Takakuwa Kevin M, Sulak Dustin
Emergency Medicine, Society of Cannabis Clinicians, Sebastopol, USA.
General Practice, Integr8 Health, Falmouth, USA.
Cureus. 2020 Dec 2;12(12):e11848. doi: 10.7759/cureus.11848.
The opioid epidemic continues to claim thousands of lives every year without an effective strategy useful in mitigating mortality. The use of medical cannabis has been proposed as a potential strategy to decrease opioid usage. The objective of this study was to determine how the use of medical cannabis affects prescribed opioid usage in chronic pain patients.
We conducted an online convenience sample survey of patients from three medical cannabis practice sites who had reported using opioids. A total of 1181 patients responded, 656 were excluded for not using medical cannabis in combination with opioid use or not meeting the definition of chronic pain, leaving 525 patients who had used prescription opioid medications continuously for at least three months to treat chronic pain and were using medical cannabis in combination with their prescribed opioid use.
Overall, 40.4% (n=204) reported that they stopped all opioids, 45.2% (n=228) reported some decrease in their opioid usage, 13.3% (n=67) reported no change in opioid usage, and 1.1% (n=6) reported an increase in opioid usage. The majority (65.3%, n=299) reported that they sustained the opioid change for over a year. Almost half (48.2%, n=241) reported a 40-100% decrease in pain while 8.6% (n=43) had no change in pain and 2.6% (n=13) had worsening pain. The majority reported improved ability to function (80.0%, n=420) and improved quality of life (87.0%, n=457) with medical cannabis. The majority (62.8%, n=323) did not want to take opioids in the future. While the change in pain level was not affected by age and gender, the younger age group had improved ability to function compared with the middle and older age groups.
Patients in this study reported that cannabis was a useful adjunct and substitute for prescription opioids in treating their chronic pain and had the added benefit of improving the ability to function and quality of life.
阿片类药物流行每年仍导致数千人死亡，却没有有效的策略来降低死亡率。医用大麻的使用已被提议作为减少阿片类药物使用的一种潜在策略。本研究的目的是确定医用大麻的使用如何影响慢性疼痛患者的阿片类药物处方用量。
我们对来自三个医用大麻诊所的曾报告使用过阿片类药物的患者进行了一项在线便利样本调查。共有1181名患者做出回应，其中656名因未将医用大麻与阿片类药物联合使用或不符合慢性疼痛的定义而被排除，剩下525名患者连续使用处方阿片类药物至少三个月来治疗慢性疼痛，并且正在将医用大麻与他们所开的阿片类药物联合使用。
总体而言，40.4%（n = 204）的患者报告他们停用了所有阿片类药物，45.2%（n = 228）的患者报告阿片类药物用量有所减少，13.3%（n = 67）的患者报告阿片类药物用量没有变化，1.1%（n = 6）的患者报告阿片类药物用量增加。大多数（65.3%，n = 299）患者报告他们保持阿片类药物用量变化的状态超过一年。近一半（48.2%，n = 241）的患者报告疼痛减轻了40% - 100%，而8.6%（n = 43）的患者疼痛没有变化，2.6%（n = 13）的患者疼痛加重。大多数患者报告使用医用大麻后功能能力得到改善（80.0%，n = 420），生活质量得到提高（87.0%，n = 457）。大多数（62.8%，n = 323）患者未来不想服用阿片类药物。虽然疼痛程度的变化不受年龄和性别的影响，但与中年和老年组相比，年轻组的功能能力有所改善。
本研究中的患者报告称，大麻在治疗慢性疼痛方面是处方阿片类药物的有用辅助药物和替代品，并且还有助于改善功能能力和生活质量。
