Study: A Quarter of People With Chronic Pain Use Cannabis

With medical cannabis legal in the majority of states in the country, the number of adults who have turned to the treatment for chronic pain has likewise increased.

That is the finding of a new study from researchers at the University of Michigan that was published in JAMA Network Open last week. 

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

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

The researchers said that “more than half of adults who used cannabis to manage their chronic pain reported that use of cannabis led them to decrease use of prescription opioid, prescription nonopioid, and over-the-counter pain medications, and less than 1% reported that use of cannabis increased their use of these medications.” 

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

Thirty-seven states in the U.S. have medical cannabis programs on the books. Among adults living with chronic pain in those states, “3 in 10 persons reported using cannabis to manage their pain,” according to the new study.

“Most persons who used cannabis as a treatment for chronic pain reported substituting cannabis in place of other pain medications including prescription opioids. 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,” the researchers wrote. “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. Limitations include the possibility of sampling and self-reporting biases, although NORC AmeriSpeak uses best-practice probability-based recruitment, and changes in pain treatment from other factors (eg, forced opioid tapering).” 

The findings serve as another source of encouragement for advocates who hope patients continue to seek treatment from cannabis, 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 says that the “rise in opioid overdose deaths can be outlined in three distinct waves.”

“The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths involving 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 rapid increases in overdose deaths involving heroin. The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids, particularly those involving illicitly manufactured fentanyl. The market for illicitly manufactured 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 also serves as 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 medications so much underscores the need for research on the benefits and risk of using cannabis for chronic pain.”