@article{bfe1c24b5ed345eca0b8267ae9ab6d0d,
title = "Real-Time Monitoring of Cannabis and Prescription Opioid Co-Use Patterns, Analgesic Effectiveness, and the Opioid-Sparing Effect of Cannabis in Individuals With Chronic Pain",
abstract = "Despite a rapid expansion of cannabis use for pain management, how cannabis and prescription opioids are co-used and whether co-use improves analgesia and promotes reduction of opioid use in the daily lives of individuals with chronic pain is poorly understood. Based upon ecological momentary assessment (EMA), the present study examined 1) how pain and use of opioids and/or cannabis in the previous moment is associated with individuals{\textquoteright} choice of opioids and/or cannabis in the next moment, 2) the effects of co-use on pain severity and pain relief, and 3) whether daily total opioid consumption differs on days when people only used opioids versus co-used. Adults with chronic pain (N = 46) using both opioids and cannabis who were recruited online completed a 30-day EMA. Elevated pain did not increase the likelihood of co-use in subsequent momentary assessments. Switching from sole use of either opioids and cannabis to co-use was common. Neither co-use nor sole use of either cannabis or opioids were associated with reductions in pain in the next moment. However, participants reported the highest daily perceived pain relief from co-use compared to cannabis and opioid use only. Post hoc analysis suggested recall bias as a potential source of this discrepant findings between momentary versus retrospective assessment. Lastly, there was no evidence of an opioid-sparing effect of cannabis in this sample. The present study shows preliminary evidence on cannabis and opioid co-use patterns, as well as the effects of co-use on pain and opoid dose in the real-world setting. Perspective: This article presents the overall patterns and effects of co-using cannabis and prescription opioids among individuals with chronic pain employing ecological momentary assessment. There were conflicting findings on the association between co-use and analgesia. Co-use was not associated with a reduction in daily opioid consumption in this sample.",
keywords = "cannabinoids, cannabis, Chronic pain, ecological momentary assessment, opioid-sparing, opioids",
author = "Mun, {Chung Jung} and Courtney Nordeck and Goodell, {Erin M.Anderson} and Ryan Vandrey and Vadim Zipunnikov and Dunn, {Kelly E.} and Finan, {Patrick H.} and Johannes Thrul",
note = "Funding Information: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: PHF is on the advisory board for Ninnion Therapeutics. RV has received consulting fees and honoraria for service on the scientific advisory board for the following companies within the past 12 months: Canopy Growth Corporation, MyMD Pharmaceuticals Inc., Syqe Medical Ltd. KED has been paid as a consultant for MindMed; received honoraria for advisory board work for Canopy Corporation and Beckley-Canopy; serves as an unpaid advisor to Peabody Pharmaceuticals; and received research and salary support from the National Institutes on Drug Abuse and the Ashley Addiction Treatment Center. Funding Information: This work was supported by the National Institute on Drug Abuse (T32DA007292; R21DA048175; and F32DA049393) and the Blaustein Pain Research Fund at Johns Hopkins School of Medicine. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: PHF is on the advisory board for Ninnion Therapeutics. RV has received consulting fees and honoraria for service on the scientific advisory board for the following companies within the past 12 months: Canopy Growth Corporation, MyMD Pharmaceuticals Inc., Syqe Medical Ltd. KED has been paid as a consultant for MindMed; received honoraria for advisory board work for Canopy Corporation and Beckley-Canopy; serves as an unpaid advisor to Peabody Pharmaceuticals; and received research and salary support from the National Institutes on Drug Abuse and the Ashley Addiction Treatment Center. Funding Information: This work was supported by the National Institute on Drug Abuse ( T32DA007292 ; R21DA048175 ; and F32DA049393 ) and the Blaustein Pain Research Fund at Johns Hopkins School of Medicine. Publisher Copyright: {\textcopyright} 2022 United States Association for the Study of Pain, Inc.",
year = "2022",
month = nov,
doi = "10.1016/j.jpain.2022.06.009",
language = "English (US)",
volume = "23",
pages = "1799--1810",
journal = "Journal of Pain",
issn = "1526-5900",
publisher = "Churchill Livingstone",
number = "11",
}