Introduction Most Americans live in a state that has legalized cannabis as a medical treatment for pain, but it is unclear how chronic pain intensity relates to cannabis use. Our objective was to examine the association between patient-reported pain measures and cannabis among adults with chronic pain.
Methods This cross-sectional study of a representative sample of adults reporting chronic non-cancer pain in 36 states and DC with active medical cannabis programs from March to April 2022 assessed cannabis use for chronic pain, categorized as active (within 30 days), past (>31 days), or never use (referent). Measures were pain intensity (primary) and interference, Widespread Pain Index, and number of chronic pain diagnoses.
Results Among 1628 participants (57% female, 69% white), 352 (22%) actively used cannabis to treat chronic pain, 137 (8%) reported past cannabis use, and 1139 (70%) never used cannabis. In adjusted models, active cannabis use was associated with higher scores for pain intensity (score difference 1.03, 95% CI 0.05 to 2.02) and pain interference (score difference 1.82, 95% CI 0.99 to 2.65) compared with never use. Persons who actively used cannabis had higher Widespread Pain Index scores (score difference 0.56, 95% CI 0.26 to 0.86) and more chronic pain diagnoses (difference 0.45, 95% CI 0.06 to 0.83).
Conclusion People with chronic non-cancer pain who used cannabis for pain reported non-clinically meaningful worse pain measures and greater burden of chronic pain conditions than their counterparts who never used cannabis. Alternatively, those with worse pain and greater burden of pain appear more likely to use cannabis.
- CHRONIC PAIN
- Pain Management
Data availability statement
No data are available. Data will not be shared per the data use agreement with NORC, which only allows access by the study team.
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Contributors All authors conceived the study, designed the study protocol and methods, interpreted the data, and critically revised the manuscript for important intellectual content. EMS performed the data analysis. MCB wrote the first draft of the manuscript. EBM is the guarantor.
Funding This study is supported by the National Institute on Drug Abuse (NIDA; grant number R01DA49789).
Disclaimer The funder did not contribute to the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Competing interests MCB reports current grants from PCORI, CDC, NIH, Michigan Department of Health and Human Services and past grants from the Arnold Foundation. The other authors report no conflicts of interest.
Provenance and peer review Not commissioned; externally peer reviewed.
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