Chronic pain patients\u27 perspectives of medical cannabis.

Medical cannabis (MC) is used for a variety of conditions including chronic pain. The goal of this report was to provide an in-depth qualitative exploration of patient perspectives on the strengths and limitations of MC. Members of MC dispensaries (N = 984) in New England including two-thirds with a history of chronic pain completed an online survey. In response to How effective is medical cannabis in treating your symptoms or conditions?, with options of 0% no relief to 100% complete relief, the average was 74.6% ± 0.6. The average amount spent on MC each year was $3064.47 ± 117.60, median =$2320.23, range = $52.14 to$52,140.00. Open-ended responses were coded into themes and subthemes. Analysis of answers to What is it that you like most about MC? (N = 2592 responses) identified 10 themes, including health benefits (36.0% of responses, eg, Changes perception and experience of my chronic pain. ), the product (14.2%, eg, Knowing exactly what strain you are getting ), nonhealth benefits (14.1%), general considerations (10.3%), and medications (7.1%). Responses (N = 1678) to What is it that you like least about MC? identified 12 themes, including money (28.4%, eg, The cost is expensive for someone on a fixed income ), effects (21.7%, eg, The effects on my lungs ), the view of others (11.4%), access (8.2%), and method of administration (7.1%). These findings provide a patient-centered view on the advantages (eg, efficacy in pain treatment, reduced use of other medications) and disadvantages (eg, economic and stigma) of MC

Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep.

A prior epidemiological study identified a reduction in opioid overdose deaths in US states that legalized medical cannabis (MC). One theory to explain this phenomenon is a potential substitution effect of MC for opioids. This study evaluated whether this substitution effect of MC for opioids also applies to other psychoactive medications. New England dispensary members ( n = 1,513) completed an online survey about their medical history and MC experiences. Among respondents that regularly used opioids, over three-quarters (76.7%) indicated that they reduced their use since they started MC. This was significantly ( p \u3c 0.0001) greater than the patients that reduced their use of antidepressants (37.6%) or alcohol (42.0%). Approximately two-thirds of patients decreased their use of anti-anxiety (71.8%), migraine (66.7%), and sleep (65.2%) medications following MC which significantly ( p \u3c 0.0001) exceeded the reduction in antidepressants or alcohol use. The patient\u27s spouse, family, and other friends were more likely to know about their MC use than was their primary care provider. In conclusion, a majority of patients reported using less opioids as well as fewer medications to treat anxiety, migraines, and sleep after initiating MC. A smaller portion used less antidepressants or alcohol. Additional research is needed to corroborate these self-reported, retrospective, cross-sectional findings using other data sources