Abstract
BackgroundSince the legalization of medical marijuana (MMJ) in Ohio in 2018, many chronic pain (CP) patients have become interested in it as an alternative or adjunct to prescription opioids. This has not only created a need for pain management specialists to learn about this potential indication for MMJ but also for them to have more detailed knowledge of patient attitudes and willingness to comply with providers’ recommendations regarding its safe use with other pain medications. For this purpose, we surveyed CP patients in a region severely affected by the opioid crisis in order to provide better education, formulate treatment plans, and develop clinical policies.MethodsWe designed and administered the Medical Marijuana Interest Questionnaire (MMIQ) online to patients of the Western Reserve Hospital Center for Pain Medicine (CPM) with a diagnosis of CP who were not yet using MMJ. Questions addressed demographic and clinical characteristics, willingness to consider MMJ, and compliance with treatment plans and concerns. We then carried out a statistical analysis including Pearson chi-square, Spearman’s rho and Kendall’s tau tests to measure associations between variables to identify factors that may influence willingness to use MMJ.ResultsAfter sending 1047 email invitations to complete the MMIQ, 242 (23.1%) completed questionnaires were returned. The average age range of all respondents was 51-60 years, 171 (70.7%) were female and 147 (60.7%) were current opioid users. The 204 (84.3%) respondents who were willing to consider using MMJ were given access to the entire questionnaire. Of these, 138 (67.6%) reported wanting to use less opioids after starting MMJ and 191 (93.6%) were amenable to following their pain specialists’ recommendations about using MMJ concurrently with opioids. Their greatest concern on a 0-5 scale was affordability (2.98) and there was a statistically significant negative correlation between older age and preference for inhaled forms (p = 0.023).ConclusionThe MMIQ was successful in eliciting important data regarding patients’ attitudes about MMJ for opioid titration and potential compliance. Our study was limited by being administered online rather than in-person, which skewed the demographic makeup of the sample. The MMIQ can be used to study similar populations or adapted to patients already using MMJ. Similar surveys of MMJ-experienced patients could be combined with chart reviews to study the success of these products for pain control and opioid substitution.
Highlights
Since the legalization of medical marijuana (MMJ) in Ohio in 2018, many chronic pain (CP) patients have become interested in it as an alternative or adjunct to prescription opioids
It has been estimated that chronic pain (CP) is one of the leading reasons for patients to seek medical care with 20% of Americans suffering from this group of conditions
Not finding a validated survey we felt was applicable to our specific goals, we developed the Medical Marijuana Interest Questionnaire (MMIQ) based on selected surveys from our search, patient questions, the approved indications for MMJ in Ohio, and our prior experience in survey research (Lombardi et al, 2020; Rochford et al, (2021) 3:37
Summary
Since the legalization of medical marijuana (MMJ) in Ohio in 2018, many chronic pain (CP) patients have become interested in it as an alternative or adjunct to prescription opioids This has created a need for pain management specialists to learn about this potential indication for MMJ and for them to have more detailed knowledge of patient attitudes and willingness to comply with providers’ recommendations regarding its safe use with other pain medications. Pain specialists following guidelines for minimizing opioid use incorporate multimodal treatment models which include procedures, behavioral approaches, and coordinated care with psychologists, physical therapists, chiropractors, and occupational therapists (Chou et al, 2016) Even with these extensive approaches, the refractory nature of both opioid dependence and chronic pain is leading many to consider less conventional approaches such as medical marijuana (MMJ). Though there have been some surveys seeking to characterize other populations of MMJ and recreational marijuana users, little data have been collected to date on the attitudes of CP patients (Takakuwa & Sulak, 2020)
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