Jylkkä Jussi, Hupli Aleksi, Nikolaeva Aleksandra, Alanen Sandra, Back Anna Erika, Lindqvist Sara, Krabbe Andreas, Lavie-Ajayi Maya, Kantonen Oskari
Department of Psychology, Åbo Akademi University, Turku, Finland.
Emerging Technologies Lab, Faculty of Social Sciences, Tampere University, Tampere, Finland.
J Cannabis Res. 2023 Nov 9;5(1):38. doi: 10.1186/s42238-023-00207-7.
Medical cannabis (MC) is increasingly used for chronic pain, but it is unclear how it aids in pain management. Previous literature suggests that MC could holistically alter the pain experience instead of only targeting pain intensity. However, this hypothesis has not been previously systematically tested.
A retrospective internet survey was used in a sample of Finnish chronic pain patients (40 MC users and 161 opioid users). The patients evaluated statements describing positive and negative phenomenological effects of the medicine. The two groups were propensity score matched to control for possible confounding factors.
Exploratory factor analysis revealed three experience factors: Negative Side Effects, Positive Holistic Effects, and Positive Emotional Effects. The MC group (matched n = 39) received higher scores than the opioid group (matched n = 39) in Positive Emotional Effects with large effect size (Rank-Biserial Correlation RBC = .71, p < .001), and in Holistic Positive Effects with medium effect size (RBC = .47, p < .001), with no difference in Negative Side Effects (p = .13). MC and opioids were perceived as equally efficacious in reducing pain intensity. Ratings of individual statements were exploratively examined in a post hoc analysis.
MC and opioids were perceived to be equally efficacious in reducing pain intensity, but MC additionally positively affected broader pain-related factors such as emotion, functionality, and overall sense of wellbeing. This supports the hypothesis that MC alleviates pain through holistically altering the pain experience.
医用大麻（MC）越来越多地用于治疗慢性疼痛，但尚不清楚它如何有助于疼痛管理。以往文献表明，MC可能从整体上改变疼痛体验，而不仅仅是针对疼痛强度。然而，这一假设此前尚未得到系统验证。
对芬兰慢性疼痛患者样本（40名MC使用者和161名阿片类药物使用者）进行回顾性网络调查。患者对描述该药物正负现象学效应的陈述进行评估。两组进行倾向得分匹配，以控制可能的混杂因素。
探索性因素分析揭示了三个体验因素：负面副作用、正面整体效应和正面情绪效应。MC组（匹配后n = 39）在正面情绪效应方面得分高于阿片类药物组（匹配后n = 39），效应量较大（等级二列相关系数RBC = 0.71，p < 0.001），在整体正面效应方面得分也高于阿片类药物组，效应量中等（RBC = 0.47，p < 0.001），负面副作用方面无差异（p = 0.13）。MC和阿片类药物在减轻疼痛强度方面被认为同样有效。在事后分析中对各个陈述的评分进行了探索性检查。
MC和阿片类药物在减轻疼痛强度方面被认为同样有效，但MC还对更广泛的疼痛相关因素产生积极影响，如情绪、功能和整体幸福感。这支持了MC通过从整体上改变疼痛体验来减轻疼痛的假设。
