Pills to Pot: Observational Analyses of Cannabis Substitution Among Medical Cannabis Users With Chronic Pain
Pills to Pot: Observational Analyses of Cannabis Substitution Among Medical Cannabis Users With Chronic Pain
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DOI：
10.1016/j.jpain.2019.01.010
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发表时间：
2019-07-01
期刊：
影响因子：
4
通讯作者：
Clauw, Daniel J.
中科院分区：
文献类型：
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作者：
Boehnke, Kevin F.;Scott, J. Ryan;Clauw, Daniel J.
慢性疼痛是常见的，昂贵的，治疗具有挑战性。许多患有慢性疼痛的人已经转向大麻作为疼痛管理的替代形式。我们报告了一项正在进行的对全国慢性疼痛的医用大麻使用者进行的在线调查的结果，该调查涉及大麻如何影响疼痛管理，健康和止痛药的使用。我们还研究了这些参数是否以及如何受到伴随娱乐使用和使用持续时间（新手：= 1年）的影响。共有1，321名参与者（59%为女性，54% ≥ 50岁）完成了调查。与其他观察性研究一致，大约80%的人报告用大麻替代传统的止痛药（53%的阿片类药物，22%的苯二氮卓类药物），并将更少的副作用和更好的症状管理作为他们这样做的理由。与有娱乐和病史的使用者相比，仅使用医疗的使用者年龄较大（52岁vs 47岁; P <.0001），饮酒的可能性较小（66% vs 79%，P <.0001），目前服用阿片类药物的可能性较大（21% vs 11%，P < .0001）。与新手使用者相比，有经验的使用者更可能是男性（64% vs 58%; P <0.0001），不服用伴随的止痛药（43% vs 30%），并报告使用后健康状况改善（74% vs 67%; P= 0.004）。鉴于慢性疼痛是获得医用大麻许可证的最常见原因，这些结果突出了医用大麻使用者不断变化的人群之间的临床重要差异。需要更多的研究，以更好地了解有效的疼痛管理方案为医用cannabsusers.Perspective：本文提出的结果，证实了以前的临床研究表明，大麻可能是一种有效的镇痛药和潜在的阿片类药物替代品。参与者报告疼痛改善，健康，副作用减少，作为替代的理由。这篇文章强调了使用持续时间和使用意图如何影响报告的治疗和替代效果。(C)2019年美国疼痛协会American Pain Society
Chronic pain is common, costly, and challenging to treat. Many individuals with chronic pain have turned to cannabis as an alternative form of pain management. We report results from an ongoing, online survey of medical cannabis users with chronic pain nationwide about how cannabis affects pain management, health, and pain medication use. We also examined whether and how these parameters were affected by concomitant recreational use, and duration of use (novice: = 1 year). There were 1,321 participants (59% female, 54% >= 50 years old) who completed the survey. Consistent with other observational studies, approximately 80% reported substituting cannabis for traditional pain medications (53% for opioids, 22% for benzodiazepines), citing fewer side effects and better symptom management as their rationale for doing so. Medical-only users were older (52 vs 47 years old; P < .0001), less likely to drink alcohol (66% vs 79%, P < .0001), and more likely to be currently taking opioids (21% vs 11%, P < .0001) than users with a combined recreational and medical history. Compared with novice users, experienced users were more likely to be male (64% vs 58%; P < .0001), take no concomitant pain medications (43% vs 30%), and report improved health (74% vs 67%; P= .004) with use. Given that chronic pain is the most common reason for obtaining a medical cannabis license, these results highlight clinically important differences among the changing population of medical cannabis users. More research is needed to better understand effective pain management regimens for medical cannabis users.Perspective: This article presents results that confirm previous clinical studies suggesting that cannabis may be an effective analgesic and potential opioid substitute. Participants reported improved pain, health, and fewer side effects as rationale for substituting. This article highlights how use duration and intentions for use affect reported treatment and substitution effects. (C) 2019 by the American Pain Society