Patient-reported outcomes in those consuming medical cannabis: a prospective longitudinal observational study in chronic pain patients

Abstract

Purpose We investigated patients with chronic pain seeking medical cannabis. We assessed their demographics, patterns of cannabis use, and the longterm effectiveness of cannabis on their pain and functional domains. Methods This observational study enrolled patients between 8 September 2015 and 31 July 2018 from community-based cannabis clinics in Ontario, Canada. In addition to collecting demographic information, the primary outcomes studied were pain intensity and painrelated interference scores assessed at baseline, three, six, and 12 months. Using validated questionnaires, we also assessed anxiety, depression, quality of life (QoL), general health symptoms, neuropathic pain, self-reported opioid consumption, and adverse events. Results Of the 1,000 patients consented, 757 (76%) participated at one or more of the study time points. At six and 12 months, 230 (30.4%) and 104 (13.

Comment on: Patient-reported outcomes in those consuming medical cannabis: a prospective longitudinal observational study in patients with chronic pain

“…The recent article by Meng et al presents an interesting and courageous longitudinal investigation on the administration of cannabis extracts for the management of chronic pain. 1 The authors discuss study limitations, and we agree with the points made. Yet, the lack of welldefined good manufacturing practice certifications for the cannabis extracts used throughout the investigation could in part explain the administration of cannabis reported high participant attrition/low completion rate, of 25% at 12 months.…”

“…Other than the fact that different amounts of cannabis extract were self-reported, it is not known what cannabis molecules patients were consuming in the study by Meng et al 1 Quantities ranging from \ 1 g to [ 20 g, predominantly from dried cannabis extracts or extracts in oil, were the most common forms used. Formulations of cannabis-based medicines that improve chronic pain must include consistent well-defined and specific levels of D9THC and CBD-a notion supported by the published literature and systematic reviews.…”

“The Drug Use Unfortunately isn’t all Bad”: Chronic Disease Self-Management Complexity and Strategy Among Marginalized People Who Use Drugs

“…In addition to accumulating evidence of cannabis’ therapeutic value across many conditions that are common in this population ( Babson et al, 2017 ; Bhattacharyya et al, 2018 ; Gibson et al, 2021 ; Jensen et al, 2015 ), there is also increasing recognition of its harm reduction potential ( Lucas, 2017 ). Evidence suggests cannabis use reduces the use of drugs like opioids and benzodiazepines ( Meng et al, 2021 ; Purcell et al, 2019 ). However, the cost of cannabis treatments must also be covered through public drug insurance if socioeconomically marginalized populations are to receive these medical or harm reduction benefits.…”

Cannabinoid Formulations and Delivery Systems: Current and Future Options to Treat Pain

“…The favourable response to oil-based cannabis may be due to the slower onset of the effect compared with smoking cannabis, as well as easier dose titration. Despite this interesting result, the authors highlighted that depression scores increased during the study [ 287 ]. Although the results are not conclusive, it is important to underline that further studies have shown that cannabis may have negative effects on the mental health of treated patients [ 288 , 289 ], and that it may exacerbate neurological diseases such as epilepsy and anxiety [ 289 ].…”