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Perioperative Patient Beliefs Regarding Potential Effectiveness of Marijuana (Cannabinoids) for Treatment of Pain: A Prospective Population Survey

Khelemsky, Yury MD*; Goldberg, Andrew T. MD*; Hurd, Yasmin L. PhD; Winkel, Gary PhD; Ninh, Allen BS§; Qian, Lucia BS§; Oprescu, Anna MPH§; Ciccone, Jeffrey MD*; Katz, Daniel J. MD*

Regional Anesthesia and Pain Medicine: September/October 2017 - Volume 42 - Issue 5 - p 652–659
doi: 10.1097/AAP.0000000000000654
Chronic and Interventional Pain: Original Articles

Background and Objectives Cannabinoids have an expanding presence in medicine. Perioperative patients' perceptions of the effectiveness of these compounds, and acceptance if prescribed for pain, have not been previously described. Our primary objective was to describe patients' beliefs regarding the potential effectiveness of cannabinoids for the treatment of acute and chronic pain, as well as gauge patient acceptance of these compounds if prescribed by a physician. In addition, demographic and pain history data were collected to elucidate the predictors of the aforementioned patient attitudes. Secondarily, we sought to characterize the subgroup of patients who reported marijuana use. Predictors of marijuana use, effectiveness, and adverse effects were also reported for this subgroup.

Methods An anonymous questionnaire was administered to 501 patients in the preoperative registration area at Mount Sinai Hospital, New York, New York. The questionnaire was designed to collect data on patient demographics, presence of pain, pain severity, use of pain medication, history of illicit-drug use, tobacco use, cannabis use, patient beliefs about the potential effectiveness of marijuana for acute and chronic pain and their willingness to use cannabis for pain, if prescribed by a physician. Normality of distributions for continuous variables was assessed with skewness and kurtosis measures. A logistic regression model was used to assess the demographic and medical characteristics of marijuana users compared with nonusers. The effectiveness of marijuana in dealing with pain and adverse effects associated with its use were examined using exploratory principal component analysis.

Results More than 80% of this cohort of preoperative patients believed that marijuana could be at least somewhat effective for the treatment of pain after surgery and would be willing to use cannabinoid compounds if prescribed by their physician. Predictors of positive attitudes toward marijuana included history of marijuana use, pain history, and being a marijuana nonuser of white race. Approximately 27% of the respondents reported a history of marijuana use. Younger patients, those with higher levels of pain in the last 24 hours, and those who found standard therapies to be less effective for their pain were more likely to use marijuana.

Conclusions Patients generally believe that marijuana could be at least somewhat effective for the management of pain and are willing to use cannabinoid compounds for this indication, if prescribed by a physician.

Supplemental digital content is available in the text.

From the Departments of *Anesthesiology, Perioperative and Pain Medicine, †Neuroscience, and ‡Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY; and §Icahn School of Medicine at Mount Sinai, New York, NY.

Accepted for publication April 12, 2017.

Address correspondence to: Yury Khelemsky, MD, Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029 (e-mail: Yury.khelemsky@mountsinai.org).

The authors declare no conflict of interest.

Y.K., the principal investigator, and G.W., the statistician, had full access to all data in the study and take responsibility for the integrity of the data and accuracy of the data analysis.

No funding was received for this study.

This work has not been presented at any meetings.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.rapm.org).

Copyright © 2017 by American Society of Regional Anesthesia and Pain Medicine.