Study register · detailQuerschnittsstudie (Online-Survey) · Chronic Pain · 2021
Exploring the use of cannabis as a substitute for prescription drugs in a convenience sample
Kvamme et al.·Harm Reduction Journal
MixedGRADELow57 citations
Samplen = 2.841 Pat.
EndpointSubstitution of prescription…
Blindingn.a.
DesignQuerschnittsstudie (Online-Survey)
”Key finding
CaM is frequently used as a substitute for prescription medications (particularly opioids), with predominantly positive self-assessment regarding efficacy and side effects.
Summary
Online survey (n=2.841 cannabis-as-medicine users); 54,6% used cannabis as a substitute for prescription medications; pain medications were the most common substitution target (67,2%). Among substitution users, 38,1% reported complete discontinuation and 45,9% substantial reduction of prescription medications; >65% perceived CaM as more effective than the replaced medication.
P
PopulationAdults (≥18 years) with medical cannabis use (prescribed or non-prescribed), n=2.841, recruited via social media, public media and patient organisations
I
InterventionCannabis as medicine (CaM) – mainly CBD oil (65,2%) and hashish/cannabis (36,6%), predominantly non-prescribed (91%), as a substitute for prescription medications
O
Outcome54,6% used CaM as a substitute for prescription medications; 38,1% reported complete discontinuation of prescription medications, 45,9% a substantial reduction; 65,8% perceived CaM as clearly more effective than the substituted medications
Confidence in the evidence
Very lowLowModerateHigh
Low
The second of four GRADE levels, the effect estimate is of limited reliability.
<h4>Background</h4>The use of cannabis as medicine (CaM) both prescribed and non-prescribed has increased markedly in the last decade, mirrored in a global shift in cannabis policy towards a more permissive stance. There is some evidence that cannabis functions as a substitute for prescription drugs, particularly opioids; however, more knowledge is needed on the motives of substitution users, their patterns of use, and perceived effects of substitution use.<h4>Aims</h4>To explore who substitutes prescription drugs with cannabis, the type of prescription drugs substituted and the type of cannabis used, and the impact that substitution with cannabis has on prescription drug use as well as the motives for substitution in terms of experienced effects and side effects.<h4>Methods</h4>A self-selected convenience sample was recruited through social media, public media, and patient organizations to take part in an anonymous online survey. Inclusion criteria were 18 years or older and use of cannabis (prescribed or non-prescribed) with a medical purpose.<h4>Results</h4>The final sample included 2.841 respondents of which the majority (91%) used non-prescribed cannabis, and more than half (54.6%) had used CaM with the purpose of replacing a prescribed drug. Compared to non-substitution users, substitution users were more likely to be women and to use CaM in the treatment of chronic pain and other somatic conditions. Pain medication (67.2%), antidepressants (24.5%), and arthritis medication (20.7%) were the most common types of drugs replaced with CaM. Among substitution users, 38.1% reported termination of prescription drug use, and 45.9% a substantial decrease in prescription drug use. The most frequent type of cannabis used as a substitute was CBD-oil (65.2%), followed by 'hash, pot or skunk' (36.6%). More than half (65.8%) found CaM much more effective compared to prescription drugs, and 85.5% that the side effects associated with prescription drug use were much worse compared to use of CaM.<h4>Conclusion</h4>CaM is frequently used as a substitute for prescription drugs, particularly opioids. More research is needed on the long-term consequences of use of CaM, including the impact from low and high THC cannabis products on specific somatic and mental health conditions.