Pain Specialists Not High on Improving Access to Medicinal Cannabis

Research reveals differences between physicians and adults suffering from chronic pain in levels of support for cannabis access, signifying implications for policymaking and healthcare practices regarding cannabis use. Results from the survey were published this past September 2024 in JAMA Network Open. The survey captured the attitudes of two key groups about cannabis policies and expanding access to cannabis for chronic pain management in states with active medical cannabis programs.

Elizabeth Stone, Ph.D., from the Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, and the team’s study methodology involved two distinct survey periods: adults with chronic pain were surveyed from March 3rd to April 11th, 2022, while physicians were surveyed from July 13th to August 4th, 2023. The survey questions asked respondents to indicate their level of support for several cannabis-related policies using a 5-point Likert scale. The response rates, 75.4% for chronic pain patients and 73.0% for physicians, lent credibility to the findings.

Individuals with chronic pain showed significantly higher support for policies advocating for federal legalization of cannabis, both for medical use (70.8%) and adult use (54.9%), compared to physicians' support (59.0% and 38.0%, respectively). Additionally, patients were more favorable toward insurance coverage for cannabis (64.0% vs. 50.6%) and state subsidies for low-income individuals (50.1% vs. 30.6%). Physicians exhibited a greater inclination to support regulations like patient registration with state medical cannabis programs, which chronic pain sufferers opposed (49.2% vs. 68.1%).

The findings reveal a complex relationship between physicians and patients concerning cannabis use. Notably, those who had prior experience with cannabis, either via personal use or professional recommendation, tended to demonstrate greater support for access-expanding policies.

“Cannabis is unique in terms of the complicated policy landscape,” Stone said in a news release. “Depending on what state you're in, it could be that medical cannabis is legal, it could be that medical and recreational use are legal, it could be that neither is legal, but some things are decriminalized.”

Currently, 38 states and Washington, D.C., have legalized medical cannabis use. Additionally, 24 states (plus D.C.) have legalized it for adult recreational use. But cannabis remains a Schedule I controlled substance under federal law.

This study is part of a National Institute on Drug Abuse-funded project on the impacts of state medical cannabis policies on opioid-related outcomes for people with chronic pain.