31% of adults with chronic pain use medical cannabis

About three in 10 adults with chronic pain who live in states with medical cannabis laws reported using cannabis to manage their pain, according to researchers, highlighting the need for more research on the subject.

Although most states have laws that allow people to use cannabis for chronic pain treatment, accurate estimates of cannabis use or its substitution of treatments for chronic pain are unavailable, Mark C. Bicket, MD, PhD, an assistant professor in the department of anesthesiology at the University of Michigan School of Medicine, and colleagues wrote in JAMA Network Open.

“Evidence is mixed about whether medical cannabis serves as a substitute for prescription opioids or other pain treatments,” they added.

Bicket and colleagues conducted a cross-sectional study, surveying a representative sample of people aged 18 years or older who have chronic pain residing in the 36 states and Washington, D.C., with active medical cannabis programs from March 3, 2022, to April 11, 2022. They fielded the survey with the National Opinion Research Center AmeriSpeak panel, a probability-based panel that includes roughly 54,000 people and is sourced from a sample covering 96% of United States households.

The final analysis included 1,661 people with chronic pain, 57.1% of whom were women.

Of the participants, 31% reported ever having used cannabis to manage their pain (95% CI, 28.2-34.1). More specifically, 25.9% (95% CI, 23.2-28.8) reported cannabis use to manage their pain in the last year and 23.2% (95% CI, 20.6-26) reported use in the past 30 days.

“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,” the researchers wrote.

Additionally, most of those who used cannabis to manage chronic pain also reported using at least one nonpharmacologic pain treatment or pharmacologic treatment — 70.6% (95% CI, 64.8-75.7) and 94.7% (95% CI, 91.3-96.8), respectively.

Fewer than half of the participants said cannabis use altered their nonpharmacologic pain treatments, the researchers wrote. But 38.7% reported that their cannabis use led to decreased physical therapy use (5.9% reported increased use); 26% reported it led to decreased cognitive behavioral therapy use (17.1% reported increased use); and 19.1% reported that it led to decreased meditation use (23.7% reported increased use).

More than 50% of those who used cannabis said it led them to decrease the use of prescription nonopioid and opioids and over the counter pain medications. Fewer than 1% reported increased use.

“Most persons who used cannabis as a treatment for chronic pain reported substituting cannabis in place of other pain medications including prescription opioids,” Bicket and colleagues wrote. “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.”