Sznitman Sharon, Mabouk Carolyn, Said Zahi, Vulfsons Simon
Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
BMJ Support Palliat Care. 2023 Dec 7;13(e2):e464-e468. doi: 10.1136/bmjspcare-2020-002661.
Various jurisdictions have legalised medical cannabis (MC) for use in chronic pain treatment. The objective of this study was to determine if the use of MC is related to a reduction in the use of prescription opioids and other prescription medications and healthcare services.
A retrospective cohort study was conducted using the medical files of 68 Israeli patients with chronic pain using MC. Number of prescription medications filled and healthcare services used were recorded separately for the baseline period (6 months prior to the start of MC treatment) and 6 months' follow-up. Paired t-tests were used to compare each individual to himself/herself from baseline to follow-up.
Patients filled less opioid prescription medication at follow-up compared with baseline, and the reduction was of small effect size. There were no significant changes in the use of other medications or use of healthcare services from pre-MC treatment to follow-up.
MC may be related to a significant yet small reduction in opioid prescription medication. Further prospective studies with representative samples are warranted to confirm the potential small opioid-sparing effects of MC treatment, its clinical importance, if any, and potential lack of association with other healthcare-related services and medication use. Due to methodological limitations of the data used in this study, results may be regarded as preliminary and causal inferences cannot be made.
不同司法管辖区已将医用大麻（MC）用于慢性疼痛治疗合法化。本研究的目的是确定MC的使用是否与处方阿片类药物及其他处方药和医疗服务的使用减少有关。
采用回顾性队列研究，使用68名使用MC治疗慢性疼痛的以色列患者的病历。分别记录基线期（MC治疗开始前6个月）和6个月随访期内所开具的处方药数量及使用的医疗服务。采用配对t检验比较每个个体从基线期到随访期自身的情况。
与基线期相比，随访期患者开具的阿片类处方药减少，且减少幅度较小。从MC治疗前到随访期，其他药物的使用或医疗服务的使用没有显著变化。
MC可能与阿片类处方药显著但较小幅度的减少有关。有必要开展进一步的前瞻性研究，纳入代表性样本，以确认MC治疗潜在的小幅度阿片类药物节省效应、其临床重要性（如有）以及与其他医疗相关服务和药物使用可能缺乏关联。由于本研究使用的数据存在方法学局限性，结果可能被视为初步结果，无法进行因果推断。
