Adding to the debate about the efficacy of cannabis in managing chronic pain is a new study indicating discontinuation rates among patients are quite high.
Medical cannabis (MC) has become increasingly popular as a treatment for chronic musculoskeletal pain. Some patients swear by it, others don’t find it beneficial. Illustrating the divide is a retrospective analysis by researchers from the Rothman Institute Foundation for Opioid Research in the USA.
Their analysis involved 78 patients over a 2 year period, with discontinuation rates measured at three-month and one-year follow-ups. The overall discontinuation rate of MC use was 57.9% at one year, with 44.7% of patients discontinuing within the first three months.
But why?
While older age was significantly associated with higher discontinuation rates and overall health status at the time of medical cannabis certification did not influence a decision to discontinue or continue treatment, the researchers state:
“The absence of significant differences in pain origin or baseline health scores suggests that factors beyond pain location or general health may contribute to the decision to discontinue MC. ”
It’s important to note the study didn’t capture THC/CBD ratios, specific administration methods of medicines, or cognitive effects.
The researchers state further research is needed to delve into the long-term effects of medical cannabis on pain management, and on patient outcomes.
The study has been published in the journal PLOS One.
But findings from other research differs.
An example is another study published earlier this year that followed chronic musculoskeletal pain patients over a one-year period. It reported most patients used topical formulations, benefited from high levels of perceived efficacy, and experienced minimal cognitive or motor side effects. Nearly 80% maintained stable usage patterns.
It’s estimated around 29% of Australians were living with chronic musculoskeletal conditions in 2022.
The Australian Rheumatology Association (ARA) believes there should be evidence of efficacy and safety from high-quality randomised controlled trials (RCTs) before any potential intervention for arthritis and other musculoskeletal conditions
is adopted into clinical practice. In its position statement, the ARA says:
“Furthermore, advice regarding the role of any intervention should weigh RCT evidence for efficacy against potential harms detected in RCTs and longer- term observational data.”
