Increase in Cannabis Use Among Adults With Rheumatic Diseases: Results From a 2014–2019 United States Observational Study

Wipfler, Kristin; Simon, Teresa A.; Katz, Patricia P.; Wolfe, Frederick; Michaud, Kaleb

doi:10.1002/acr.24752

Cited by 13 publications

(10 citation statements)

References 47 publications

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“…In patients with rheumatic diseases, we found few cannabis users (4.6%), but a significant number of patients were in favour of using therapeutic cannabis in the future while being supervised or when cannabis is legalised in France. These results are in line with those of Wipfer which showed an increase in cannabis consumption in adults with rheumatic diseases in the USA in 2019 (5).…”

Section: Sirssupporting

confidence: 91%

Frequency of cannabis use in patients with rheumatoid arthritis or spondyloarthropathies: a single-centre study

Ouatah

Authier

Tournadre

et al. 2023

Clinical and Experimental Rheumatology

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Section: Sirssupporting

confidence: 91%

Frequency of cannabis use in patients with rheumatoid arthritis or spondyloarthropathies: a single-centre study

Ouatah

Authier

Tournadre

et al. 2023

Clinical and Experimental Rheumatology

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“…Although broad expertise was recruited and an extensive list of interventions was considered in this guideline, we could not ensure expertise in every area of integrative RA management or consider all possible integrative interventions. For example, members of the Patient Panel inquired about use of cannabinoids as an RA treatment, given the rising prevalence of their use in rheumatic diseases (29,30). Cannabinoids were not included in this guideline, and emerging evidence for cannabidiol, a pharmacologic therapy that is not FDA-approved for RA, is being synthesized in a living systematic review through a joint US Department of Veterans Affairs and Center for Evidence-Based Policy at Oregon Health & programs, exercise programs, and weight loss.…”

Section: Discussionmentioning

confidence: 99%

2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis

England,

Smith,

Baker

et al. 2023

Arthritis Care & Research

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To develop initial American College of Rheumatology (ACR) guidelines on the use of exercise, rehabilitation, diet, and additional interventions in conjunction with disease-modifying antirheumatic drugs (DMARDs) as part of an integrative management approach for people with rheumatoid arthritis (RA).Methods. An interprofessional guideline development group constructed clinically relevant Population, Intervention, Comparator, and Outcome (PICO) questions. A literature review team then completed a systematic literature review and applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to rate the certainty of evidence. An interprofessional Voting Panel (n = 20 participants) that included 3 individuals with RA achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations.Results. The Voting Panel achieved consensus on 28 recommendations for the use of integrative interventions in conjunction with DMARDs for the management of RA. Consistent engagement in exercise received a strong recommendation. Of 27 conditional recommendations, 4 pertained to exercise, 13 to rehabilitation, 3 to diet, and 7 to additional integrative interventions. These recommendations are specific to RA management, recognizing that other medical indications and general health benefits may exist for many of these interventions.Conclusion. This guideline provides initial ACR recommendations on integrative interventions for the management of RA to accompany DMARD treatments. The broad range of interventions included in these recommendations illustrates the importance of an interprofessional, team-based approach to RA management. The conditional nature of most recommendations requires clinicians to engage persons with RA in shared decision-making when applying these recommendations.Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide guidance for patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to the recommendations within this guideline to be voluntary, with the ultimate determination regarding their application to be made by the clinician in light of each patient's individual circumstances. Guidelines and recommendations are intended to promote beneficial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed and endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice. ACR recommendations are not intended to dictate payment or insurance decisions, and drug formularies or other third-party analyses that cite ACR guidelines should state this. These recommendations cannot adequately convey all uncertainties and nuances of patient care.

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“…4,37,42,47 Use of many analgesic medications is contraindicated by kidney or liver disease and prescription psychotropic medications or anticoagulants, 14,59 which may limit pain management options for older VHA patients and thus lead to cannabis use. Cannabis use for managing symptoms of pain and arthritis is increasing among adults age $65 61 and may be associated with a higher risk of CUD. 19 Although many adults use cannabis without developing CUD or other harms, 34 we demonstrated that veterans with chronic pain have experienced disproportionately greater increases in the prevalence of CUD diagnoses than veterans without chronic pain.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…In the United States, ;50.2 million adults have chronic pain 65 (ie, pain that persists $3 months), 56 which is associated with significant morbidity and poor functioning. 16,31,47 Cannabis is now commonly used to treat chronic pain, 11,40,61,63 and many adults perceive cannabis as beneficial for pain management, 36 although evidence for the effectiveness of cannabis to treat chronic pain is mixed. 12,45,46,53,60,62 Although some systematic reviews demonstrate that cannabis is associated with reductions in chronic pain 45,62 and improvements in sleep and physical functioning, 60 others show minimal therapeutic benefit for chronic pain.…”

Section: Introductionmentioning

confidence: 99%

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Increasing risk of cannabis use disorder among U.S. veterans with chronic pain: 2005-2019

Mannes

Malte

Olfson

et al. 2023

Pain

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In the United States, cannabis is increasingly used to manage chronic pain. Veterans Health Administration (VHA) patients are disproportionately affected by pain and may use cannabis for symptom management. Because cannabis use increases the risk of cannabis use disorders (CUDs), we examined time trends in CUD among VHA patients with and without chronic pain, and whether these trends differed by age. From VHA electronic health records from 2005 to 2019 (∼4.3-5.6 million patients yearly), we extracted diagnoses of CUD and chronic pain conditions (International Classification of Diseases [ICD]-9-CM, 2005-2014; ICD-10-CM, 2016-2019). Differential trends in CUD prevalence overall and age-stratified (<35, 35-64, or ≥65) were assessed by any chronic pain and number of pain conditions (0, 1, or ≥2). From 2005 to 2014, the prevalence of CUD among patients with any chronic pain increased significantly more (1.11%-2.56%) than those without pain (0.70%-1.26%). Cannabis use disorder prevalence increased significantly more among patients with chronic pain across all age groups and was highest among those with ≥2 pain conditions. From 2016 to 2019, CUD prevalence among patients age ≥65 with chronic pain increased significantly more (0.63%-1.01%) than those without chronic pain (0.28%-0.47%) and was highest among those with ≥2 pain conditions. Over time, CUD prevalence has increased more among VHA patients with chronic pain than other VHA patients, with the highest increase among those age ≥65. Clinicians should monitor symptoms of CUD among VHA patients and others with chronic pain who use cannabis, and consider noncannabis therapies, particularly because the effectiveness of cannabis for chronic pain management remains inconclusive.

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Increase in Cannabis Use Among Adults With Rheumatic Diseases: Results From a 2014–2019 United States Observational Study

Cited by 13 publications

References 47 publications

Frequency of cannabis use in patients with rheumatoid arthritis or spondyloarthropathies: a single-centre study

Frequency of cannabis use in patients with rheumatoid arthritis or spondyloarthropathies: a single-centre study

2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis

Increasing risk of cannabis use disorder among U.S. veterans with chronic pain: 2005-2019

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