Medical cannabis has a high discontinuation rate for treatment of musculoskeletal pain

1. Medical cannabis has a high discontinuation rate among patients with chronic musculoskeletal pain, particularly in the first few months, particularly in older patients

2. Pain location and baseline health status are not reliable indicators of whether a patient will continue medical cannabis use.

Evidence Rating Level: 3 (Average)

In this retrospective study, 78 patients with chronic musculoskeletal pain certified for medical cannabis (MC) at a single orthopedic institute between October 2022 and December 2024 were followed for up to one year to assess discontinuation rates and associated factors. Demographics, pain origin, and baseline Patient-Reported Outcomes Measurement Information System (PROMIS) Global Physical Health (GPH) and Global Mental Health (GMH) scores were collected. Discontinuation status was confirmed through follow-up visits and the state MC registry. At three months, 44.7% of patients had discontinued MC, primarily due to dissatisfaction, preference for alternative treatments, or surgical intervention. By one year, 57.9% had ceased use, with older age significantly associated with discontinuation (mean 71.5 vs. 64.5 years; p = 0.04). Pain origin, including low back pain, did not significantly differ between those continuing and discontinuing, and baseline GPH/GMH scores were similar in both groups. These findings suggest that over half of patients stop MC within a year, with older adults more likely to discontinue, and that baseline health status and pain location are not strong predictors of adherence. Further research is warranted to identify modifiable factors that could improve long-term MC use for chronic musculoskeletal pain.

Click to read the study in PLOSONE

Image: PD

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