Patients Report Substituting Cannabis for Pain Relief Medications

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PainRelief.com Interview with:
Mark Christopher Bicket, MD, PhD
Assistant Professor,Department of Anesthesiology
Assistant Professor,Health Management and Policy
School of Public Health
University of MichiganAnn Arbor, MI 48109

PainRelief.com: What is the background for this study? What are the main findings?

  • Most states have laws that allow people with chronic pain to use cannabis as a treatment. But evidence about whether medical cannabis use lowers the use of other treatments for chronic pain is not clear. 
  • We conducted a rigorous survey of adults living in the 36 states and D.C. in the spring of 2022.
  • Among the 1,661 adults who had chronic pain, we asked about their use of cannabis, prescription opioids, and non-opioid treatments for chronic pain. 
  • Cannabis use for chronic pain was common, reported in roughly 3 in 10 people at any time and 1 in 4 in the past year.
  • In contrast, a minority said cannabis use decreased their use of non-pharmacologic treatments like physical therapy or meditation, and some reported their use increased.
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Opioid Prescriptions Differ Between Surgeons and Advanced Practice Clinicians

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PainRelief.com Interview with:
Caitlin Priest, MD
Integrated Plastic Surgery Residency
Department of Surgery
Michigan Medicine

Dr. Priest

PainRelief.com: What is the background for this study? What are the main findings?

Response: Opioid pain medications are commonly provided after surgery to help with acute postsurgical pain, however, these prescriptions often exceed what is used by most patients, resulting in excess opioids. Advanced practice clinicians (nurse practitioners and physicians assistants) are becoming an increasingly important part of surgical care teams. Despite their growing role in providing care for surgical patients, there is little data on the perioperative opioid prescribing practices of advanced practice clinicians.

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Altered Body Perception in Stroke Survivors with Chronic Pain

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PainRelief.com Interview with:
Dr Brendon Haslam PhD
La Trobe University and The Florey Institute of Neuroscience and Mental Health
University of Melbourne
On behalf of the research team that is a collaboration of researchers from the University of South Australia, La Trobe University, University of Melbourne and University of California, San Francisco

Dr Haslam PhD

PainRelief.com: What is the background for this study?

Response: People who experience a stroke are three times more likely to experience chronic pain than the general population. Chronic pain following stroke has additional impact on stroke survivors, making it even harder for them to carry out everyday tasks related to their personal care, occupational and recreational activities. As a result, stroke survivors with chronic pain suffer additional disorders of mood, including depression, that further reduce their quality of life beyond that that is caused by the stroke itself.

Unfortunately, there is currently very little evidence to show effective treatments for stroke survivors with chronic pain. This includes the use of medications and other health therapies. In looking to understand chronic pain following stroke, and be able to develop new therapy approaches for this population, we explored how stroke survivors with and without pain perceive their own bodies. For this study, we particularly explored how they perceived their hand size to be.

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CMAJ Study Finds Metformin Associated with Reduced Risk of Joint Replacement in Diabetic Patients

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PainRelief.com Interview with:
Zhaohua Zhu (Alex)
PhD, Associated Professor
Clinical Research Center
Zhujiang Hospital of Southern Medical University

PainRelief.com: What is the background for this study?

Osteoarthritis is a leading cause of pain and disability in older adults, but there are no effective drugs in preventing or reversing osteoarthritis progression.

•Metformin is the first-line pharmacologic treatment and the most commonly prescribed drug worldwide for diabetes mellitus.

•Recent experimental studies have showed that both intragastric and intraarticular metformin use can attenuate cartilage degradation and modulated pain in osteoarthritis mouse models. However, it is unclear whether metformin use is associated with reduced risk of total joint replacement in patients with type 2 diabetes mellitus.

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Wake Forest Study Finds Diet and Exercise Can Lead to Pain Relief from Knee Arthritis

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PainRelief.com Interview with:
Stephen P. Messier, Ph.D.
Professor J.B. Snow Biomechanics Laboratory
Department of Health and Exercise Science
Worrell Professional Center
Wake Forest University
Winston Salem, NC 27109

Dr. Messier

PainRelief.com: What is the background for this study?   What are the main findings?

Response: Some weight loss and exercise programs that have been successful in academic center-based trials have not been evaluated in community settings.  The results showed that among patients with knee osteoarthritis and overweight or obesity, diet and exercise compared with an attention control led to statistically significant differences in pain, function, mobility, body weight, waist circumference, and quality of life.

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Potential Unintended Harms of Discontinuing Opioid Treatment For Chronic Pain

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PainRelief.com Interview with:
Mary Clare Kennedy, PhD
Canada Research Chair in Substance Use Policy and Practice Research
Assistant Professor, School of Social Work
University of British Columbia | Okanagan Campus
Research Scientist, British Columbia Centre on Substance Use

PainRelief.com: What is the background for this study?

Response: In an effort to reduce opioid-related harms, Canada and the United States have implemented guidelines for prescribing opioids for chronic pain. One of the recommendations in these guidelines is that prescribers reduce opioid doses and potentially discontinue treatment when risks outweigh benefits. Concerns have been raised that these guidelines could result in more clinicians inappropriately reducing doses or cutting patients off of prescribed opioids, which could increase the risk of harms such as overdose. However, the effects of discontinuing and tapering opioid treatment for pain on overdose risk have been understudied. 

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Marijuana May Be Substituting for Opioids for Cancer-Related Pain Relief

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PainRelief.com Interview with:
Yuhua Bao, PhD
Department of Population Health Sciences, Department of Psychiatry
Weill Cornell Medicine, New York, New York

Dr. Yuhua Bao

PainRelief.com: What is the background for this study?

Response: We know that opioid use is declining among cancer patients. We also know that marijuana use is increasing among cancer patients; this increase is related to the recent wave of medical marijuana legalization (adopted by 37 states and D.C. as of Feb 2022).

We do not know if medical marijuana legalization has led to changes in opioid use for cancer patients and what were the implications for cancer pain outcomes.

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Study Uses Medicare Claims to Link Physician Beliefs About Benzodiazipene Safety and Prescription Fills

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PainRelief.com Interview with:
Donovan Maust, M.D., M.S. 
Associate Professor, Psychiatry
University of Michigan Medical School

PainRelief.com: What is the background for this study?

Response: Benzodiazepine prescribing has been quite persistent and even increasing among middle aged adults even as we’ve learned more about the associated harms.

To develop effective interventions to address prescribing, it would be helpful to understand how clinicians make their prescribing decisions. But then it is a problem if you ask clinicians about a particular behavior (e.g., prescribing) but don’t have actual objective data about their prescribing behavior.

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Dentists Reports Patients Coming to Appointments High on Marijuana

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Survey from the American Dental Association

PainRelief.com: What is the background for this study? What are the main findings?

Response: Each year, the ADA surveys dentists and consumers around emerging issues or trends in healthcare. As legalization and use of marijuana continues to increase, oral health issues around marijuana use are beginning to emerge. This, combined with a lack of awareness and understanding of the potential adverse health effects of routine marijuana use, was the reason for including it in our survey work.

cannabis-marijuana

PainRelief.com: What should readers take away from your report?

Response: Because legalized marijuana, whether personal or medicinal, is still relatively new, people may not be aware of the effects marijuana can have on oral health and dental visits. Readers should be aware that marijuana use can effect oral health in general as well as limit the care delivered at dental visits if used before an appointment.

Dentists and patients should also take away the importance of open conversation about marijuana use during dental visits. Health history updates can be a natural place to start an open dialogue.

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Study Assesses Cannabis Therapies for Low Back Pain Relief

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PainRelief.com Interview with:
Dror Robinson, M.D., Ph.D
Department of Orthopedics, Hasharon Hospital
Rabin Medical Center
Petah Tikva, Israel

PainRelief.com: What is the background for this study? What are the main findings?

cannabis-marijuana

Response: The background of the study is my concern as an orthopedic surgeon, regarding the optimal pain relief therapy for low back pain.  I am interested in particular with patients who failed prior interventions, either pharmaceutical or surgical.  These patients are an unfortunately growing group of patients without a good therapeutic option.  Most of them become chronic pain patients with the resultant multi-domain dysfunction both physical and mental. 

Cannabis appears to be able to allow both mental recovery and physical function recovery in such patients.  The main findings in the current study is that in patients with chronic pain due to low back pathology inhaled high-THC cannabis therapy is superior to extract high-CBD cannabis therapy.  Maximal therapeutic effect is reached after 18 months of therapy and appears to require high THC concentrations as compared with more balanced THC:CBD chemovars.

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