Patients Report Substituting Cannabis for Pain Relief Medications

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.

Home Sensors Developed for Overnight Monitoring in Opioid Use Disorder

PainRelief.com Interview with:
Marian Wilson, PhD, MPH, RN, PMGT-BC 
Associate Professor
Assistant Editor, Pain Management Nursing
Washington State University College of Nursing

Dr. Wilson

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

Response: People with opioid use disorder often experience withdrawal symptoms that can interfere with recovery success. Our team was interested in whether noninvasive home sensors could provide accurate information to detect overnight restlessness and sleep problems that could indicate opioid withdrawal for adults prescribed methadone for opioid use disorder.

Novel Protocol Reduced Use of Opioid Pain Relievers After Knee and Shoulder Surgeries

PainRelief.com Interview with:
Nicole Simunovic, MSc
On behalf of the NO PAin Principal Investigators

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

Response: Orthopaedic surgeons prescribe more opioids than any other type of surgeon in North America. Opioids have the potential to be highly addictive and can cause serious harm or even death if taken in excess. The goal of our clinical study was to determine if an opioid sparing approach to postoperative pain management was safe and effective in patients undergoing arthroscopic knee and shoulder surgery.

States with Mandated Prescription Monitoring Programs Had Marked Increase in Heroin-Related Deaths

PainRelief.com Interview with:
Dr. Tongil “TI” Kim,
Assistant professor of marketing
Naveen Jindal School of Management
The University of Texas at Dallas (abbreviated UT Dallas)

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

Response: We examine the early deployment of mandated prescription drug monitoring program (PDMP) use (2006-2015) in the U.S., when 19 states mandated PDMP use. We find 6.37 more heroin-related deaths per million population per year—a 50.1% increase—following PDMP mandates compared to states that did not.

Uninsured Pay Higher Out-of-Pocket Costs for Opioid Antidote Naloxone

PainRelief.com Interview with:
Evan D. Peet, PhD Professor
Pardee RAND Graduate School

Dr. Peet

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

Response: This study is part of a broader CDC funded project looking at access to naloxone and naloxone’s impacts on opioid-related overdose deaths. There have been increasing efforts to expand access to naloxone, with a variety of different laws being passed by states across the nation. But one part of access that has been understudied is the cost borne by patients.

High out-of-pocket costs may act as a barrier to this life-saving drug, so in this study we look at trends in out-of-pocket costs of naloxone and how they vary by payor and drug brand.

Study Highlights Challenges of Opioid Use Disorder in Patients with Cancer Pain

PainRelief.com Interview with:
Katie Fitzgerald Jones MSN, APN
PhD candidate Connell School of Nursing
Boston College
Jonas Mental Health Scholar 2021-2023
American Academy of Nursing Jonas Policy Scholar 
Ruth L. Kirschstein National Service Award (F31NR019929-01)

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

Response: I am a Palliative and Addiction Nurse Practitioner at VA Boston and a Ph.D. candidate at Boston College Connell School of Nursing. In my clinical practice, I regularly care for people with cancer who have a co-occurring substance use disorder. 

How to best care for people with substance use disorders, such as opioid use disorder is especially complex in people with cancer because opioid management is a standard of cancer-pain management and cancer prognoses can influence opioid decisions and vary. It is important when prescribing opioids that you attend to safety while also addressing pain. People with untreated opioid use disorder or concerning opioid behaviors (such as taking more opioids than prescribed or using opioids with unprescribed medications that increase the risk for opioid-related harm such as benzodiazepines) have an increased risk for opioid related-harms. It is also an area that lacks consensus and is absent from cancer-specific pain guidelines.

This study was conducted with leaders in palliative care including senior author, Jessica Merlin to tackle the question of what is consensus among palliative care and addiction clinicians to caring for people with opioid misuse or use disorder and cancer-related pain and how this is influenced by prognosis?

Concurrent Opioid and Benzodiazepine Prescriptions for Pain Relief Fall But Still Common

PainRelief.com Interview with:
Kun Zhang PhD
Senior Service Fellow and Health Scientist
Opioid Overdose Prevention Health Systems Team
Division of Unintentional Injury Prevention
Centers for Disease Control and Prevention

Dr. Zhang

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

Response: When taken together by patients, opioids and benzodiazepines can result in synergistic respiratory depression which elevates overdose risk; however, these two medications have been commonly co-prescribed in the U.S.

Since 2016 there has been efforts to address the concurrent use of these two drugs, for example the 2016 FDA Boxed Warning and the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain.

Our study aimed at tracking and analyzing recent trends in concurrent use of these two medications using national level data.

As Opioid Prescriptions Fall, Alternate Prescriptions for Pain Relief Increase

PainRelief.com Interview with:
Lauren R. Gorfinkel MPH
New York State Psychiatric Institute
New York, NY
Department of Medicine, University of British Columbia
Vancouver, Canada

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

Response: The opioid crisis has led to clear declines in opioid prescribing across North America, however, chronic pain remains an extremely common health problem with limited treatment options. This study was therefore interested in using nationally-representative data to find out whether alternative pain medications are growing more popular as opioid prescriptions decline.

Older Adult Black Men at Disproportionate Risk of Fatal Opioid Overdose

PainRelief.com Interview with:
Maryann Mason, PhD
Department of Emergency Medicine
Northwestern University Feinberg School of Medicine
Buehler Center for Health Policy and Economics,
Northwestern University, Chicago, Illinois

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

Response: This study came about because we were looking at data for Cook County, Illinois and saw an increase in older adult opioid overdose deaths.  That made us wonder if there was a national trend or the observation was limited to our local area.  We undertook the research to determine that and found that it is indeed a national phenomenon.

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Less-is-More Approach to Pain Relief After Surgery

PainRelief.com Interview with:
Dr Deanne Jenkin PhD
UNSW Australia,
now Research Fellow at The Daffodil Centre
Sydney, Australia

Dr Jenkin

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

Response: At the time, long-term opioid use for chronic non-cancer pain was increasing and there were signs that their benefit was overestimated whilst the harms were underestimated. Our randomized trial found that after going home from fracture surgery, strong opioids were not better for pain relief compared to a milder, potentially safer opioid alternative.

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