Elsevier

Pain Management Nursing

Volume 21, Issue 1, February 2020, Pages 43-47
Pain Management Nursing

Original Article
Cannabis Use Motivations among Adults Prescribed Opioids for Pain versus Opioid Addiction

https://doi.org/10.1016/j.pmn.2019.06.009Get rights and content

Abstract

Background

Cannabis has been linked to reduced opioid use, although reasons for cannabis use among adults prescribed opioids are unclear.

Aims

The purpose of this study was to determine whether motivations for cannabis use differ between adults prescribed opioids for persistent pain versus those receiving opioids as medication-assisted treatment for opioid use disorder.

Design

A cross-sectional survey design was used.

Participants

Adults prescribed opioids for persistent pain (n = 104) or opioid use disorder (n = 139) were recruited from outpatient settings.

Methods

Data were collected on surveys asking about cannabis use and compared the two populations. A series of regression models examined population characteristics and cannabis use motivations using validated measures of the Marijuana Motives Measure scale.

Results

More than half the sample (n = 122) reported current, daily cannabis use and 63% reported pain as a motivation for use. Adults with persistent pain were more likely to be older, female, and have higher levels of education (p < .05). Adults with opioid use disorder were more likely to report “enhancement” (p < .01) and relief of drug withdrawal symptoms (p < .001) as motivations for cannabis use. The most common reasons for cannabis use in both populations were social and recreational use and pain relief.

Conclusions

Both studied populations have unmet health needs motivating them to use cannabis and commonly use cannabis for pain. Persistent pain participants were less likely to use cannabis for euphoric effects or withdrawal purposes. Nurses should assess for cannabis use, provide education on known risks and benefits, and offer options for holistic symptom management.

Section snippets

Participants and Procedures

This study was a secondary analysis of data collected from December 2016 through April 2017 by the senior author that has been published previously (Bigand et al., 2019, Wilson et al., 2018). The parent study samples consisted of 300 total participants—150 from an OUD population and another 150 from a PP population. Participants were recruited from two outpatient opioid treatment programs and three pain clinics in Washington State, where medical and recreational cannabis use was legal at the

Descriptive Statistics

Among the 243 participants who reported ever having used marijuana, 9.9% of participants reported having a current medical marijuana registration and 50.2% of participants reported current, daily cannabis use. Adults with PP were significantly more likely to be older, female, and have higher levels of education compared with adults with OUD (Table 1). There were no significant differences between the populations on other demographic factors.

Reasons for Cannabis Use

Across the sample, 63% reported pain as a motivation

Discussion

Within this sample, adults who used opioids for PP and adults who used opioids for OUD differed significantly regarding cannabis use motivations related to enhancement and withdrawal. Both populations were motivated to use cannabis for several health-related reasons including pain, sleep, and anxiety. These findings are important for nursing care assessment and planning because the current prescribed opioid treatments may be insufficient for managing symptoms. Medicinal cannabis for PP has been

Acknowledgments

The authors wish to acknowledge Rebecca M. Craft, Ph.D., Department of Psychology, Washington State University, for her contributions as primary investigator on the Washington State University Grand Challenges Seed Grant that supported this subproject.

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    This work was supported by Washington State University, United States (Grant no. WSU128515).

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