A Quarter of People With Chronic Pain Use Cannabis

Can marijuana help with chronic pain ?

Following the legalization of medical marijuana in most states in the country, the number of adults turning to it to manage chronic pain has increased.

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

The researchers surveyed 1,723 adults, 96% of whom (1,663) completed the full questionnaire.

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

The researchers reported that “more than half of adults who used cannabis for chronic pain reported that marijuana use led to a decrease in the use of prescription opioids, over-the-counter opioids, and over-the-counter pain medications, and less than 1% reported that cannabis use increased the use of these medications.”

“Fewer than 50% of respondents reported that marijuana use changed their use of non-pharmacological pain treatments,” the results state. “Among adults with chronic pain in this study, 38.7% reported that marijuana use led to a decrease in physical therapy use (5.9% reported that it led to an increase in use), 19.1% reported that it led to a decrease in the use of meditation (23.7% said it led to an increase in use), and 26.0% said it led to a decrease in the use of cognitive behavioural therapy (17.1% said it led to an increase in use). ”

Thirty-seven US states have medical marijuana programs in place. According to a new survey of adults living with chronic pain in these states, “3 in 10 reported using marijuana for pain management.”

“The majority of people who used hemp as a treatment for chronic pain reported that cannabis replaced other painkillers, including prescription opioids. The high rate of marijuana substitution for both opioids and non-opioids underscores the importance of research to clarify the efficacy and potential side effects of cannabis in the treatment of chronic pain,” the researchers wrote. “Our results suggest that state cannabis laws have allowed access to marijuana as an analgesic despite gaps in knowledge about its use as an analgesic. Limitations include potential sampling and self-report bias, although NORC AmeriSpeak uses best practices for probability-based recruitment, and changes in pain management due to other factors (e.g., forced opioid dose reduction).”

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The findings serve as another source of encouragement for advocates who hope patients continue to seek treatment from marijuana, rather than highly addictive prescription drugs.

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 states that “the increase in opioid overdose deaths can be divided into three distinct waves.

“The first wave began with the increase in opioid prescriptions in the 1990s, and the number of overdose deaths from prescription opioids (natural and semi-synthetic opioids and methadone) has been increasing since at least 1999,” according to the CDC. “The second wave began in 2010 with a sharp increase in heroin overdose deaths. The third wave began in 2013 with a significant increase in synthetic opioid overdose deaths, particularly those related to illicitly manufactured fentanyl. The market for illicitly produced fentanyl is constantly changing and can be found in combination with heroin, pills and cocaine.”

Mark Bicket, one of the authors of the new study, who also serves as an assistant professor in the Department of Anesthesiology and co-director of the Michigan Opioid Prescribing Network, said that “the fact that patients report that marijuana replaces pain medications to such an extent underscores the need for research into the benefits and risks of marijuana use for chronic pain.“