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.
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.
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%).
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.