Cannabinoid Use Patterns, Perspective Vary in Patients With Chronic Pain

Individuals with self-reported chronic pain have a wide range of views and experiences regarding cannabinoid use, according to study findings published in The Clinical Journal of Pain.

Results from randomized trials evaluating cannabinoids for chronic pain often report inconclusive, mixed results whereas multiple prospective observational studies have reported that cannabinoids improved pain and had opioid-sparing effects.

As the utility of cannabinoids in pain remains unclear, researchers designed this study to evaluate cannabinoid use patterns among patients with chronic pain. To that end, study participants who self-reported chronic pain were recruited using the web-based survey platform Qualtrics^XM in 2021.

A total of 969 individuals completed the survey. These were the following characteristics:

• a third of participants were aged 60-69 years (32.9%),
• 92.0% were White,
• 63% were women,
• 25.6% were on disability,
• they had a median current pain intensity of 7 (Interquartile range [IQR], 5-8) points,
• 64.8% had been living with pain for more than 10 years,
• 31.2% reported having 4 or more pain conditions, and
• 46.9% used opioids.

The most common pain conditions were peripheral neuropathy (53%), chronic low back pain (51%), osteoarthritis (40%), and fibromyalgia (30%).

Overall, 46% endorsed currently using, 22% previously using, and 32% never using cannabinoids for their pain. Stratified by use history, significant group differences for age, employment status, duration of pain, pain conditions, and use of opioids were observed.

Among cannabinoid users, 80% of current and 90.5% of former users only used cannabinoids for medical purposes (P =.0005). The most common delivery routes were ingestion of cannabidiol (54.5%), ingestion of cannabis (45.8%), and topical cannabidiol (37.9%). Most users obtained cannabinoids from medical dispensaries (55.1%).

A minority of current (27.5%) and former (45.1%) users reported no side effects from cannabinoid use. Former users were more likely to report interference from dry mouth, drowsiness, increased appetite, difficulty thinking straight, dizziness, fatigue, increased heart rate, irrational fears, and nausea compared with current users (all P =.043).

More individuals who currently took cannabinoids said they discussed their use with their clinician (73%) compared with former users (60.4%; P =.008). Fewer than a third of all users were completely satisfied with their communication experience with clinicians (32.1%) and few (16.0%) were extremely satisfied with clinician knowledge about cannabinoids. Current users were more likely to source information about cannabinoids from the internet (62.8% vs 51.6%; P =.007) and less likely to source information from friends and family (27.3% vs 46.9%; P =.0042) than former users, respectively.

Former users discontinued use due to side effects (29.6%), lack of efficacy (29%), waning of efficacy (17.4%), expense (17.4%), and illegality (10.3%), among others.

Nonusers had not tried cannabinoids because their doctor never suggested use (40.4%), the illegality (25.3%), lack of federal regulation (18.6%), and stigma (15.1%), among others.

The researchers concluded, “These data will be useful to inform future research evaluating cannabinoid efficacy and tolerability in chronic pain patients and should spur educational initiatives for clinicians who treat patients with chronic pain.”

Disclosures: This research was supported by GW Pharmaceuticals. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

This article originally appeared on Clinical Pain Advisor