Comparing the effects of medical cannabis for chronic pain patients with and without co-morbid anxiety: A cohort study
Lara Bapira, Simon Erridgea,b, Martha Nicholasa, Manaswini Pillaia, Nishaanth Dalavayea, Carl Holveyb, Ross Coomberb,c, Jonathan Hoarea,b, Shaheen Khanb,d, Mark W Weatherallb,e, James J Ruckerb,f,g, Michael Platta,b and Mikael H Sodergren
- 1Imperial College Medical Cannabis Research Group Department of Surgery and Cancer, Imperial College London, London, UK.
- 2Department of Medicine, Sapphire Medical Clinics, London, UK.
- 3Department of Trauma and Orthopaedics, St. George’s Hospital NHS Trust, London, UK.
- 4Department of Palliative Care, Guy’s & St. Thomas’ NHS Foundation Trust, London, UK.
- 5Department of Palliative Medicine, Buckinghamshire Healthcare NHS Trust, Amersham, UK.
- 6Department of Psychological Medicine, Kings College London, London, UK.
- 7Centre for Affective Disorders, South London & Maudsley NHS Foundation Trust, London, UK.
Affiliationer
Introduction: There is growing evidence on the efficacy of cannabis-based medicinal products (CBMPs) for chronic pain (CP). Due to the interaction between CP and anxiety, and the potential impact of CBMPs on both anxiety and CP, this article aimed to compare the outcomes of CP patients with and without co-morbid anxiety following CBMP treatment.
Methods: Participants were prospectively enrolled and categorized by baseline General Anxiety Disorder-7(GAD-7) scores, into ‘no anxiety'(GAD-7 < 5) and 'anxiety'(GAD-7 ≥ 5) cohorts. Primary outcomes were changes in Brief Pain Inventory Short-Form, Short-form McGill Pain Questionnaire-2, Pain Visual Analogue Scale, Sleep Quality Scale (SQS), GAD-7 and EQ-5D-5L index values at 1, 3 and 6 months. Results: 1254 patients (anxiety = 711; no anxiety = 543) met inclusion criteria. Significant improvements in all primary outcomes were observed at all timepoints (p < 0.050), except GAD-7 in the no anxiety group(p > 0.050). The anxiety cohort reported greater improvements in EQ-5D-5L index values, SQS and GAD-7(p < 0.050), but there were no consistent differences in pain outcomes. Conclusion: A potential association between CBMPs and improvements in pain and health-related quality of life (HRQoL) in CP patients was identified. Those with co-morbid anxiety reported greater improvements in HRQoL.
Keywords: Cannabis; anxiety; cannabidiol; chronic pain; pain; tetrahydrocannabinol.
