• Morgan A Ford, Gwen T Lapham, Theresa E Matson, Casey Luce, Malia M Oliver, and Ingrid A Binswanger.
• From the Kaiser Permanente Colorado Institute for Health Research, Aurora, CO (MAF, IAB), Kaiser Permanente Washington Health Research Institute, Seattle, WA (GTL, TEM, CL, MMO), Department of Health Systems and Population Health, University of Washington, Seattle, WA (GTL), Colorado Permanente Medical Group, Aurora, CO (IAB), Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO (IAB), Department of Health Systems Sciences, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA (IAB).
• J Am Board Fam Med. 2024 Jan 5; 36 (6): 9961007996-1007.

BackgroundMedical cannabis is commonly used for chronic pain, but little is known about differences in characteristics, cannabis use patterns, and perceived helpfulness among primary care patients who use cannabis for pain versus nonpain reasons.MethodsAmong 1688 patients who completed a 2019 cannabis survey administered in a health system in Washington state, where recreational use is legal, participants who used cannabis for pain (n = 375) were compared with those who used cannabis for other reasons (n = 558) using survey and electronic health record data. We described group differences in participant characteristics, use patterns, and perceptions and applied adjusted multinomial logistic and modified Poisson regression.ResultsParticipants who used cannabis for pain were significantly more likely to report using applied (50.7% vs 10.6%) and beverage cannabis products (19.2% vs 11.6%), more frequent use (47.1% vs 33.1% for use ≥2 times per day; 81.6% vs 69.7% for use 4 to 7 days per week), and smoking tobacco cigarettes (19.2% vs 12.2%) than those who used cannabis for other reasons. They were also significantly more likely to perceive cannabis as very/extremely helpful (80.5% vs 72.7%), and significantly less likely to use cannabis for nonmedical reasons (4.8% vs 58.8%) or report cannabis use disorder symptoms (51.7% vs 61.1%).DiscussionPrimary care patients who use cannabis for pain use it more frequently, often in applied and ingested forms, and have more co-use of tobacco, which may differentially impact safety and effectiveness. These findings suggest the need for different approaches to counseling in clinical care.© Copyright by the American Board of Family Medicine.

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