Cannabis for Chronic Pain

[George K]

https://www.acpjournals.org/doi/10.7326/M23-0053

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Participants:

583 820 commercially insured adults with chronic noncancer pain.

Measurements:

Proportion of patients receiving any opioid prescription, nonopioid prescription pain medication, or procedure for chronic noncancer pain; volume of each treatment type; and mean days’ supply and mean morphine milligram equivalents per day of prescribed opioids, per patient in a given month.

Results:

In a given month during the first 3 years of law implementation, medical cannabis laws led to an average difference of 0.05 percentage points (95% CI, −0.12 to 0.21 percentage points), 0.05 percentage points (CI, −0.13 to 0.23 percentage points), and −0.17 percentage points (CI, −0.42 to 0.08 percentage points) in the proportion of patients receiving any opioid prescription, any nonopioid prescription pain medication, or any chronic pain procedure, respectively, relative to what we predict would have happened in that month had the law not been implemented.

Limitations:

This study used a strong nonexperimental design but relies on untestable assumptions involving parallel counterfactual trends. Statistical power is limited by the finite number of states. Results may not generalize to noncommercially insured populations.

Conclusion:

This study did not identify important effects of medical cannabis laws on receipt of opioid or nonopioid pain treatment among patients with chronic noncancer pain.

[Doctor Phibes]

I wonder - is that because cannabis isn't effective or because doctors are reluctant to prescribe it as a substitute for opioids?

[George K]

@Doctor-Phibes said in Cannabis for Chronic Pain:

I wonder - is that because cannabis isn't effective or because doctors are reluctant to prescribe it as a substitute for opioids?

I know several pain docs who have been pushing cannabis for years. It's been about 5 years since it became legal (for medical use) in Illinois, and since then they've been pushing it.

Also, DEA has become very strict, VERY STRICT, about how much opioids can be prescribed for chronic pain. This, despite the lack of science evidence that chronic pain patients are dying of opioid overdose.