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Individuals with higher scores on the Fibromyalgia Survey Criteria, using medical cannabis for chronic pain, show increased medication use, substitution of cannabis for other medications, more side effects, and diminished therapeutic effects, highlighting challenges in managing chronic nociplastic pain with cannabis.
The following is a summary of “Relationship Between Nociplastic Pain Involvement and Medication Use, Symptom Relief, and Adverse Effects Among People Using Medical Cannabis for Chronic Pain,” published in the January 2024 issue of Pain by Ryan et al.
The usage of cannabis for chronic pain management is on the rise, yet its impact on chronic nociplastic pain (NPP), thought to arise from disruptions in the nervous system’s pain processing, remains inadequately understood. This cross-sectional study (n=1213) aimed to gauge the degree of NPP among individuals using medical cannabis for chronic pain by utilizing the 2011 Fibromyalgia (FM) Survey Criteria as a surrogate measure.
Employing quartile-split analysis, associations between the extent of NPP and medication use, characteristics of cannabis use, and symptom relief were explored. Continuous variables underwent assessment via one-way analysis of variance, while categorical variables were examined using the Pearson χ2 test. Odds ratios were calculated using binomial logistic regression.
The study cohort, largely comprised of females (59%), displayed a mean age of 49.4±13.6 years. Elevated FM scores correlated with less self-reported enhancement in pain and health following the initiation of medical cannabis use, as well as an increased incidence of cannabis-related side effects. Intriguingly, higher FM scores corresponded not only to greater concomitant medication use (including opioids and benzodiazepines) but also to a higher tendency to substitute cannabis for various classes of medications, such as opioids and benzodiazepines.
This investigation sheds light on how individuals in the higher NPP quartiles exhibit heightened analgesic intake, an increased likelihood of replacing medications with cannabis, greater side effect occurrence, and diminished therapeutic effects from cannabis. These seemingly conflicting outcomes might signify a greater symptom burden, initial polypharmacy, or the challenge of using cannabis to manage NPP. Further exploration is required to elucidate the effects of cannabinoids in addressing NPP.
