Doctors Less Likely to Support Broader Access to Cannabis Than Pain Patients

Physicians were less likely than chronic pain patients to support expanding access to cannabis for medical purposes, according to survey findings published in JAMA Network Open.

Respondents included 1,000 physicians and 1,661 people with chronic pain practicing or living in states with medical cannabis programs. For example, physicians were less likely to support federal legalization of medical cannabis (59% vs 71% for chronic pain patients) or requiring insurance coverage of cannabis for chronic pain treatment (51% vs 64%, respectively), but they were more likely to support requiring patient registration with a state medical cannabis program for access (68% vs 49%, P<0.001 for all).

In this interview, study author Elizabeth Stone, PhD, of the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, discusses the findings and implications.

The following is a transcript of her remarks:

In this study we conducted two surveys, one with adults with chronic pain and one with providers who treat patients with chronic pain. We conducted these surveys in states that have active medical cannabis programs, and we were interested in assessing support for different policies that would expand access to medical cannabis specifically for the treatment of chronic pain.

What we found in this study was that a majority of respondents were supportive of federal legalization of medical cannabis. And in general, patients with chronic pain were more supportive of expanding access to medical cannabis than were physicians.

A majority of respondents were also supportive of increasing education for providers around the use of medical cannabis for the treatment of chronic pain.

And probably as expected, the group with the highest support for expanding access to cannabis were people that had used cannabis to manage their own chronic pain symptoms.

Chronic pain affects one in five people in the United States. It’s a huge population of people, and chronic pain management and treatment can be very complex. In recent years, there’s been shifting guidance, particularly moving away from opioids and emphasizing non-opioid pain treatments. And cannabis is actually used, we found in another survey that one-third of chronic pain patients used cannabis to manage their chronic pain.

And so understanding support for policies, especially in the unique landscape of mixed legal status of cannabis, was really important for just understanding people’s interest and access to this as a chronic pain treatment option.

I think an important thing to focus on moving forward is this provider-education piece, I think particularly in two ways. I think first increasing education and research on the efficacy of cannabis for management of chronic pain. There is moderate evidence that it is an effective treatment, but better understanding modes of use or concentration or who it would work for would be really helpful for providers.

And then I think on the other side is a policy training piece for providers in terms of what does it mean for me to recommend cannabis to patients in the state where I am practicing? Are there implications for me and my practice? What is the process for them and better understanding what that looks like on the legal side as well.