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A recent study highlights that more than 20% of patients visiting orthopedic surgeons for chronic musculoskeletal (MSK) pain have turned to marijuana for relief. Among these individuals, nearly two-thirds found marijuana to be somewhat effective, and more than 90% reported at least slight effectiveness.
The study indicates that 57% of patients considered cannabis more effective than other pain medications, with 40% reducing their use of other analgesics since starting cannabis. However, only 26% had cannabis recommended by a physician for their MSK pain.
The most frequently used cannabinoid among the patients was CBD, with 39% favoring it. Another 20% preferred a mix of various cannabinoids, while 23% were unsure about the composition of their marijuana. Interestingly, among nonusers, about 65% expressed interest in trying cannabis for pain management but faced obstacles such as lack of access, knowledge and evidence.
The study, featured in the “Cannabis Research Journal,” did not aim to definitively prove the effectiveness of cannabis in managing MSK pain. Instead, it focused on usage patterns, self-reported effectiveness and barriers to use among nonusers. The cohort consisted of 629 adult patients (18 years of age and older) with chronic MSK pain who visited Toronto Western Hospital for the first time to see an orthopedic surgeon.
According to the report, 72% of those who had previously used marijuana as a pain reliever still did so as part of their treatment plan. The preferred methods of consumption were oils (57%), smoking (36%) and vaporizing (32%). Common side effects reported were dry mouth (43%), lack of motivation (15%) and fatigue (23%), while 39% experienced no side effects. Additionally, many users found cannabis effective for other symptoms, such as headaches (18%), sleep disturbances (44%) and anxiety (26%), although 43% reported no relief for these symptoms.
Patients obtained the products from various sources, including compassion clubs or dispensaries (43%), licensed providers (34%), and relatives and friends (33%). Despite the relief reported, the study found that users often experienced more pain and a broader range of other health issues. However, the researchers did not attribute these conditions to marijuana use, suggesting that those with more severe conditions might seek marijuana as an alternative or additional relief.
In comparison to nonusers, the study found that marijuana users frequently had more comorbid conditions, such as greater rates of depression, more painful body parts and more frequent trips to pain specialists. This implies that the use of cannabis may be a reaction to more intense pain and discontentment with conventional therapies. Additionally, those who used cannabis also frequently took a broader variety of drugs, including opioids, muscle relaxants and antidepressants. This could mean that people looked to cannabis as a backup therapy when other therapies weren’t working.
Chronic pain syndrome was found to be one of the most reliable indicators of cannabis usage, suggesting that individuals with chronic MSK pain frequently feel unsatisfied with traditional therapies and turn to alternative pain-management techniques. But the largest predictor, which more than tenfold increased the risk of utilizing cannabis for pain management, was prior recreational marijuana use.
The authors called for more double-blind, placebo-controlled trials to better understand the effectiveness of cannabis for pain management, acknowledging the potential for a placebo effect.
These views expressed by marijuana users could give medical cannabis companies such as Cronos Group Inc. (NASDAQ: CRON) (TSX: CRON) some additional pointers on how to better position their products to serve the needs of these categories of patients.
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