Lots of people are using medical marijuana to treat their arthritis and other muscle aches and pains, often without consulting their doctor, a new study reports.As many as 1 in 5 patients who consult an orthopedic surgeon for chronic musculoskeletal pain are using a cannabis product to treat them, Canadian researchers found. "We found 20 percent had reported past or current use of cannabis with the specific intention to manage pain," said study author Dr. Timothy Leroux, an orthopedic surgeon at the University of Toronto. "Not just recreational users, but patients who said, 'I'm using cannabis because I want to improve pain with this condition.'" There's also a lot of interest in medical marijuana among arthritis sufferers who haven't yet tried it, Leroux and his team found. Two-thirds of nonusers are interested in trying a cannabis product to treat their muscle and joint pain, the researchers reported. "A lot of patients feel they have a lack of knowledge and are staying on the sidelines while we gather more science," Leroux said. For this study, he and his colleagues surveyed more than 600 patients who visited a Toronto orthopedic clinic. People using cannabis generally had high praise for the products. Nine out of 10 said it was effective in managing their pain, and 4 in 10 said it decreased their reliance on other pain medications. Nearly 6 in 10 said cannabis products were more effective than other drugs. "This is encouraging in the face of the ongoing opioid epidemic, as we look to find safe alternatives to opioids for pain control," said Dr. Yili Huang, director of the Pain Management Center at Northwell Phelps Hospital in Sleepy Hollow, N.Y. "Cannabis may help decrease, or in some cases completely replace, the amount of opioid medication necessary to control pain," said Huang, who wasn't part of the study. "This may be because cannabis works on many different pain pathways in our body and can even interact with the separate chemical pathways opioids work on." Pain patients using medical cannabis in the study were more likely to have multiple conditions, report a greater burden of pain and a greater number of painful areas on their bodies. They were also more likely to have a history of pain clinic visits, a longer time with a painful condition and a higher rate of pain medication use, researchers found. They also were more likely to use or have used pot for recreation. While people are seeking pain relief, however, they aren't necessarily looking to get high. The most common cannabinoid used was cannabidiol, or CBD, a marijuana compound that does not cause intoxication, researchers said. Only about a quarter of people reported using a product with THC, which gets you high. Distressingly, the remainder of people "had no idea what they were taking," Leroux said. The most common way people took a cannabis product was by ingesting an oil, with 60 percent saying they used a marijuana-derived oil, researchers said. "We found a general trend toward more edible products and products that were non-hallucinogenic," Leroux said. The study did reveal some concerning trends, however. Only a quarter of marijuana users said they'd talked with a physician first. "Most people were not taking cannabis on the recommendation of a physician or seeking advice from a physician in order to take cannabis," Leroux said. "They were using it in the way they would use a drug, but without physician oversight." That's a problem because cannabis products can have side effects and might interact with other medications, he said. While patients might benefit from a doctor's advice, Leroux said unfortunately, many doctors shy away from conversations about medical marijuana. "For the time being, I would suggest that you go about this with caution, and if you choose to use the product that you talk to someone more familiar with those products," he said.
Leroux presented these findings at a virtual exhibition by the American Academy of Orthopaedic Surgeons. Such research is typically considered preliminary until published in a peer-reviewed journal.