in heroin overdose deaths. The third wave began in 2013 with a significant increase in overdose deaths from synthetic opioids, particularly illicitly manufactured fentanyl. The market for illicit 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 is also an 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 relievers so much underscores the need for research into the benefits and risks of using cannabis for chronic pain.”