Dubois Cerina, Bobitt Julie, Ding Lei, Eurich Dean T, Knapp Ashley A, Jordan Neil
Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
School of Public Health, University of Alberta, Edmonton, AB, Canada.
Subst Use Misuse. 2024;59(12):1785-1796. doi: 10.1080/10826084.2024.2383585. Epub 2024 Jul 28.
The state of Illinois' Opioid Alternative Pilot Program (OAPP) is the first and only official harm-reduction program in the US to address the opioid crisis via facilitation of safe and legal access to medical cannabis. This study evaluates the association of medical cannabis use with pain level and frequency of opioid use in the first cohort of OAPP participants in 2019.
A survey was sent OAPP enrollees between February and July 2019. Cannabis users ( = 626) were compared to non-users ( = 234) to determine whether there was an association between cannabis use and self-reported (a) pain level and (b) frequency of opioid use. Backward stepwise regression models were used.
A total of 860 participants was included in the analysis. Overall, 75% of the study sample reported pain as their primary medical symptom, and 67% of cannabis users reported having a disability. The mean difference in pain level between cannabis users and non-users was 4.5 units (on a 100-point scale) higher among cannabis users than non-users ( = 0.03); and cannabis use was statistically associated with pain level. High-frequency opioid users had lower odds of reporting cannabis use within the past year than low/no opioid users.
Although there was a statistical association between cannabis use and pain, the difference of 4.5 points in pain level between users and non-users was too small to reflect a clinically meaningful relative difference. This study may provide useful information to providers and clinicians about how the OAPP and similar programs may reduce opioid use and improve health outcomes.
伊利诺伊州的阿片类药物替代试点项目(OAPP)是美国首个也是唯一一个通过促进安全合法获取医用大麻来应对阿片类药物危机的官方减少伤害项目。本研究评估了2019年OAPP首批参与者中使用医用大麻与疼痛程度及阿片类药物使用频率之间的关联。
在2019年2月至7月期间向OAPP登记者发送了一份调查问卷。将大麻使用者(n = 626)与非使用者(n = 234)进行比较,以确定大麻使用与自我报告的(a)疼痛程度和(b)阿片类药物使用频率之间是否存在关联。使用了向后逐步回归模型。
共有860名参与者纳入分析。总体而言,75%的研究样本报告疼痛是其主要医疗症状,67%的大麻使用者报告有残疾。大麻使用者与非使用者之间的疼痛程度平均差异为4.5个单位(在100分制上),大麻使用者比非使用者高(P = 0.03);且大麻使用与疼痛程度在统计学上相关。高频阿片类药物使用者在过去一年中报告使用大麻的几率低于低/无阿片类药物使用者。
尽管大麻使用与疼痛之间存在统计学关联,但使用者与非使用者之间4.5分的疼痛程度差异太小,无法反映出具有临床意义的相对差异。本研究可能会为提供者和临床医生提供有用信息,说明OAPP及类似项目如何减少阿片类药物使用并改善健康结果。