Cannabis Improves Quality of Life for Chronic Pain Patients, Study Finds
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Patients who use medical cannabis to address their chronic pain report significant improvements to their overall quality of life as well as improvements in pain, according to a new paper published in Medical Cannabis and Cannabinoids.
The study, led by scientists at the University of the Sciences in Philadelphia, surveyed nearly 200 medical cannabis patients in Pennsylvania over the course of 8 weeks. The researchers found significant improvements in health-related quality of life as well as significant reductions in pain and feelings of anxiety. However, the patients also reported some decline in overall self-care.
In light of this, the researchers believe that further study into the relationship between medical cannabis use and self-care is warranted.
Cannabis use linked to improved quality of life
But while there has been a significant amount of research dedicated to investigating the relationship between cannabis use and pain, there is comparatively little out there examining the subsequent impact of medical cannabis treatment on the quality of life. The quality-of-life-focused studies that do exist have also tended to focus exclusively on patients with fibromyalgia, not chronic pain patients as a whole, or have used unvalidated tools for assessing patient quality of life.
In this study, the researchers sought to specifically determine if there was a significant association between health-related quality of life (HRQoL) measures and medical cannabis use in patients using the drug for pain management. Eligible study participants – all adult pain patients enrolled in the Pennsylvania Medical Marijuana Program – were contacted through mailing lists provided in partnership with the Releaf App or Keystone Canna Remedies dispensaries.
A total of 181 patients completed all four study surveys, conducted at baseline then two, four, and eight weeks later. The survey included basic demographic questions, a pain scale, and the EQ-5D survey. This survey is recognized by the National Institute for Health and Care Excellence (NICE) as the preferred measure of HRQoL in adults.
The researchers found that over a six-week period between surveys two and four, the medical cannabis users reported improvements in both subjective pain scores and HRQoL. This small but statistically significant improvement in HRQoL was determined to be down to better pain and anxiety metrics measured by the EQ-5D survey.
Quality of life survey also detects a decline in effective self-care
In addition to these positive reductions in pain and feelings of anxiety, the EQ-5D survey also revealed a decline in self-care. After the six-week study period, more participants reported having slight or moderate problems with self-care than at baseline. While no patients began to experience new severe problems with self-care over the course of the study, this general decline significantly tempered the overall positive improvement in patient QoL while using medical cannabis.
“A review of the literature found no other study connecting the use of marijuana with declines in self-care in pain patients using MM [medical marijuana],” the researchers wrote. “Given that our study found a decline in self-care among pain patients using MM, it would be of interest to learn what aspects of self-care change when using MM for pain.”
The researchers highlight a need for closer study of self-care in patients using medical cannabis, pointing out that the Marijuana Consequences Questionnaire (MACQ) does already contain a nine-question domain evaluating self-care, which covers areas such as eating, activity, physical appearance, and perceived energy levels/motivation. While this questionnaire is generally used to assess the negative consequences of recreational cannabis use, this section could potentially be applied to assessing self-care in medical cannabis patients.
While this observed decline in self-care is a concerning area for further investigation, the HRQoL for medical cannabis patients using cannabis for pain was still increased by a statistically significant amount overall, demonstrating that medical cannabis can positively impact patient quality of life.
Cannabis, pain, and quality of life for patients
Under the looming figure of the opioid crisis, scientists are working to identify other drugs that might serve as effective replacements or adjunct medications for opioids, which can present a risk for addiction if used for chronic pain long-term. As a result, study into medical cannabis, pain, and quality of life data has become a major research field in recent years, with a number of high-profile research projects now dedicated, at least in part, to this cause.
In 2019, researchers at the University of Georgia were awarded a $3.5 million grant from the National Institute on Drug Abuse (NIDA), a branch of the National Institutes of Health (NIH), to study the effects of medical cannabis laws on the health behavior of patients with chronic pain.
Earlier this year, Europe’s largest medical cannabis patient registry, Project Twenty21, released its first set of preliminary results examining medical cannabis use in Europe. These findings indicated significant improvements in patient quality of life when using legally licensed medical cannabis. The preliminary data from this project, which is monitored by the independent drugs charity Drug Science, also highlighted the ability of these patients to manage other secondary conditions, including anxiety, insomnia, and depression when prescribed cannabis.
“On a measurement of 0-to-100, where 100 presents the best imaginable quality of life, the mean score for our T21 patients [when initiating treatment] was 46.8,” Dr Anne Katrin Schlag, head of research at Drug Science, told Analytical Cannabis following the results’ publication.
“We compared our findings to normative data from the UK household population. Here, the mean was 85.7 – showing just how low quality of life is for our patients [at initiation of treatment]. Yet our 3-month follow up data, albeit with a small sample size of 64 so far, shows that patients' quality of life improved significantly, from 46.8 to 63.3 – a 50 percent increase in self-reported quality of life, which indicates a large effect of CBMPs [cannabis-based medicinal products] for improved health.”
Despite these advances, some pain research experts maintain that more high-quality evidence is needed before they can fully endorse medical cannabis as a way of tackle chronic pain and improving patient quality of life. In March, the International Association for the Study of Pain (IASP) published a position statement explaining that while current preclinical research does “support the concept of cannabinoid-mediated analgesia,” the IASP “does not currently endorse general use of cannabis and cannabinoids for pain relief” on account of a “lack of high-quality clinical evidence.” Further research into the clinical pharmacology of cannabis and cannabinoids in pain relief is needed to produce this type of high-quality evidence for professional consideration.