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The Risk of Pain Leading to Cannabis Use Disorder?

A Call to Psychiatrists & Healthcare Providers to Monitor

From the American Journal of Psychiatry.


Objective: Given changes in U.S. marijuana laws, attitudes, and use patterns, individuals with pain may be an emerging group at risk for nonmedical cannabis use and cannabis use disorder. The authors examined differences in the prevalence of nonmedical cannabis use and cannabis use disorder among U.S. adults with and without pain, as well as whether these differences widened over time.

Conclusions: The results suggest that adults with pain are a group increasingly vulnerable to adverse cannabis use outcomes, warranting clinical and public health attention to this risk. Psychiatrists and other health care providers treating patients with pain should monitor such patients for signs and symptoms of cannabis use disorder.

While many individuals can use cannabis without harm, evidence indicates that regular or heavy users are at increased risk for health consequences, including vehicle crashes, respiratory symptoms, emergency department visits, psychiatric symptoms, withdrawal, and cannabis use disorder (1). Despite this evidence, however, U.S. adults have become increasingly likely to perceive cannabis use as harmless (2), and nonmedical use of cannabis, including daily or near-daily use, has increased among U.S. adults since the early 2000s (2-4). The prevalence of adult cannabis use disorder has also increased, including among hospital inpatients (5), Veterans Health Administration patients (6), and in one general population study (4) (although not in another [2]). Given the evidence for an increase in the prevalence of cannabis use disorder, identifying characteristics that increase the risk of frequent nonmedical cannabis use and cannabis use disorder is an important public health issue. Pain may be one such characteristic.

Pain, an unpleasant sensory-emotional experience associated with actual or potential tissue damage (7), is common in U.S. adults (8), is a leading cause of disability (9), and is associated with substance use disorders (10, 11). Since 1996, 34 states have passed laws authorizing cannabis use for various medical conditions, including pain...


Read the journal article.