Self-Medication Paths: A Descriptive Study Unveiling the Interplay Between Medical and Nonmedical Cannabis in Chronic Pain Management.

Objectives: Cannabis is used by one-third of people living with chronic pain to alleviate their symptoms despite warnings from several organizations regarding its efficacy and safety. We currently know little about self-medication practices (use of cannabis for therapeutic purposes without guidance), mainly since the legalization of recreational cannabis in countries such as Canada has expanded the scope of this phenomenon. This study aimed to describe legal cannabis self-medication for pain relief in people living with chronic pain and to explore perceptions of the effectiveness and safety of cannabis.
Methods: A cross-sectional descriptive study was performed among 73 individuals living with chronic pain and using cannabis (Quebec, Canada). Data collection using telephone interviews occurred in early 2023.
Results: Results indicated that 61.6% of participants reported using cannabis without the guidance of a health care professional (self-medication). Surprisingly, among those, 40.0% held a medical authorization. Overall, 20.6% of study participants were using both medical and legal nonmedical cannabis. Different pathways to self-medication were revealed. Proportion of women versus men participants self-medicating were 58.2% versus 70.6% ( P =0.284). In terms of perceptions, 90.4% of the sample perceived cannabis to be effective for pain management; 72.6% estimated that it posed no or minimal health risk.
Discussion: Cannabis research is often organized around medical versus nonmedical cannabis but in the real-world, those 2 vessels are connected. Interested parties, including researchers, health care professionals, and funding agencies, need to consider this. Patients using cannabis feel confident in the safety of cannabis, and many of them self-medicate, which calls for action.
Competing Interests: This project was a COPE Cohort spin-off initiative. The implementation of the cohort was supported by the Quebec Network on Drug Research and the exploitation of its data was cofunded by the Quebec Pain Research Network, 2 thematic networks of the Fonds de recherche du Québec–Santé (FRQS). In part of her masters’ degree training, C.A. (first author) received scholarships from the Canadian Consortium for the Investigations on Cannabinoids (CCIC), the Fondation de l’Université du Québec en Abitibi-Témiscamingue (FUQAT), the Fondation des Universités du Québec (FUQ), and a travel awards from the Quebec Pain Research Network (QPRN). The Chronic Pain Epidemiology Research Chair led by AL is funded by the FUQAT, in partnership with local businesses: the Pharmacie Jean-Coutu de Rouyn-Noranda and Glencore Fonderie Horne (copper smelter). The remaining authors declare no conflict of interest.
(Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)