Medical Cannabis Experience at an Urban Academic Pain Practice
Aaron Burshtein1, Paul Shekane2
1Neurology, 2Anesthesiology, Icahn School of Medicine at Mount Sinai
Objective:
n/a
Background:

Chronic pain affects millions of individuals and incidence continues to rise. Cannabis has beneficial medicinal properties for pain. This study examined the patient population using medical cannabis for chronic pain.

Design/Methods:

A cross-sectional survey from a single-center academic pain management clinic between November 1st, 2018 and November 30th, 2020. Data was collected on initial visit and follow up ≥ one month after starting treatment.

Results:

Thirty-seven patients were included. Mean age was 53 years and majority were females (73%). Most prevalent demographics included Caucasian (54%), then Black (19%) and Hispanic (19%). Patients had some college/no degree (26%), bachelor’s degree (26%), and master’s degree (26%). Most had an income level >$100,000 (45%) and $75,000 to $99,999 (19%). Top 5 conditions for prescription were fibromyalgia (16%), lumbar radiculopathy (16%), rheumatoid arthritis (8%), cervical radiculopathy (5%), and neoplasm-related pain (5%). Mean NRS was significantly lower after treatment with cannabis for ≥ 1 month (7.94 vs. 5.03, p<0.001). Morphine equivalents was significantly lower after treatment with cannabis (51.2 vs. 27.1, p<0.05), showing a 22% reduction in opioid usage. Median morphine equivalent decreased from 15 mg to 2.5 mg after cannabis usage (p<0.05). There was no difference in change in NRS or morphine equivalents based on ethnicity, income level, or degree type. Preferences were highest for equal THC/CBD (42%) or low THC/high CBD (36%) concentrations in tincture (43%) or vape (35%) forms with tolerable side effects. Mean spent in past month was $237.67. Barriers for therapy included cost (44%), fear of traveling with medication (30%), and side effects (5%).

Conclusions:

There is mixed data on the impact of medical cannabis on opiate usage for chronic non-cancer pain. We demonstrate efficacy in decreasing NRS pain scores and opioid usage. Medical cannabis is a reasonable alternative to opioids and is an available adjunct treatment for chronic pain.

10.1212/WNL.0000000000208681
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.