From the Journals

Chronic pain patients swapping opioids for medical cannabis


 

FROM JAMA NETWORK OPEN

Pain a leading indication

Commenting on the findings, Jason W. Busse, PhD, professor, department of anesthesia, and associate director, Centre for Medicinal Cannabis Research, McMaster University, Hamilton, Ont., said the study reinforces results of some prior research.

“It gives us current information certainly highlighting the high rate of use of medical cannabis among individuals with chronic pain once it becomes legally available.”

In addition, this high rate of use “means we desperately need information about the benefits and harms” of medical marijuana, he said.

Dr. Busse noted the survey didn’t provide information on the types of cannabis being used or the mode of administration. Oil drops and sprays cause less pulmonary harm than smoked versions, he said. It’s also not clear from the survey if participants are taking formulations with high levels of tetrahydrocannabinol that are associated with greater risk of harm.

He noted cannabis may interact with prescription drugs to make them less effective or, in some cases, to augment their adverse effects.

Dr. Busse pointed out some patients could be using fewer opioids because providers are under “enormous pressure” to reduce prescriptions of these drugs in the wake of spikes in opioid overdoses and deaths.

Chronic pain is “absolutely the leading indication” for medical marijuana, said Dr. Busse. U.S. reimbursement data suggest up to 65% of individuals get cannabis to treat a listed indication for chronic pain.

He said he hopes this new study will increase interest in funding new trials “so we can have better evidence to guide practice to help patients make decisions.”

The study received support from the National Institute on Drug Abuse. Dr. Bicket reported receiving personal fees from Axial Healthcare as well as grants from the National Institutes of Health, the Centers for Disease Control and Prevention, Michigan Department of Health and Human Services, Arnold Foundation, and the Patient-Centered Outcomes Research Institute outside the submitted work. Dr. Busse reported no relevant financial relationships.

A version of this article first appeared on Medscape.com.

Pages

Recommended Reading

Safest, most effective medications for spine-related pain in older adults?
MDedge Emergency Medicine
NSAIDs linked to heart failure risk in diabetes
MDedge Emergency Medicine
Cannabis for pain linked to slight risk for arrhythmia
MDedge Emergency Medicine
Is acetaminophen really safer than NSAIDs in heart disease?
MDedge Emergency Medicine
Children with sickle cell anemia not getting treatments, screening
MDedge Emergency Medicine
Could a vaccine (and more) fix the fentanyl crisis?
MDedge Emergency Medicine
Gout too often treated only in emergency department
MDedge Emergency Medicine
‘A huge deal’: Millions have long COVID, and more are expected
MDedge Emergency Medicine
Fentanyl vaccine a potential ‘game changer’ for opioid crisis
MDedge Emergency Medicine
Screen all patients for cannabis use before surgery: Guideline
MDedge Emergency Medicine