Medical Cannabis Fails the Long-Term Test: 58% of Patients Quit Within a Year
upstart writes:
More than half of patients stopped medical cannabis within a year, especially older adults. Discontinuation was unrelated to pain type or overall health:
New research shows that more than half of patients prescribed medical cannabis for chronic musculoskeletal pain stop treatment within a year. The findings raise concerns about the drug's durability as a long-term pain management option, particularly for older adults.
The study, recently published in PLOS One by researchers at the Rothman Institute Foundation for Opioid Research & Education, reported that 57.9 percent of 78 Pennsylvania patients certified for medical cannabis discontinued use within twelve months. Nearly half of these patients-44.7 percent-stopped during the first three months.
Researchers conducted a retrospective review, following patients newly certified through Pennsylvania's medical marijuana program to determine whether they renewed their certifications or pursued other treatments over a two-year period. Age emerged as the only statistically significant predictor of discontinuation: patients who stopped were, on average, about seven years older than those who continued (71.5 years compared with 64.5 years). Measures of baseline physical and mental health, assessed through PROMIS Global Physical Health and Global Mental Health scores, were similar between the two groups, suggesting that the decision to stop was not linked to overall health status at the outset.
Contrary to what some pain specialists might assume, the location of a patient's pain-whether in the lower back, neck, joints, or elsewhere-was not a significant factor in whether they discontinued cannabis treatment. While a slightly larger proportion of those who stopped reported low back pain, the difference was too small to be statistically meaningful. The results instead suggest that a variety of influences, including dissatisfaction with treatment, unwanted side effects, or choosing more definitive procedures such as injections or surgery, may be more important in determining whether patients continue using cannabis.
[...] The authors caution that their study, while among the first to carefully monitor one-year certification status for medical cannabis in orthopedic pain patients, leaves key questions unanswered. Specific details about cannabis formulation, dosage, and method of delivery were not consistently documented, nor were side effects, functional improvements, or patients' perceptions of relief. This makes it unclear whether discontinuation was due to a lack of effectiveness, adverse effects, financial burden, or even symptom improvement to the point where cannabis was no longer needed. They also point out that their sample was taken from a single institution's patient population and may not represent broader trends.
Journal Reference:
Mohammad Khak, Sina Ramtin, Juliet Chung, et al. Discontinuation rates and predictors of Medical Cannabis cessation for chronic musculoskeletal pain, PLOS ONE (DOI: 10.1371/journal.pone.0329897)
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