Cannabis for pain management is employed by approximately 27% of people with multiple sclerosis (PWMS), according to an observational study, published in Multiple Sclerosis and Related Disorders.
At least half of PWMS report pain that is often disabling. In recent years, alternative pharmacological and nonpharmacological strategies, including cannabis, for pain management have become available.
To evaluate cannabis use patterns among PWMS with chronic pain, participants (N=242) in a parent study were recruited between 2018 and 2021 through online advertisements using the National Multiple Sclerosis (MS) Society, ClinicalTrials.gov, and University of Washington MS Center. At baseline, participants responded to a questionnaire about pain-related and disease-related variables prior to randomization. In this study, baseline data were compared between individuals who did (n=65) and did not (n=177) endorse using cannabis for pain management.
The study population comprised 83.5% women, they were aged mean 52.9 (SD, 11.2) years, 85.1% were White, 62.4% had relapsing remitting MS, they had been diagnosed 13.5 (SD, 9.7) years previously, and mean Numeric Pain Scale (NRS) pain score was 5.6 (SD, 1.8) points.
The participants who used cannabis were significantly younger (U, 4621.5; P =.019) and reported greater NRS pain (U, 6839.0; P =.022), painDETECT (U, 7125.5; P =.001), and Brief Pain Inventory (BPI; U, 6720.5; P =.027) scores than nonusers. The differences in pain scores indicated that cannabis use was associated with greater pain intensity, pain interference, and neuropathic pain.
Compared with nonusers, those who used cannabis for pain management also were more likely to report using nonopioid analgesics (63.1% vs 55.9%), anticonvulsants (36.9% vs 28.8%), opioids (21.5% vs 17.5%), sedative-hypnotics (9.2% vs 6.8%), and antidepressants (9.2% vs 3.4%), respectively.
Among participants who used cannabis for pain management, 42% used oil or tincture, 22% vape, 17% edible, 15% topical, 12% smoke, and 5% capsule delivery methods. In addition, 15% of users reported 10 other delivery methods, such as flower, marijuana, or unsure.
“Findings of this study shed light on factors that may intersect with cannabis use for pain management,” according to the researchers. “These findings also highlight a number of interesting questions that would be best answered in future prospective research, such as the longitudinal trends in cannabis use for pain management, as well as longitudinal associations between cannabis use, pain-related coping, and the use of other medications for pain, such as opioids.”
This study was limited by the fact that no causal relationships were evaluated.
Link K, Knowles LM, Alschuler KN, Ehde DM. Characterizing cannabis use in a sample of adults with multiple sclerosis and chronic pain: An observational study. Mult Scler Relat Disord. 2023;75:104742. doi:10.1016/j.msard.2023.104742