title: Use of prescription pain medications among medical cannabis patients: comparisons of pain levels, functioning, and patterns of alcohol and other drug use.
abstract: OBJECTIVE
  Management of chronic pain is one of the most common reasons given by individuals seeking medical cannabis. However, very little information exists about the concurrent use of cannabis and prescription pain medication (PPM). This study fills this gap in knowledge by systematically comparing medical cannabis users who use or do not use PPM, with an emphasis on understanding whether concurrent use of cannabis and PPM is associated with more serious forms of alcohol and other drug involvement.
  
  
  METHODS
  Data from this study were collected from a medical cannabis clinic in southwestern Michigan (N = 273). Systematic comparisons were made on measures of sociodemographics, reasons for substance use, pain, functioning, and perceptions of PPM and medical cannabis efficacy.
  
  
  RESULTS
  PPM users tended to be older and reported higher levels of pain and lower levels of functioning. The overall sample exhibited higher lifetime and past-3-month rates of alcohol and other noncannabis drug use than did the general population. Approximately 40% of subjects reported combining cannabis with alcohol, but no significant difference was observed between PPM users and nonusers. PPM users and nonusers did not exhibit any difference in either lifetime or past-3-month use of other drugs, including cocaine, sedatives, street opioids, and amphetamines. PPM users rated the efficacy of cannabis higher than PPM for pain management and indicated a strong desire to reduce PPM usage.
  
  
  CONCLUSIONS
  Use of PPM among medical cannabis users was not identified as a correlate for more serious forms of alcohol and other drug involvement. However, longitudinal study designs are needed to better understand the trajectories of alcohol and other drug involvement over time among medical cannabis users.
authors.affiliation: School of Social Work, University of Michigan, Ann Arbor, Michigan.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Perron
authors.affiliation: Veterans Affairs (VA) Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC), Department of Veterans Affairs Healthcare System, Ann Arbor, Michigan.|Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
authors.forename: Kipling
authors.initials: K
authors.lastname: Bohnert
authors.affiliation: School of Social Work, University of Michigan, Ann Arbor, Michigan.
authors.forename: Angela K
authors.initials: AK
authors.lastname: Perone
authors.affiliation: Center of Excellence in Substance Abuse Treatment and Education, Philadelphia VA Medical Center, Philadelphia, Pennsylvania.|National Center for PTSD, VA Palo Alto Health Care System, Palo Alto, California.|Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California.|Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Marcel O
authors.initials: MO
authors.lastname: Bonn-Miller
authors.affiliation: Veterans Affairs (VA) Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC), Department of Veterans Affairs Healthcare System, Ann Arbor, Michigan.|Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
authors.forename: Mark
authors.initials: M
authors.lastname: Ilgen
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D064086:Medical Marijuana / Q000627:therapeutic use*; D008875:Middle Aged; D009042:Motivation; D010146:Pain / Q000188:drug therapy*; D055553:Prescription Drugs / Q000627:therapeutic use; D019966:Substance-Related Disorders / Q000453:epidemiology*
chemical_list: D064086:Medical Marijuana; D055553:Prescription Drugs