Medical Cannabis Certification Is Associated With Decreased Opiate Use in Patients With Chronic Pain: A Retrospective Cohort Study in Delaware

Abstract

BackgroundOpioid medications are commonly used to treat chronic pain around the world. While these medications are quite effective at reducing pain, they can create opioid dependence and lead to further drug addiction. Longterm opioid use has significantly contributed to the "opioid epidemic" that is currently ravaging the United States, leading to opioid overdoses and unintentional deaths, particularly in Delaware. ObjectiveTo determine if medical marijuana certification helps patients in Delaware with chronic pain reduce their opiate use. MethodsIn this study, we examined individuals who were provided with legal; medical cannabis certifications in the state of Delaware between June 2018 and October 2019 and were concurrently being treated with opioid medications for chronic pain at a private pain management practice. Using a posthoc analysis, we conducted a retrospective cohort study on the individuals (n = 81) to determine if there was a decrease in their opioid use following medical cannabis certification. Opioid use was measured in morphine milligram equivalent (MME) through the Delaware prescription monitoring program (PMP) database. ResultsOverall, the average change in prescribed opioid use was found to be -12.3 morphine milligram equivalent (MME) units when including all individuals (p < 0.00001). Among the included individuals with baseline opioid use, medical cannabis certification was associated with a 31.3% average decrease in opioid use (n = 63). When examining subgroups based upon pain location, individuals with neck pain displayed a 41.5% average decrease in MME (n = 27), while individuals with low back pain were observed to have a 29.4% decrease in opioid use (n = 58). Similarly, individuals with knee pain (n = 14) reduced their opioid use by 32.6%. ConclusionThe results display an association between medical cannabis certification and a decrease in opiate use among the study group individuals. This study suggests that medical cannabis use may help individuals to reduce their opiate requirements along with physician intervention. More research is needed to validate these findings with appropriate controls and verification of cannabis use.

O uso de cannabis medicinal no tratamento de transtornos por uso de opioides: Uma revisão sistemática

“…Diversos estudos pré-clínicos e clínicos têm explorado as propriedades terapêuticas dos medicamentos à base de Cannabis, especialmente no que diz respeito à redução de dependência e do abuso de opioides (Lucas, 2012;Balu et al, 2021).…”