Association of cannabis use with patient-reported pain measures among adults with chronic pain in US states with medical cannabis programs
Mark C Bicket 1 2 3, Elizabeth M Stone 4 5, Emma Beth McGinty 6
- 1Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA mbicket@med.umich.edu.
- 2Opioid Prescribing Engagement Network, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.
- 3Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
- 4Center for Health Services Research, Rutgers Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey, USA.
- 5Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
- 6Department of Population Health Sciences, Weill Cornell Medical College, New York, New York, USA.
Affiliationer
Introduction: Most Americans live in a state that has legalized cannabis as a medical treatment for pain, but it is unclear how chronic pain intensity relates to cannabis use. Our objective was to examine the association between patient-reported pain measures and cannabis among adults with chronic pain.
Methods: This cross-sectional study of a representative sample of adults reporting chronic non-cancer pain in 36 states and DC with active medical cannabis programs from March to April 2022 assessed cannabis use for chronic pain, categorized as active (within 30 days), past (>31 days), or never use (referent). Measures were pain intensity (primary) and interference, Widespread Pain Index, and number of chronic pain diagnoses.
Results: Among 1628 participants (57% female, 69% white), 352 (22%) actively used cannabis to treat chronic pain, 137 (8%) reported past cannabis use, and 1139 (70%) never used cannabis. In adjusted models, active cannabis use was associated with higher scores for pain intensity (score difference 1.03, 95% CI 0.05 to 2.02) and pain interference (score difference 1.82, 95% CI 0.99 to 2.65) compared with never use. Persons who actively used cannabis had higher Widespread Pain Index scores (score difference 0.56, 95% CI 0.26 to 0.86) and more chronic pain diagnoses (difference 0.45, 95% CI 0.06 to 0.83).
Conclusion: People with chronic non-cancer pain who used cannabis for pain reported non-clinically meaningful worse pain measures and greater burden of chronic pain conditions than their counterparts who never used cannabis. Alternatively, those with worse pain and greater burden of pain appear more likely to use cannabis.
Keywords: CHRONIC PAIN; OUTCOMES; Pain Management.
