Social Dimensions of Health, University of Victoria, Victoria, BC, Canada.
Canadian Institute for Substance Use Research, Victoria, BC, Canada.
Pain Med. 2021 Mar 18;22(3):727-739. doi: 10.1093/pm/pnaa396.
This article presents findings from a large prospective examination of Canadian medical cannabis patients, with a focus on the impacts of cannabis on prescription opioid use and quality of life over a 6-month period.
The Tilray Observational Patient Study took place at 21 medical clinics throughout Canada. This analysis includes 1,145 patients who had at least one postbaseline visit, with follow-up at 1, 3, and 6 months. Instruments included a comprehensive cannabis use inventory, the World Health Organization Quality of Life Short Form (WHOQOL-BREF), and a detailed prescription drug questionnaire.
Participants were 57.6% female, with a median age of 52 years. Baseline opioid use was reported by 28% of participants, dropping to 11% at 6 months. Daily opioid use went from 152 mg morphine milligram equivalent (MME) at baseline to 32.2 mg MME at 6 months, a 78% reduction in mean opioid dosage. Similar reductions were also seen in the other four primary prescription drug classes identified by participants, and statistically significant improvements were reported in all four domains of the WHOQOL-BREF.
This study provides an individual-level perspective of cannabis substitution for opioids and other prescription drugs, as well as associated improvement in quality of life over 6 months. The high rate of cannabis use for chronic pain and the subsequent reductions in opioid use suggest that cannabis may play a harm reduction role in the opioid overdose crisis, potentially improving the quality of life of patients and overall public health.
本文介绍了一项针对加拿大医用大麻患者的大型前瞻性研究结果,重点关注大麻在 6 个月内对处方类阿片药物使用和生活质量的影响。
Tilray 观察性患者研究在加拿大的 21 家医疗诊所进行。本分析纳入了至少有一次基线后就诊且随访时间为 1、3 和 6 个月的 1145 名患者。研究工具包括一份全面的大麻使用清单、世界卫生组织生活质量简表(WHOQOL-BREF)和一份详细的处方药问卷。
参与者中 57.6%为女性,中位年龄为 52 岁。基线时有 28%的参与者报告使用阿片类药物,6 个月时降至 11%。每日阿片类药物用量从基线时的 152 毫克吗啡毫克当量(MME)降至 6 个月时的 32.2 MME,平均阿片类药物剂量减少了 78%。参与者报告的其他四类主要处方药也出现了类似的减少,WHOQOL-BREF 的所有四个领域均报告了统计学显著的改善。
这项研究从个体层面提供了医用大麻替代阿片类药物和其他处方药的视角,以及 6 个月内生活质量的相关改善。慢性疼痛患者大麻使用率高,随后阿片类药物使用量减少,这表明大麻可能在阿片类药物过量危机中发挥减少伤害的作用,有可能改善患者的生活质量和整体公共健康。