title: Medical Cannabis Use Is Associated With Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain.
abstract: Opioids are commonly used to treat patients with chronic pain (CP), though there is little evidence that they are effective for long term CP treatment. Previous studies reported strong associations between passage of medical cannabis laws and decrease in opioid overdose statewide. Our aim was to examine whether using medical cannabis for CP changed individual patterns of opioid use. Using an online questionnaire, we conducted a cross-sectional retrospective survey of 244 medical cannabis patients with CP who patronized a medical cannabis dispensary in Michigan between November 2013 and February 2015. Data collected included demographic information, changes in opioid use, quality of life, medication classes used, and medication side effects before and after initiation of cannabis usage. Among study participants, medical cannabis use was associated with a 64% decrease in opioid use (n = 118), decreased number and side effects of medications, and an improved quality of life (45%). This study suggests that many CP patients are essentially substituting medical cannabis for opioids and other medications for CP treatment, and finding the benefit and side effect profile of cannabis to be greater than these other classes of medications. More research is needed to validate this finding.
  
  
  
  This article suggests that using medical cannabis for CP treatment may benefit some CP patients. The reported improvement in quality of life, better side effect profile, and decreased opioid use should be confirmed by rigorous, longitudinal studies that also assess how CP patients use medical cannabis for pain management.
authors.affiliation: Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Kevin F
authors.initials: KF
authors.lastname: Boehnke
authors.affiliation: Om of Medicine, Ann Arbor, Michigan.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Litinas
authors.affiliation: Departments of Anesthesiology, Medicine (Rheumatology), and Psychiatry, Medical School, University of Michigan, Ann Arbor, Michigan; Chronic Pain and Fatigue Research Center, Medical School, University of Michigan, Ann Arbor, Michigan. Electronic address: dclauw@med.umich.edu.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Clauw
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D057915:Drug Substitution / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D064086:Medical Marijuana / Q000627:therapeutic use*; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D064086:Medical Marijuana
keywords: Medical cannabis; chronic pain; opioids; side effects