Medical cannabis linked to lower opioid use for intractable pain

  • O'Connell M & al.
  • Ann Pharmacother
  • 1 Nov 2019

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Using medical cannabis may reduce average daily milligram morphine equivalent (MME) doses in patients with intractable pain.
  • More research is needed to confirm opioid-sparing effects and effects on diazepines.

Why this matters

  • Although more research is needed, pain clinicians might wish to consider medical cannabis treatment in the setting of chronic intractable pain to reduce overall opioid burden.

Key results

  • 77 eligible for inclusion; 58.4% (n=45) women; average age, 54 years.
  • At baseline, average daily MME, diazepine equivalents (DE) were 140.64±184.64 mg, 18.33±10.84 mg, respectively.
  • Median daily MME, DE were 105 (interquartile range [IQR], 43.75-155.63) mg, 17.5 (IQR, 8.13-28.13) mg, respectively.
  • Statistically significant decline in median MME observed from baseline to 3 months (−32.5 mg; P=.013), baseline to 6 months (−39.1 mg; P=.001).
  • Nonsignificant decline seen in median DE at 3 months (−3.75 mg; P=.285), no change at 6 months (−0 mg; P=.833).
  • Significance remained for MME even when patients taking >500 MMEs were excluded (3 months: −34.29 mg [P=.035]; 6 months: −34.29 mg [P=.004]).

Study design

  • Single-centre, retrospective 6-month cohort study evaluating influence of medical cannabis on daily opioids, benzodiazapines for intractable pain.
  • Funding: None.

Limitations

  • Retrospective.
  • Small sample.
  • Dose equivalency tables ambiguity.
  • Limited generalisability.