Characteristics of patients with non-cancer pain and long-term prescription opioid use who have used medical versus recreational marijuana
Abstract Objective Marijuana use is increasingly common among patients with chronic non-cancer pain (CNCP) and long-term opioid therapy (LTOT). We determined if lifetime recreational and medical marijuana use were associated with more frequent and higher dose prescription opioid use. Design Cross-se...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Journal of Cannabis Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42238-024-00218-y |
| _version_ | 1797273364368195584 |
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| author | Whitney M. Davidson Anika Mahavni Timothy Chrusciel Joanne Salas Lisa R. Miller-Matero Mark D. Sullivan Celeste Zabel Patrick J. Lustman Brian K. Ahmedani Jeffrey F. Scherrer |
| author_facet | Whitney M. Davidson Anika Mahavni Timothy Chrusciel Joanne Salas Lisa R. Miller-Matero Mark D. Sullivan Celeste Zabel Patrick J. Lustman Brian K. Ahmedani Jeffrey F. Scherrer |
| author_sort | Whitney M. Davidson |
| collection | DOAJ |
| description | Abstract Objective Marijuana use is increasingly common among patients with chronic non-cancer pain (CNCP) and long-term opioid therapy (LTOT). We determined if lifetime recreational and medical marijuana use were associated with more frequent and higher dose prescription opioid use. Design Cross-sectional Subjects Eligible patients (n=1,037), who had a new period of prescription opioid use lasting 30-90 days, were recruited from two midwestern health care systems to a study of long-term prescription opioid use and mental health outcomes. The present cross-sectional analyses uses baseline data from this on-going cohort study. Methods Primary exposures were participant reported lifetime recreational and medical marijuana use versus no lifetime marijuana use. Prescription opioid characteristics included daily versus non-daily opioid use and ≥50 morphine milligram equivalent (MME) dose per day vs. <50 MME. Multivariate, logistic regression models estimated the association between lifetime recreational and medical marijuana use vs. no use and odds of daily and higher dose prescription opioid use, before and after adjusting for confounding. Results The sample was an average of 54.9 (SD±11.3) years of age, 57.3% identified as female gender, 75.2% identified as White, and 22.5% identified as Black race. Among all participants, 44.4% were never marijuana users, 21.3% were recreational only, 7.7% medical only and 26.6% were both recreational and medical marijuana users. After controlling for all confounders, lifetime recreational marijuana use, as compared to no use, was significantly associated with increased odds of daily prescription opioid use (OR=1.61; 95%CI:1.02-2.54). There was no association between lifetime recreational or medical marijuana use and daily opioid dose. Conclusion Lifetime medical marijuana use is not linked to current opioid dose, but lifetime recreational use is associated with more than a 60% odds of being a daily prescription opioid user. Screening for lifetime recreational marijuana use may identify patients with chronic pain who are vulnerable to daily opioid use which increases risk for adverse opioid outcomes. Prospective data is needed to determine how marijuana use influences the course of LTOT and vice versa. |
| first_indexed | 2024-03-07T14:42:19Z |
| format | Article |
| id | doaj.art-03d167b50415429e8036664dd8e6b50f |
| institution | Directory Open Access Journal |
| issn | 2522-5782 |
| language | English |
| last_indexed | 2024-03-07T14:42:19Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cannabis Research |
| spelling | doaj.art-03d167b50415429e8036664dd8e6b50f2024-03-05T20:09:24ZengBMCJournal of Cannabis Research2522-57822024-02-016111010.1186/s42238-024-00218-yCharacteristics of patients with non-cancer pain and long-term prescription opioid use who have used medical versus recreational marijuanaWhitney M. Davidson0Anika Mahavni1Timothy Chrusciel2Joanne Salas3Lisa R. Miller-Matero4Mark D. Sullivan5Celeste Zabel6Patrick J. Lustman7Brian K. Ahmedani8Jeffrey F. Scherrer9Department of Family and Community Medicine, Saint Louis University School of MedicineDepartment of Family and Community Medicine, Saint Louis University School of MedicineDepartment of Family and Community Medicine, Saint Louis University School of MedicineDepartment of Family and Community Medicine, Saint Louis University School of MedicineCenter for Health Policy and Health Services Research and Behavioral Health Services, Henry Ford HealthDepartment of Psychiatry and Behavioral Science, University of Washington School of MedicineCenter for Health Policy and Health Services Research and Behavioral Health Services, Henry Ford HealthDepartment of Psychiatry, Washington University School of MedicineCenter for Health Policy and Health Services Research and Behavioral Health Services, Henry Ford HealthDepartment of Family and Community Medicine, Saint Louis University School of MedicineAbstract Objective Marijuana use is increasingly common among patients with chronic non-cancer pain (CNCP) and long-term opioid therapy (LTOT). We determined if lifetime recreational and medical marijuana use were associated with more frequent and higher dose prescription opioid use. Design Cross-sectional Subjects Eligible patients (n=1,037), who had a new period of prescription opioid use lasting 30-90 days, were recruited from two midwestern health care systems to a study of long-term prescription opioid use and mental health outcomes. The present cross-sectional analyses uses baseline data from this on-going cohort study. Methods Primary exposures were participant reported lifetime recreational and medical marijuana use versus no lifetime marijuana use. Prescription opioid characteristics included daily versus non-daily opioid use and ≥50 morphine milligram equivalent (MME) dose per day vs. <50 MME. Multivariate, logistic regression models estimated the association between lifetime recreational and medical marijuana use vs. no use and odds of daily and higher dose prescription opioid use, before and after adjusting for confounding. Results The sample was an average of 54.9 (SD±11.3) years of age, 57.3% identified as female gender, 75.2% identified as White, and 22.5% identified as Black race. Among all participants, 44.4% were never marijuana users, 21.3% were recreational only, 7.7% medical only and 26.6% were both recreational and medical marijuana users. After controlling for all confounders, lifetime recreational marijuana use, as compared to no use, was significantly associated with increased odds of daily prescription opioid use (OR=1.61; 95%CI:1.02-2.54). There was no association between lifetime recreational or medical marijuana use and daily opioid dose. Conclusion Lifetime medical marijuana use is not linked to current opioid dose, but lifetime recreational use is associated with more than a 60% odds of being a daily prescription opioid user. Screening for lifetime recreational marijuana use may identify patients with chronic pain who are vulnerable to daily opioid use which increases risk for adverse opioid outcomes. Prospective data is needed to determine how marijuana use influences the course of LTOT and vice versa.https://doi.org/10.1186/s42238-024-00218-yPainOpioidPsychiatryCohortEpidemiology |
| spellingShingle | Whitney M. Davidson Anika Mahavni Timothy Chrusciel Joanne Salas Lisa R. Miller-Matero Mark D. Sullivan Celeste Zabel Patrick J. Lustman Brian K. Ahmedani Jeffrey F. Scherrer Characteristics of patients with non-cancer pain and long-term prescription opioid use who have used medical versus recreational marijuana Journal of Cannabis Research Pain Opioid Psychiatry Cohort Epidemiology |
| title | Characteristics of patients with non-cancer pain and long-term prescription opioid use who have used medical versus recreational marijuana |
| title_full | Characteristics of patients with non-cancer pain and long-term prescription opioid use who have used medical versus recreational marijuana |
| title_fullStr | Characteristics of patients with non-cancer pain and long-term prescription opioid use who have used medical versus recreational marijuana |
| title_full_unstemmed | Characteristics of patients with non-cancer pain and long-term prescription opioid use who have used medical versus recreational marijuana |
| title_short | Characteristics of patients with non-cancer pain and long-term prescription opioid use who have used medical versus recreational marijuana |
| title_sort | characteristics of patients with non cancer pain and long term prescription opioid use who have used medical versus recreational marijuana |
| topic | Pain Opioid Psychiatry Cohort Epidemiology |
| url | https://doi.org/10.1186/s42238-024-00218-y |
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