When you consider who funded this study – Funding for the study was provided by the National Institute on Drug Abuse, the New York State Psychiatric Institute, and the VA Centers of Excellence in Substance Addiction Treatment and Education

Could one expect any sort of different conclusion that the one that those conducting this study came to?  Does this suggest that chronic pain should not be treated and/or any treatment of chronic pain is considered a “use disorder”?

Cannabis Laws Linked to cannabis use disorder in Adults With Chronic Pain

https://www.medscape.com/viewarticle/997414

TOPLINE:

Enactment of medical and recreational cannabis laws in the US has been associated with an increase in the prevalence of cannabis use disorder (CUD), with particularly steep increases noted among older adults with chronic pain, a study of US veterans shows.

METHODOLOGY:

• To study a reported increase in the prevalence of CUD among adults with chronic pain, researchers assessed the effect of medical cannabis laws (MCL) and recreational cannabis laws (RCL) on the increase in the US Veterans Health Administration (VHA).
• They analyzed 15 repeated cross-sectional VHA electronic health record datasets from 2005 to 2019; 3.2 to 4.6 million patients were included per year.
• Patients were stratified by chronic pain status using validated criteria.

TAKEAWAY:

• Overall, the associations of MCL and RCL with CUD prevalence were greater among patients with chronic pain compared to those without the condition.
• Enacting MCL led to a 0.135% absolute increase in CUD prevalence among patients with chronic pain, 8.4% of which was directly attributable to MCL, vs a 0.037% absolute increase in CUD among those without chronic pain, 5.7% of which was attributable to MCL.
• Enacting RCL led to a 0.188% absolute increase in CUD prevalence among patients with chronic pain, with 11.5% of the total increase due to RCL, vs a 0.042% absolute increase in patients without chronic pain, 6.0% of which was attributable to RCL.
• Introducing RCL was associated with the greatest increases in CUD prevalence among patients aged 65–75 years with chronic pain.

IN PRACTICE:

“When developing cannabis legislation, unintended consequences should be considered, including increased risk of cannabis use disorder in large vulnerable subgroups of the population such as patients with chronic pain,” the authors write. “The national increases in cannabis use disorder prevalence, including the disproportionate increase among those with chronic pain, underscore a growing need in the VHA and elsewhere to screen for cannabis use and offer evidence-based treatments for cannabis use disorder,” they add.

SOURCE:

The study, with first author Deborah Hasin PhD, Columbia University Irving Medical Center, New York, was published online October 11 in The Lancet Psychiatry.

LIMITATIONS:

Patients in the VHA differ from the general population in that most are White men, and many are in the older age group (65–75 years). No subject pain measure or cannabis use measure were available.

DISCLOSURES:

Funding for the study was provided by the National Institute on Drug Abuse, the New York State Psychiatric Institute, and the VA Centers of Excellence in Substance Addiction Treatment and Education. Hasin has disclosed no relevant financial relationships. A complete list of author disclosures is available with the original article.

Filed under: General Problems