W. Benjamin Nowell
ATLANTA — More than one-third of patients with rheumatic diseases reported using marijuana to relieve pain with minimal guidance from their physicians, according to findings presented at ACR/ARP 2019.
“Research about the safety and efficacy of marijuana for medical use (MMU) and cannabidiol (CBD) is seriously lacking,” W. Benjamin Nowell, PhD, director of Patient-Centered Research at CreakyJoints, told Healio Rheumatology. “Physicians simply are not armed with any data they can share with patients to counsel them about MMU, including whether it can be safely used in combination with prescription medications. In the absence of high-quality data, many patients end up making their own decisions about MMU without medical guidance.”
In an attempt to rectify this situation, Nowell and colleagues analyzed findings from a 77-item cross-sectional survey about marijuana use that was completed by 1,059 respondents with physician-diagnosed musculoskeletal or rheumatic diseases. The study population was culled from the ArthritisPower research registry, while the survey included questions about attitudes and perceptions surrounding MMU and CBD products.
Results showed that 37% of the cohort reported MMU, with most patients (93%) using it for a specific condition. According to the survey, 51% of patients used marijuana for rheumatoid arthritis, 46% for osteoarthritis, and 35% for fibromyalgia.
Among the 63% who had never used MMU, illegality was the most commonly reported reason, at 40%, followed by 24% who cited potential impairment, and around 20% each for patients who did not know where or how to obtain the drug.
A key point showed that 77% of patients in the study live in a state where medical marijuana use is legal, but only 40% had cards to purchase it legally. More than two-thirds (68%) of patients who live in a state where MMU is legal had informed their doctor of their MMU use. However, just 54% of those who lived in states where MMU is illegal consulted their doctor (P = .02).
“Regardless of legal status in the state where they reside, this study showed us that people with arthritis are using marijuana for medical or health reasons,” Kelly Gavigan, manager of research and data science at CreakyJoints, noted in an interview with Healio Rheumatology. “But what is most concerning is that one-third of current or past MMU users did not inform their health care providers about using MMU.”
Among those who did have a conversation with their doctor, less than half perceived that their doctors took it into consideration as part of their overall treatment regimen, according to Gavigan. “This may be attributed to the variable legal status of MMU, since people were less likely to talk to their doctor about MMU use in states where it is not legal,” she said.
Nowell offered a solution to some the inconsistencies in MMU highlighted by this study. “Regulators should reschedule marijuana in a manner that adequately protects the public by facilitating clinical trials on the use of medical marijuana among people living with a rheumatic or musculoskeletal condition,” he said. – by Rob Volansky
Gavigan K. Abstract 2248. Legal Matters: Attitudes regarding marijuana for medical use among patients with rheumatic and musculoskeletal disease. Presented at: American College of Rheumatology/Association of Rheumatology Professionals Annual Meeting; Nov. 9-13, 2019; Atlanta.
Disclosure: Gavigan and Nowell report no relevant financial disclosures.