Chronic Pain
Study register · detail Kohortenstudie · Chronic Pain · 2023

Cannabinoid Therapy: Attitudes and Experiences of People With Chronic Pain.

Mixed GRADE Low 3 citations
Samplen = 969 Pat.
Durationunclear
EndpointSelf-reported pain improvement
Blindingn.a.
DesignKohortenstudie
Key finding

Respondents currently taking cannabinoids more often report large pain improvements and fewer side effects; however, clinical trials show mixed and often inconclusive results.

Summary

Web-based cross-sectional survey among n=969 patients with chronic pain (46% currently taking cannabinoids, 22% formerly, 32% never). Current users report large pain improvement more often (incl. difficult-to-treat chronic overlapping pain syndromes such as pelvic pain), improved comorbidities (sleep), lower side-effect burden. Never-users cite lack of physician recommendation (40%), illegality (25%), lack of FDA approval (19%) as reasons.

P
PopulationAdults with self-reported chronic pain, n=969, recruited via patient organizations
I
InterventionCannabinoids (various, for pain management; currently taking n=444, previously taking n=213)
O
Outcome46% currently take cannabinoids; current users reported large pain improvements (incl. pelvic pain) more often, better sleep quality and lower side-effect burden than former users; 40% of never-users cited lack of clinician recommendation as the main reason
Confidence in the evidence
Low

The second of four GRADE levels, the effect estimate is of limited reliability.

Quality profile
Sample size
Blinding
Effect size Mixed
Citations / year
Authors
Gewandter JS, Edwards RR, Hill KP, Wasan AD, Hooker JE, Lape EC, Besharat S, Cowan P, Le Foll B, Ditre JW
DOI 10.1097/ajp.0000000000001109
Design: Kohortenstudie
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Abstract
Objective: Clinical trials of cannabinoids for chronic pain have mixed and often inconclusive results. In contrast, many prospective observational studies show the analgesic effects of cannabinoids. This survey study aimed to examine the experiences/attitudes of individuals with chronic pain who are currently taking, have previously taken, or never taken cannabinoids for chronic pain to inform future research. Methods: This study is based on a cross-sectional, web-based survey of individuals with self-reported chronic pain. Participants were invited to participate through an email that was distributed to the listservs of patient advocacy groups and foundations that engage individuals with chronic pain. Results: Of the 969 respondents, 444 (46%) respondents reported currently taking, 213 (22%) previously taken, and 312 (32%) never taken cannabinoids for pain. Participants reported using cannabinoids to treat a wide variety of chronic pain conditions. Those currently taking cannabinoids (vs previously) more frequently reported: (1) large improvements from cannabinoids in all pain types, including particularly difficult-to-treat chronic overlapping pain conditions (eg, pelvic pain), (2) improvements in comorbid symptoms (eg, sleep), and (3) lower interference from side effects. Those currently taking cannabinoids reported more frequent and satisfactory communication with clinicians regarding cannabinoid use. Those never taken cannabinoids reported a lack of suggestion/approval of a clinician (40%), illegality (25%), and lack of FDA regulation (19%) as reasons for never trying cannabinoids. Conclusion: These findings underscore the importance of conducting high-quality clinical trials that include diverse pain populations and clinically relevant outcomes that if successful, could support FDA approval of cannabinoid products. Clinicians could then prescribe and monitor these treatments similarly to other chronic pain medications.

The impediment to action advances action. — Marcus Aurelius