Nearly 90% of patients with arthritis and musculoskeletal (MSK) joint pain regard cannabis as an effective and safe pain treatment, according to a new Canadian study.
The research, published in the Journal of International Medical Research, found that 26% of the 406 patients surveyed had used cannabis previously to manage their pain symptoms, whilst 16% had used it in the past month.
Significantly, patients believed cannabis could treat over 50% of their pain and replace nearly half of their analgesic pain medications, with most feeling comfortable discussing cannabis use with their physicians.
Over 600 million people worldwide live with arthritis, and one in four of these report severe joint pain. The most common treatment for joint pain associated with arthritis and MSK is the prescription of opioids, which are generally regarded as effective at managing short-term pain symptoms. However, their use for the treatment of chronic pain is advised against by most medical professionals due to the risk of addiction, overdose, abuse, and other unwanted side effects.
North American nations are currently experiencing an opioid epidemic. In the US alone, opioids cause an estimated 55,000 US deaths a year.
“Postoperative opioid overprescription seems to be a problem unique to North America as patients in other parts of the world consume opioids less frequently and in lower doses. The USA is responsible for the consumption of 80% of the global opioid supply. Opioid prescriptions showed a decline between 2012 and 2017; however, the number of days per prescription continued to rise,” the authors wrote.
Medicinal cannabis is now legal in some form in around 50 countries and 40 US states, including the UK, Germany, Canada, Uruguay, Australia, and California.
Germany and Australia both have over a million cannabis patients, whilst in the UK, patient numbers continue to double yearly, with current estimates suggesting 100,000 people are now prescribed cannabis.
Cannabis has been well documented as a safe and effective pain management tool and is comfortably tolerated by various groups of patients. However, researchers felt there was a lack of information directly relating to how cannabis treats those living with severe joint pain caused by arthritis and MSK.
“Cannabis modulates pain primarily through the endocannabinoid system (ECS) and activation of cannabinoid receptors (CB1 and CB2), which inhibits painful signals and reduce inflammation as well as through interactions with noncannabinoid targets, with studies supporting the analgesic properties of cannabis,” the authors wrote.
“However, there is lack of robust data on the use of cannabis for pain management in orthopedic surgery, highlighting the need for further investigation.”
The study used a survey to question patients from three separate Canadian clinics on their thoughts, experiences, and perceptions of cannabis as a treatment for their arthritis or MSK condition. The survey also collected anonymous data on patients’ conditions, medications, and personal details such as age and gender.
Nearly two-thirds (63%) were prescribed some kind of analgesic; of these, 64.5% were prescribed opioids. Naproxen was the most common non-opioid painkiller used.
More than a quarter of patients had used cannabis at some point in the past to treat their symptoms, and 35.8% reported using it recreationally. Nearly one in six reported using cannabis in the past month to treat their severe joint pain.
“Cannabis use among patients with arthritis and MSK joint pain is highly prevalent, and patients are generally open to discussing it with their healthcare providers,” the study conclusion said.
“Data on patient preferences, including preferred methods of administration, distribution, and perceived barriers, can help clinicians and researchers better understand the future use of cannabis for pain management. More research, particularly through RCTs, is essential to assess the safety and efficacy of cannabis use before it can be officially endorsed as a treatment option for this patient group.”
