Medical Marijuana Can Reduce Use Of Opioid Painkillers For Treating Back Pain & Osteoarthritis

Providing patients with chronic back pain and osteoarthritis (OA) access to medical cannabis can reduce or even eliminate the use of opioids for pain management, according to two studies presented at the 2022 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

The studies, led by Principal Investigator Asif M. Ilyas, MD, MBA, FAAOS, also demonstrated that pain and quality of life scores improved after patients were certified for medical cannabis.

"In the setting of the current opioid crisis, we must identify alternatives that may mitigate the reliance on opioids for controlling pain," said Dr. Ilyas, program director of the hand & upper extremity surgery fellowship at Rothman Orthopaedic Institute and professor of orthopedic surgery at Thomas Jefferson University Hospital in Philadelphia. "At this point, we are not advocating for the routine use of medical cannabis or saying it is a better option, but our studies show potential."

Medical Cannabis Use In Chronic Back Pain & OA Patients

The two studies reviewed data of filled opioid prescriptions filled for patients with chronic back pain and OA who were certified for medical cannabis access between February 2018 and July 2019.

The average morphine milligram equivalents (MME) per day of opioid prescriptions filled six months before access to medical cannabis was compared to the six months after patients gained access.

Chronic Back Pain Data

• A significant decrease in the overall average MME per day after a medical cannabis prescription, from 15.1 to 11.0 (n=186).
• 38.7% of patients dropped to zero MME per day.
• Patients who started at less than 15 MME per day and greater than 15 MME per day had significant decreases, from 3.5 to 2.1 (n=134) and 44.9 to 33.9 (n=52). The percentages of patients who dropped to zero MME per day in these groups were 48.5% and 13.5%, respectively.
• Compared to baseline (three, six, and nine months), patients reported improved intensity, frequency, and daily function after medical cannabis use.
• Patients who used two or more routes of administration for medical cannabis showed a significant decrease in MME per day, from 13.2 to 9.5 (n=76).

OA Patients Data

• There was significant decrease in the average MME per day of prescriptions filled by patients, from 18.2 to 9.8 (n=40). The average drop in MME per day was 46.3%.
• The percentage of patients who dropped to zero MME per day was 37.5%.
• Patients' pain scores decreased significantly, from 6.6 (n=36) to 5.0 (n=26) and 5.4 (n=16), at three and six months, respectively.
• The Global Physical Health quality of life score increased significantly, from 37.5 to 41.4, at three months.
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