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Most people consider medical marijuana safe for pain despite limited research

Nearly two-thirds of respondents in a nationwide survey showed interest in using marijuana or cannabinoids for pain management, with many reporting that they believed those options were safer than opioids and had fewer side effects than other pain medications.

Results from the American Society of Anesthesiologists’ survey showed that many in the United States are unaware of the potential risks linked to marijuana and cannabidiol use.

“As a community of physicians, it's important for us to remember that 100 million people in this country suffer from chronic pain,” Edward R. Mariano, MD, MAS, chief of anesthesiology and perioperative care service and associate chief of staff for inpatient surgical services in the VA Palo Alto Health Care System, told Healio Primary Care.

“As their physicians, we have to ask the right questions and make sure our patients are comfortable talking with us about their pain and what they are using, including cannabinoids,” he continued.

 

Nearly two-thirds of respondents in a nationwide survey showed interest in using marijuana or cannabinoids for pain management, with many reporting that they believed those options were safer than opioids and had fewer side effects than other pain medications..

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Survey Findings

Results from the survey were based on responses from 1,005 adults aged 18 years and older.

Marijuana or cannabinoid use was reported by 37% of millennials, 25% of Gen Xers and 18% of baby boomers.

More than two-thirds of respondents said that they would consider using marijuana or cannabinoids to treat pain. Of those, 62% said they felt marijuana and cannabinoids were safer than opioids, and 57% thought they had fewer adverse effects than other available pain medications.

Among the respondents:

• 57% felt more research is needed;
• 34% believed that they do not need to discuss marijuana and cannabinoid product use with their doctors;
• 48% felt that they know what to expect from marijuana or cannabinoids;
• 13% said they have or would use marijuana because no other pain management has worked for them; and
• 40% thought that the FDA approved cannabidiol sold in grocery stores, truck stops, health food stores and medical marijuana dispensaries.

Implications of the findings

Mariano explained that one of the biggest issues with increasing interest in marijuana or cannabinoids for pain management is that patients do not realize these products are unregulated, and many who buy their own products do not know what is in them. One study, he noted, found that among 84 , only 31% were accurately labeled.

Research into medical marijuana has been limited because marijuana is considered a Schedule I drug by the Drug Enforcement Administration, Mariano said. This means that although 33 states have legalized marijuana in some form, the federal government considers it to have high abuse potential and does not currently approve it for medical use.

“There are over 100 active cannabinoids in marijuana, and we don't know which one or ones work best alone or in combination, in what doses, and in which patients or conditions,” Mariano told Healio Primary Care.

Legislation pushing more research

To address the need for more information, the American Society of Anesthesiologists endorsed two bills that would expand research on marijuana and cannabinoids — the Medical Cannabis Research Act of 2019 (H.R. 601) and the Cannabidiol and Marijuana Research Expansion Act (S. 2032).

Both bills would increase the number of registered manufacturers able to produce cannabinoids for research purposes.

“The intent is to improve the quality of production and increase the supply of cannabinoids specifically for research,” Mariano told Healio Primary Care. “Researchers would be able to use these products to conduct preclinical studies or clinical studies through the FDA investigational new drug process.”– by Erin Michael

References:

American Society of Anesthesiologists. Survey reveals skyrocketing interest in marijuana and cannabinoids for pain. https://www.asahq.org/about-asa/newsroom/news-releases/2019/08/survey-reveals-skyrocketing-interest-in-marijuana-and-cannabinoids-for-pain/. Accessed Sept. 24, 2019.

Bonn-Miller MO, et al. JAMA. 2017;doi:10.1001/jama.2017.11909.

Congress.gov. H.R.601 - Medical Cannabis Research Act of 2019. https://www.congress.gov/bill/116th-congress/house-bill/601/text?format=txt&q=%7B%22search%22%3A%5B%22medical+cannabis+research+act%22%5D%7D&r=1%27&s=5. Accessed Sept. 24, 2019.

Congress.gov. S.2032 - Cannabidiol and Marijuana Research Expansion Act. https://www.congress.gov/bill/116th-congress/senate-bill/2032/text?r=11&s=1. Accessed Sept. 24, 2019.

Drug Enforcement Administration. Drug Scheduling. https://www.dea.gov/drug-scheduling. Accessed Sept. 24, 2019.

Disclosures: Healio Primary Care was unable to confirm relevant financial disclosures prior to publication.