Department of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Adv Ther. 2020 Aug;37(8):3571-3583. doi: 10.1007/s12325-020-01416-9. Epub 2020 Jul 6.
To date, no study has reported the prevalence of cannabis use in chronic pain patients. The aim of this study is to investigate the trends in cannabis use among chronic pain in-patients from 2011 to 2015 in the USA.
Patients were identified from the National Inpatient Sample (NIS) database using the International Classification of Diseases, Ninth and Tenth Revision, diagnosis codes for chronic pain and cannabis use. Annual estimates and trends were determined for cannabis use, patient characteristics, cannabis use among subgroups of chronic pain conditions, cost, length of stay, and associated discharge diagnosis.
Between 2011 to 2015, a total of 247,949 chronic pain patients were cannabis users, increasing from 33,189 to 72,115 (P < 0.001). There were upward trends of cannabis use in females (38.7-40.7%; P = 0.03), Medicare insured patients (32.7-40.4%; P < 0.01), patients with lowest annual household income (36.1-40.9%; P = 0.02), patients aged 45-64 years (45.9-49.2%; P < 0.001), and patients with tobacco use disorder (63.8-72.4%; P < 0.0001). Concurrently, cannabis use decreased among patients with opioid use disorder (23.8-19.9%; P < 0.001). Cannabis use increased from 2011 to 2015 in patients with chronic regional pain syndrome, trauma, spondylosis, and failed back surgery syndrome. Adjusted total hospitalization cost increased from $31,271 ($1333) in 2011 to $38,684 ($946) in 2015 (P < 0.001).
Cannabis use increased substantially from 2011 to 2015, while the rates of cannabis use in opioid users down-trended simultaneously. Disparities in cannabis use among subgroups should be explored further.
迄今为止，尚无研究报告美国慢性疼痛患者中大麻使用的流行率。本研究旨在调查 2011 年至 2015 年美国慢性疼痛住院患者中大麻使用的趋势。
使用国际疾病分类，第九和第十修订版的诊断代码，从国家住院患者样本（NIS）数据库中确定慢性疼痛和大麻使用患者。确定大麻使用、患者特征、慢性疼痛疾病亚组中的大麻使用、成本、住院时间和相关出院诊断的年度估计值和趋势。
2011 年至 2015 年期间，共有 247949 例慢性疼痛患者为大麻使用者，从 33189 例增加到 72115 例（P<0.001）。女性（38.7-40.7%；P=0.03）、医疗保险患者（32.7-40.4%；P<0.01）、家庭年收入最低的患者（36.1-40.9%；P=0.02）、45-64 岁的患者（45.9-49.2%；P<0.001）和有烟草使用障碍的患者（63.8-72.4%；P<0.0001）中大麻使用呈上升趋势。同时，阿片类药物使用障碍患者的大麻使用减少（23.8-19.9%；P<0.001）。从 2011 年到 2015 年，慢性区域性疼痛综合征、创伤、脊椎病和腰椎术后综合征患者的大麻使用率增加。调整后的总住院费用从 2011 年的 31271 美元（1333 美元）增加到 2015 年的 38684 美元（946 美元）（P<0.001）。
从 2011 年到 2015 年，大麻的使用量大幅增加，而同时阿片类药物使用者的大麻使用率呈下降趋势。应进一步探讨亚组中大麻使用的差异。
