A study being published in the upcoming issue of the journal Pain, and published online ahead of print by the National Library of Medicine, has found that medical marijuana may be more effective than prescription medications in treating chronic pain.
The study, conducted by researchers from the University of Pittsburgh and the National Institutes of Health’s National Cancer Institute, analyzed 440 patients certified for medical marijuana by pain specialists within a single healthcare system, using patient-reported outcomes stored in the University of Pittsburgh Patient Outcomes Repository for Treatment (PORT). At the three-month mark, 38.6% of medical marijuana patients reported clinically significant improvements in pain, function, or overall well-being, with these benefits sustained at six months.
Among the 157 medical marijuana patients who also used opioids, opioid consumption decreased by an average of 39.3% over six months. For comparison, the study examined 8,114 patients from the same clinics who were treated with prescription pain medications, including both opioid and non-opioid options. In this group, 34.9% reported meaningful improvements at three months.
Using stratified modeling and logistic regression, researchers found that medical marijuana patients were 2.6 times more likely to respond positively to treatment compared to those using prescription medications (P < 0.01). While the findings suggest medical marijuana may offer a more effective alternative for some patients, the study acknowledges that potential harms were not available in the PORT registry.
Below is the study’s full abstract:
Reviews of the effectiveness of medicinal cannabis for chronic pain vary in their conclusions. IASP has identified that a key missing evidence in this debate is data from observational cohort studies, analyzed with comparative effectiveness methods. In a medically supervised context to the use of marijuana for chronic pain, we identified 440 patients certified for medical marijuana by pain specialists in a single healthcare system. They were characterized by a battery of patient-reported outcomes stored electronically in the University of Pittsburgh Patient Outcomes Repository for Treatment (PORT). At 3 months, 38.6% were responders, based on clinically meaningful improvements in pain, function, or global impression of change, and maintained this response at 6 months. In the 157 patients who were coprescribed opioids, at 6 months there was a mean 39.3% decrease in morphine milligram equivalents (P < 0.05 for the difference vs baseline). In addition, 8114 patients treated in the same pain clinics with prescription pain medications instead (nonopioid or opioid) during the same timeframe were selected from PORT as a control group for comparison. They had a 34.9% rate of response at 3 months. Using the causal inference method of stratified modeling, logistic regression revealed an odds ratio of 2.6 in favor of medical marijuana vs medication treatment (P < 0.01). Potential harms data were not available in the PORT registry. Medical marijuana was comparatively more effective than prescription medications for the treatment of chronic pain at 3 months, although the populations compared were slightly different.
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