The Effect of Medicinal Cannabis on Pain and Quality-of-Life Outcomes in Chronic Pain

Haroutounian, Simon; Ratz, Yael; Ginosar, Yehuda; Furmanov, Karina; Saifi, Fayez; Meidan, Ronit; Davidson, Elyad

doi:10.1097/ajp.0000000000000364

Cited by 200 publications

(211 citation statements)

References 63 publications

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“…Those who use cannabis are more likely than those who do not to have higher pain severity, receive more opioid analgesic prescriptions, and take higher opioid analgesic doses (Degenhardt et al, 2015; Hefner, Sofuoglu & Rosenheck, 2015), but patients initiating medical cannabis for chronic pain reduced their opioid analgesic doses substantially (44%–64%) in two studies (Boehnke, Litinas & Clauw, 2016; Haroutounian et al, 2016). Further longitudinal studies are needed to understand the true impacts of cannabis use on patients’ opioid analgesic use, including dose, as well as pain and function.…”

Section: Discussionmentioning

confidence: 99%

Cannabis Use is Associated with Lower Odds of Prescription Opioid Analgesic Use Among HIV-Infected Individuals with Chronic Pain

Sohler

Starrels

Khalid

et al. 2018

Substance Use & Misuse

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BACKGROUND Chronic pain is common in the United States and prescribed opioid analgesics use for non-cancer pain has increased dramatically in the past two decades, possibly accounting for the current opioid addiction epidemic. Co-morbid drug use in those prescribed opioid analgesics is common, but there are few data on polysubstance use patterns. OBJECTIVE We explored patterns of use of cigarette, alcohol, and illicit drugs in HIV-infected people with chronic pain who were prescribed opioid analgesics. METHODS We conducted a secondary data analysis of screening interviews conducted as part of a parent randomized trial of financial incentives to improve HIV outcomes among drug users. In a convenience sample of people with HIV and chronic pain, we collected self-report data on demographic characteristics; pain; patterns of opioid analgesic use (both prescribed and illicit); cigarette, alcohol, and illicit drug use (including cannabis, heroin, and cocaine) within the past 30 days; and current treatment for drug use and HIV. RESULTS Almost half of the sample of people with HIV and chronic pain reported current prescribed opioid analgesic use (N=372, 47.1%). Illicit drug use was common (N=505, 63.9%), and cannabis was the most commonly used illicit substance (N=311, 39.4%). In multivariate analyses, only cannabis use was significantly associated with lower odds of prescribed opioid analgesic use (adjusted odds ratio=0.57; 95% confidence interval: 0.38-0.87). CONCLUSIONS/IMPORTANCE Our data suggest that new medical cannabis legislation might reduce the need for opioid analgesics for pain management, which could help to address adverse events associated with opioid analgesic use.

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Section: Discussionmentioning

confidence: 99%

Cannabis Use is Associated with Lower Odds of Prescription Opioid Analgesic Use Among HIV-Infected Individuals with Chronic Pain

Sohler

Starrels

Khalid

et al. 2018

Substance Use & Misuse

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“…24 Other studies describe patient substitution of medical cannabis for opioids or discontinuation of opioid use. 25,26 This reported augmentation of opioid analgesia is likely due to the effect of cannabis on opioid pathways. As noted above, there is crossover between the endocannabinoid and dopamine systems; CBD, and to a lesser extent THC, can also interfere directly with opioids by increasing dissociation rates from opioid receptors.…”

Section: Pharmacology Of Cannabismentioning

confidence: 99%

The role of medical cannabis in the opioid crisis

Samoilov¹,

Browne²

2018

UWOMJ

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Opioid use increased dramatically in the 1990s upon introduction of newer, more relaxed regulations. As opioid prescriptions for pain increased, a parallel increase in opioid abuse and addiction occurred; this phenomenon is widely known as the opioid crisis. Cannabis had long been considered a recreational drug until legislation in 2001 allowed highly limited access to the drug for medicinal purposes. Although small-scale clinical trials show promising results for the use of cannabis in pain management, it is not currently indicated for chronic or severe-to-moderate acute pain, for which opioids are typically considered the standard of care. The impending legalization of recreational cannabis may mark a turning point in pain medicine as the general public becomes able to selfmedicate with cannabis. This increased availability may lead individuals prescribed opioids to combine or replace them with cannabis, with potential positive impacts. There is growing evidence that cannabinoid compounds present in cannabis are able to augment opioid-induced pain relief. Increased availability of cannabis is linked to decreased opioid-related mortality and hospitalizations; furthermore, cannabis might act as a tool to treat opioid addiction. Cannabis does possess adverse effects and addiction risk, and expanded research into its properties is needed. However, its relatively decreased risk profile and potential positive effects indicate that it may serve an important role in addressing the opioid crisis.

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“…Smaller surveys have been done on the prevalence of cannabis use and analgesic effectiveness in patient populations with underlying pain conditions, but these are less representative of the broader demographic that our study aimed to describe. [8][9][10] Overall, we have found that more Various forms of cannabis have been used for thousands of years to treat a variety of conditions, and modern research efforts have recently identified the endogenous system involved in mediating its actions. The EC system is composed of 2 major receptors, CB1 and CB2, with the former found at presynaptic sites in the peripheral and central nervous systems and the latter mostly on immune cells.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Patient Beliefs Regarding Potential Effectiveness of Marijuana (Cannabinoids) for Treatment of Pain

Khelemsky

Goldberg

Hurd

et al. 2017

Regional Anesthesia and Pain Medicine

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The Effect of Medicinal Cannabis on Pain and Quality-of-Life Outcomes in Chronic Pain

Cited by 200 publications

References 63 publications

Cannabis Use is Associated with Lower Odds of Prescription Opioid Analgesic Use Among HIV-Infected Individuals with Chronic Pain

Cannabis Use is Associated with Lower Odds of Prescription Opioid Analgesic Use Among HIV-Infected Individuals with Chronic Pain

The role of medical cannabis in the opioid crisis

Perioperative Patient Beliefs Regarding Potential Effectiveness of Marijuana (Cannabinoids) for Treatment of Pain

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