Mark A Ware1,2,3,4, Marc O Martel5,6,7, Roman Jovey8, Mary E Lynch9, Joel Singer10. 1. Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, Canada. mark.ware@mcgill.ca. 2. Department of Family Medicine, McGill University, Montreal, Canada. mark.ware@mcgill.ca. 3. Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal, Canada. mark.ware@mcgill.ca. 4. Montreal General Hospital, A5.140, 1650 Cedar Avenue, Montreal, Quebec, H3G 1A4, Canada. mark.ware@mcgill.ca. 5. Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, Canada. 6. Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal, Canada. 7. Faculty of Dentistry, McGill University, Montreal, Canada. 8. CPM Centres for Pain Management, Mississauga, Ontario, Canada. 9. Department of Anesthesia, Pain Medicine, and Perioperative Care, Dalhousie University, Halifax, Canada. 10. School of Population and Public Health, University of British Columbia, Vancouver, Canada.
Abstract
BACKGROUND: Despite evidence supporting the benefits of cannabinoids for symptom control across a wide range of medical conditions, concerns have been raised regarding the potential misuse and/or problematic use of cannabinoids (CBs). OBJECTIVE: The first objective of this study was to examine the incidence of problematic prescription cannabinoid use (PPCBU) over a 12-month period among patients initiating cannabinoid therapy. The second objective was to examine the factors associated with PPCBU. A total of 265 patients who were prescribed oral cannabinoid therapy as part of usual medical practice were enrolled into this prospective observational study. Patients first completed a series of baseline questionnaires assessing demographic, clinical, and substance use variables. Three measures designed to assess PPCBU were then administered at 3, 6, and 12 months after initiation of cannabinoid therapy. RESULTS: At each of the follow-up assessment time points, a significantly greater number of patients scored below (vs above) cutoff scores on the three main PPCBU outcomes (all p's < .001). At any follow-up time point, a maximum of roughly 25% of patients demonstrated PPCBU. Heightened odds of PPCBU were observed among patients with a history of psychiatric problems, tobacco smokers, and recreational cannabis users (all p's < .05). Results indicated that past-year substance abuse, assessed using the DAST-20, was the strongest predictor of PPCBU (p < .005). CONCLUSION: Findings from the present study could have implications for clinicians considering the use of cannabinoids for the management of patients with medical conditions. Although results indicated that the majority of patients included in this study did not reach cutoff scores on the three main PPCBU outcomes, our findings suggest that PPCBU should be routinely assessed and monitored over the course of cannabinoid therapy, particularly among patients with a history of psychiatric or substance use problems.
BACKGROUND: Despite evidence supporting the benefits of cannabinoids for symptom control across a wide range of medical conditions, concerns have been raised regarding the potential misuse and/or problematic use of cannabinoids (CBs). OBJECTIVE: The first objective of this study was to examine the incidence of problematic prescription cannabinoid use (PPCBU) over a 12-month period among patients initiating cannabinoid therapy. The second objective was to examine the factors associated with PPCBU. A total of 265 patients who were prescribed oral cannabinoid therapy as part of usual medical practice were enrolled into this prospective observational study. Patients first completed a series of baseline questionnaires assessing demographic, clinical, and substance use variables. Three measures designed to assess PPCBU were then administered at 3, 6, and 12 months after initiation of cannabinoid therapy. RESULTS: At each of the follow-up assessment time points, a significantly greater number of patients scored below (vs above) cutoff scores on the three main PPCBU outcomes (all p's < .001). At any follow-up time point, a maximum of roughly 25% of patients demonstrated PPCBU. Heightened odds of PPCBU were observed among patients with a history of psychiatric problems, tobacco smokers, and recreational cannabis users (all p's < .05). Results indicated that past-year substance abuse, assessed using the DAST-20, was the strongest predictor of PPCBU (p < .005). CONCLUSION: Findings from the present study could have implications for clinicians considering the use of cannabinoids for the management of patients with medical conditions. Although results indicated that the majority of patients included in this study did not reach cutoff scores on the three main PPCBU outcomes, our findings suggest that PPCBU should be routinely assessed and monitored over the course of cannabinoid therapy, particularly among patients with a history of psychiatric or substance use problems.
Authors: Beatrix M Schieffer; Quyhn Pham; Jennifer Labus; Ariel Baria; Walter Van Vort; Philip Davis; Frederick Davis; Bruce D Naliboff Journal: J Pain Date: 2005-09 Impact factor: 5.820
Authors: Edward Michna; Edgar L Ross; Wilfred L Hynes; Srdjan S Nedeljkovic; Sharonah Soumekh; David Janfaza; Diane Palombi; Robert N Jamison Journal: J Pain Symptom Manage Date: 2004-09 Impact factor: 3.612
Authors: Roger Chou; Gilbert J Fanciullo; Perry G Fine; Jeremy A Adler; Jane C Ballantyne; Pamela Davies; Marilee I Donovan; David A Fishbain; Kathy M Foley; Jeffrey Fudin; Aaron M Gilson; Alexander Kelter; Alexander Mauskop; Patrick G O'Connor; Steven D Passik; Gavril W Pasternak; Russell K Portenoy; Ben A Rich; Richard G Roberts; Knox H Todd; Christine Miaskowski Journal: J Pain Date: 2009-02 Impact factor: 5.820
Authors: Stephen F Butler; Simon H Budman; Kathrine C Fernandez; Brian Houle; Christine Benoit; Nathaniel Katz; Robert N Jamison Journal: Pain Date: 2007-05-09 Impact factor: 6.961
Authors: Marc O Martel; Patrick H Finan; R Kathryn McHugh; Mohammed Issa; Robert R Edwards; Robert N Jamison; Ajay D Wasan Journal: Drug Alcohol Depend Date: 2016-03-18 Impact factor: 4.492
Authors: Margaret Haney; Erik W Gunderson; Judith Rabkin; Carl L Hart; Suzanne K Vosburg; Sandra D Comer; Richard W Foltin Journal: J Acquir Immune Defic Syndr Date: 2007-08-15 Impact factor: 3.731
Authors: Arsène Zongo; Cerina Lee; Jihane El-Mourad; Jason R B Dyck; Elaine Hyshka; John G Hanlon; Dean T Eurich Journal: Can J Psychiatry Date: 2021-11-20 Impact factor: 5.321