Researchers from Montreal, Canada found that in a survey of patients with rheumatic conditions, less than 3% reported using cannabis for medical reasons. This challenges the reliability of musculoskeletal complaints as a justification for medical marijuana use.

Based on information from the 2011 Canadian Alcohol and Drug Use Monitoring Survey, the researchers had previously conservatively estimated that 4 out of 100 people with rheumatic pain may be using marijuana to relieve their symptoms.

Mary-Ann Fitzcharles, MD, from Montreal General Hospital and colleagues surveyed 1000 patients with rheumatic conditions, and compared the characteristics of medical marijuana users with non-users.

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They found that:

  • 38 patients reported currently using either medical or recreational marijuana (3.8%; 95% CI: 2.8-5.2).
  • 43 patients (4.3%) reported ever using medical marijuana (95% CI: 3.2-5.7), and 28 of those patients were currently using medical marijuana (2.8%; 95% CI: 1.9-4.0).

The researchers also found the following characteristics of medical marijuana users:

  • Those currently using medical marijuana were using it for a range of rheumatic diseases; over half had osteoarthritis.
  • Those who used marijuana for medical reasons were more likely to be younger, disabled or unemployed, and have poorer overall health.
  • Those using medical marijuana reported higher pain levels and greater amounts of opioid use, but physicians rated their overall disease status as comparable with non-users.
  • Those who used medical marijuana were more often previous recreational marijuana users compared with non-users; approximately 40% of those using medical marijuana reported that they were currently also using recreational marijuana.
  • Those who used medical marijuana were more likely to be current cigarette smokers than those who didn’t use medical marijuana (12 (42.9%) vs 124 (12.8%)), respectively; (P <.001).
  • 33% of those who use marijuana recreationally stated that they would consider using marijuana for medical reasons.

“This low rate of use in patients with a rheumatologist-confirmed diagnosis is in stark contrast to the high rates of severe arthritis frequently reported by medicinal marijuana users, especially in Canada,” the authors wrote.

The researchers concluded that this low rate of medical marijuana use in those with rheumatic diseases challenges the reliability of musculoskeletal complaints as a reason for medical marijuana use, especially the complaint of “severe arthritis.”

“Although marijuana could be used for legitimate medical purposes by patients with more severe rheumatic diseases, it is also possible that this disease label is currently used by some to inappropriately access marijuana under the guise of a common medical condition,” the authors wrote.

The researchers concluded that further research is needed on medical marijuana‘s use in rheumatic conditions before recommendations by the medical community can be made.

Disclosure: Peter A. Ste-Marie was supported by research grant support from the Louise and Alan Edwards Foundation, Montreal. Mark A. Ware, MD, MSc, has received a grant from CanniMed to study vaporized cannabis in osteoarthritis.

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  1. Ste-Marie PA, Shir Y, Rampakakis E, et al. Survey of herbal cannabis (marijuana) use in rheumatology clinic attenders with a rheumatologist confirmed diagnosis. Pain. 2016;157(12):2792-2797. doi:10.1097/j.pain.0000000000000706.