Cartoon shows a hand holding cannabis leaves and CBD oil
Credit: Tatiana Ayazo

Cannabis, also known as marijuana, has long been used to treat pain, and a growing body of scientific evidence shows that it often works. The catch, of course, is that obtaining it and figuring out how to use it safely and legally hasn’t always been so straightforward. In recent years, however, many states have changed their laws that permit the sale and use of this drug: 36 U.S. states now allow medical marijuana. So perhaps it’s not surprising that more people with rheumatic diseases — who often struggle with chronic pain — would start trying it.

According to a new study, published in the journal Arthritis Care & Research, the number of rheumatic disease patients who report using cannabis tripled from 6 percent in 2014 to 18 percent in 2019. Most lived in states where the drug is now legal, at least for medical purposes.

Researchers recruited participants in FORWARD, a patient-reported research data bank for rheumatic disorders in the United States, and surveyed them about their past and current use of cannabis. More than 11,000 people participated.

The researchers found that patients who used cannabis were more apt than non-users to have more severe disease symptoms including worse pain, fatigue, sleep, anxiety, and depression. Patients were also more likely to use cannabis if they were taking “weak” opioids such as codeine, tramadol, or hydrocodone (as opposed to strong opioids like morphine, fentanyl, or oxycodone).

“This suggests that patients with rheumatic diseases who try cannabis are those who are feeling worse, and that their pain management needs may not be adequately addressed by other therapies,” the authors wrote. “We anticipate that interest in and use of cannabis among patients with rheumatic diseases will continue to expand as laws change, cannabis availability increases, and research in this area advances.”

As interest continues to rise, health care providers should continue to learn more about this drug so that they’re better equipped to advise their patients. “Most of our physicians and health professionals are unfamiliar with cannabis and any of its potential harms or benefits for our patient populations,” study coauthor Kaleb Michaud, PhD, told Healio Rheumatology.

ArthritisPower, CreakyJoints’ research registry, has also studied the use of cannabis among people with rheumatic diseases. Read more about this research on how the legal status of cannabis affects whether patients discuss it with their doctors. A separate study showed that more than half of participants have tried marijuana or CBD for medical reasons.

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Laday J. Cannabis use tripled in patients with rheumatic disease over 5 years. Healio Rheumatology. July 28, 2021. https://www.healio.com/news/rheumatology/20210728/cannabis-use-tripled-in-patients-with-rheumatic-disease-over-5-years.

State Medical Marijuana Laws. National Conference of State Legislatures. May 18, 2021. https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx.

Terrie YC. Medical Cannabis for Chronic Pain. U.S. Pharmacist. March 19, 2020. https://www.uspharmacist.com/article/medical-cannabis-for-chronic-pain.

Wipfler K, et al. Increase in Cannabis Use Among Adults with Rheumatic Diseases: Results from a 2014-2019 US Observational Study. Arthritis Care and Research. July 15, 2021. doi: https://doi.org/10.1002/acr.24752.