Opioid Use in Chronic Pain Patients

Pain News Network. January 08, 2021
By Pat Anson, PNN Editor

Nearly half of chronic pain patients using medical cannabis reported significant improvement in their pain levels and most were able to reduce or stop their use of opioid pain medication, according to a large new study.

The findings, recently published in the journal Cureus, involved 550 chronic pain patients being treated at three licensed medical cannabis clinics in the northeastern United States. The study is one of the first to look at patients who were prescribed opioids for at least three months and continued to use opioids after starting cannabis therapy.

“Our results show a remarkable percentage of patients both reporting complete cessation of opioids and decreasing opioid usage by the addition of medical cannabis, with results lasting for over a year for the majority,” wrote lead author Kevin Takakuwa, MD, an emergency medicine physician affiliated with the Society of Cannabis Clinicians.

“We hypothesize these effects may be due to the reported synergistic decrease in pain that has been shown with adding cannabis to opioids. Likely, as a result, the majority expressed not wanting opioids in the future, particularly those in the younger age group.”
Pain patients enrolled in the study initially took a small amount of cannabis orally (a balanced blend of THC and CBD) and titrated to a higher dose until it had an effect.

Almost half (48%) reported a significant decrease in their pain, and most said they had improved quality of life (87%) and better physical function (80%) while using medical cannabis.

Most reported they either stopped using prescription opioids (40%) or reduced their opioid use (45%). Nearly two thirds said they sustained the change for over a year (65%) and did not want to take opioids again (63%).

“One reason for our impressive results may be the focused protocol employed by the study sites, which recommends a small amount of oral cannabis taken in conjunction with each opioid medication dose with small increments to titration, in a motivated patient population,” wrote Takakuwa.

“There has never been a randomized controlled human trial examining how to use medical cannabis in combination with opioids and there is no established protocol that exists. Experts disagree on how to manage opioid prescriptions in patients with chronic pain who use cannabis, and many clinicians defer to the patient or dispensary agent on decisions regarding specific cannabis products and dosages.”

But some doctors take another approach and simply get rid of patients after learning they use cannabis. It’s worth noting that nearly one in four patients (24.8%) enrolled in the study reported losing access to prescription medication or medical care as a result of their cannabis use or after testing positive for THC.

The Centers for Disease Control and Prevention specifically recommends that doctors not test for THC or dismiss patients for their cannabis use “because this could constitute patient abandonment and could have adverse consequences for patient safety” by forcing them to live with untreated pain or turn to street drugs.

—————————————————————-Article is from Pain News Network which I received on January 16, 2021 and was originally posted on January 8, 2021.

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