Patterns and correlates of medical cannabis use for pain among patients prescribed long-term opioid therapy

Shannon M. Nugent, Bobbi Jo Yarborough, Ning X. Smith, Steven K. Dobscha, Richard A. Deyo, Carla A. Green, Benjamin J. Morasco

Research output: Research - peer-reviewArticle

Abstract

Objective Little is known about co-occurring long-term opioid therapy (LTOT) and medical cannabis use. We compared characteristics of patients prescribed LTOT who endorsed using medical cannabis for pain to patients who did not report cannabis use. Method Participants (n = 371) prescribed LTOT completed self-report measures about pain, substance use, and mental health. Results Eighteen percent of participants endorsed using medical cannabis for pain. No significant differences were detected on pain-related variables, depression, or anxiety between those who endorsed medical cannabis use and those who did not. Medical cannabis users had higher scores of risk for prescription opioid misuse (median = 17.0 vs. 11.5, p < 0.001), rates of hazardous alcohol use (25% vs. 16%, p < 0.05), and rates of nicotine use (42% vs. 26%, p = 0.01). Multivariable analyses indicated that medical cannabis use was significantly associated with risk of prescription opioid misuse (β = 0.17, p = 0.001), but not hazardous alcohol use (aOR = 1.96, 95% CI = 0.96–4.00, p = 0.06) or nicotine use (aOR = 1.61, 95% CI = 0.90–2.88, p = 0.11). Conclusion There are potential risks associated with co-occurring LTOT and medical cannabis for pain. Study findings highlight the need for further clinical evaluation in this population. Future research is needed to examine the longitudinal impact of medical cannabis use on pain-related and substance use outcomes.

LanguageEnglish (US)
Pages104-110
Number of pages7
JournalGeneral Hospital Psychiatry
Volume50
DOIs
StatePublished - Jan 1 2018

Fingerprint

Medical Marijuana
Opioid Analgesics
Pain
Therapeutics
Nicotine
Prescriptions
Alcohols
Cannabis
Self Report
Mental Health
Anxiety
Depression
Population

Keywords

  • Chronic pain
  • Long-term-opioid therapy
  • Medical cannabis
  • Prescription opioid misuse

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Patterns and correlates of medical cannabis use for pain among patients prescribed long-term opioid therapy. / Nugent, Shannon M.; Yarborough, Bobbi Jo; Smith, Ning X.; Dobscha, Steven K.; Deyo, Richard A.; Green, Carla A.; Morasco, Benjamin J.

In: General Hospital Psychiatry, Vol. 50, 01.01.2018, p. 104-110.

Research output: Research - peer-reviewArticle

@article{221ded77210b4186bf74fd38dd1596f2,
title = "Patterns and correlates of medical cannabis use for pain among patients prescribed long-term opioid therapy",
abstract = "Objective Little is known about co-occurring long-term opioid therapy (LTOT) and medical cannabis use. We compared characteristics of patients prescribed LTOT who endorsed using medical cannabis for pain to patients who did not report cannabis use. Method Participants (n = 371) prescribed LTOT completed self-report measures about pain, substance use, and mental health. Results Eighteen percent of participants endorsed using medical cannabis for pain. No significant differences were detected on pain-related variables, depression, or anxiety between those who endorsed medical cannabis use and those who did not. Medical cannabis users had higher scores of risk for prescription opioid misuse (median = 17.0 vs. 11.5, p < 0.001), rates of hazardous alcohol use (25% vs. 16%, p < 0.05), and rates of nicotine use (42% vs. 26%, p = 0.01). Multivariable analyses indicated that medical cannabis use was significantly associated with risk of prescription opioid misuse (β = 0.17, p = 0.001), but not hazardous alcohol use (aOR = 1.96, 95% CI = 0.96–4.00, p = 0.06) or nicotine use (aOR = 1.61, 95% CI = 0.90–2.88, p = 0.11). Conclusion There are potential risks associated with co-occurring LTOT and medical cannabis for pain. Study findings highlight the need for further clinical evaluation in this population. Future research is needed to examine the longitudinal impact of medical cannabis use on pain-related and substance use outcomes.",
keywords = "Chronic pain, Long-term-opioid therapy, Medical cannabis, Prescription opioid misuse",
author = "Nugent, {Shannon M.} and Yarborough, {Bobbi Jo} and Smith, {Ning X.} and Dobscha, {Steven K.} and Deyo, {Richard A.} and Green, {Carla A.} and Morasco, {Benjamin J.}",
year = "2018",
month = "1",
doi = "10.1016/j.genhosppsych.2017.11.001",
volume = "50",
pages = "104--110",
journal = "General Hospital Psychiatry",
issn = "0163-8343",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Patterns and correlates of medical cannabis use for pain among patients prescribed long-term opioid therapy

AU - Nugent,Shannon M.

AU - Yarborough,Bobbi Jo

AU - Smith,Ning X.

AU - Dobscha,Steven K.

AU - Deyo,Richard A.

AU - Green,Carla A.

AU - Morasco,Benjamin J.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective Little is known about co-occurring long-term opioid therapy (LTOT) and medical cannabis use. We compared characteristics of patients prescribed LTOT who endorsed using medical cannabis for pain to patients who did not report cannabis use. Method Participants (n = 371) prescribed LTOT completed self-report measures about pain, substance use, and mental health. Results Eighteen percent of participants endorsed using medical cannabis for pain. No significant differences were detected on pain-related variables, depression, or anxiety between those who endorsed medical cannabis use and those who did not. Medical cannabis users had higher scores of risk for prescription opioid misuse (median = 17.0 vs. 11.5, p < 0.001), rates of hazardous alcohol use (25% vs. 16%, p < 0.05), and rates of nicotine use (42% vs. 26%, p = 0.01). Multivariable analyses indicated that medical cannabis use was significantly associated with risk of prescription opioid misuse (β = 0.17, p = 0.001), but not hazardous alcohol use (aOR = 1.96, 95% CI = 0.96–4.00, p = 0.06) or nicotine use (aOR = 1.61, 95% CI = 0.90–2.88, p = 0.11). Conclusion There are potential risks associated with co-occurring LTOT and medical cannabis for pain. Study findings highlight the need for further clinical evaluation in this population. Future research is needed to examine the longitudinal impact of medical cannabis use on pain-related and substance use outcomes.

AB - Objective Little is known about co-occurring long-term opioid therapy (LTOT) and medical cannabis use. We compared characteristics of patients prescribed LTOT who endorsed using medical cannabis for pain to patients who did not report cannabis use. Method Participants (n = 371) prescribed LTOT completed self-report measures about pain, substance use, and mental health. Results Eighteen percent of participants endorsed using medical cannabis for pain. No significant differences were detected on pain-related variables, depression, or anxiety between those who endorsed medical cannabis use and those who did not. Medical cannabis users had higher scores of risk for prescription opioid misuse (median = 17.0 vs. 11.5, p < 0.001), rates of hazardous alcohol use (25% vs. 16%, p < 0.05), and rates of nicotine use (42% vs. 26%, p = 0.01). Multivariable analyses indicated that medical cannabis use was significantly associated with risk of prescription opioid misuse (β = 0.17, p = 0.001), but not hazardous alcohol use (aOR = 1.96, 95% CI = 0.96–4.00, p = 0.06) or nicotine use (aOR = 1.61, 95% CI = 0.90–2.88, p = 0.11). Conclusion There are potential risks associated with co-occurring LTOT and medical cannabis for pain. Study findings highlight the need for further clinical evaluation in this population. Future research is needed to examine the longitudinal impact of medical cannabis use on pain-related and substance use outcomes.

KW - Chronic pain

KW - Long-term-opioid therapy

KW - Medical cannabis

KW - Prescription opioid misuse

UR - http://www.scopus.com/inward/record.url?scp=85034113780&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85034113780&partnerID=8YFLogxK

U2 - 10.1016/j.genhosppsych.2017.11.001

DO - 10.1016/j.genhosppsych.2017.11.001

M3 - Article

VL - 50

SP - 104

EP - 110

JO - General Hospital Psychiatry

T2 - General Hospital Psychiatry

JF - General Hospital Psychiatry

SN - 0163-8343

ER -