Highlights
- •Medical cannabis users reported wide variability in cannabinoid use preferences.
- •Differences in sex, intentions behind use, and duration of use affected cannabis use behavior.
- •The majority of users reported preference for cannabidiol-containing products.
- •Very few users consulted with a doctor about cannabinoid product selection.
ABSTRACT
Cannabis is commonly used to manage chronic pain, but cannabis use patterns among
individuals with chronic pain, has not been well-characterized. We report cannabinoid,
administration route, and product selection preferences among medical cannabis users
with chronic pain from an ongoing, online survey. We also examined whether these preferences
are affected by differences in sex, intentions behind use (medical only [MED] vs medical + recreational
[MEDREC]), and experience with cannabis (novice: <1 year vs experienced: ≥1 year).
The survey was completed by 1,321 participants (59% female) 76.5% of whom used cannabis
every day. 93.4% used 2 or more administration routes and 72.5% used 3 or more. Female,
MED, and novice users were less likely to smoke or vaporize (all P < .0001), but more likely to rank edibles, tinctures, and topicals as a first-choice
administration route than their counterparts. Female and MED users also preferred
low THC: high cannabidiol ratios significantly more than their counterparts. Overall,
only 2.6% of participants selected cannabis products with input from a medical professional,
although 54.9% relied on advice from dispensary employees. More male, MEDREC, and
experienced users selected products based on factors that reflected greater comfort
with cannabis (eg, smell, visual properties, cannabis variety). The wide variability
in cannabis use among these different groups indicates the need for further research
to investigate how specific use routines relate to clinical outcomes.
Perspective
Medical cannabis users with chronic pain show distinct differences in cannabinoid
preferences and administration associated with user sex, intentions behind use, and
experience with cannabis. This article highlights the wide variability in cannabis
preferences among medical cannabis users with chronic pain, which may be relevant
for clinical outcomes.
Key words
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Article info
Publication history
Published online: May 24, 2019
Accepted:
May 2,
2019
Received in revised form:
April 3,
2019
Received:
January 18,
2019
Footnotes
Conflict of interest: Drs. Boehnke, Goesling, and Williams, and Mr. Scott declare no conflicts of interest. Dr. Clauw has consulted for Pfizer, Inc, Eli Lilly and Company, Tonix Pharmaceuticals, Aptinyx, Regeneron, IMC, and Intec. Dr. Litinas is Chief Medical Officer at and co-owner of Om of Medicine, a medical cannabis provisioning center in Ann Arbor, MI. Dr. Sisley leads the Scottsdale Research Institute, has received funding from the Multidisciplinary Association for Psychedelic Studies and is a member of the Steering Committee/Entrepreneurship and Social Initiative Impact Advisor Board for the Lambert Center for the Study of Medicinal Cannabis and Hemp.
Identification
Copyright
© 2019 by the American Pain Society
