Four in 10 Minnesotans who have taken medical marijuana (cannabis) for intractable pain report that their pain has eased by 30 percent or more, according to a report released Thursday by the Minnesota Department of Health (MDH).
An even larger share (61 percent) say the use of medical marijuana has improved their lives in ways beyond reducing pain — by helping them sleep, for example, and by enabling them to cut back or eliminate their dependence on potentially addictive opioid drugs.
Those findings are based on data collected from 2,174 patients who enrolled in Minnesota’s medical cannabis program from August through December 2016 to get relief from intractable pain — defined by MDH as “pain in which the cause cannot be removed.” Until Aug. 1, 2016, patients with intractable pain did not qualify for the program.
Because of the way the data was collected — through self-evaluations and surveys — the findings in the MDH report do not prove a cause-and-effect relationship between the use of marijuana and pain reduction. Indeed, the scientific evidence to date regarding the effectiveness of marijuana for the treatment of chronic pain is unclear, primarily because no large, well-designed clinical trials have been conducted.
Still, MDH officials believe the new report’s findings are useful.
“This study helps improve our understanding of the potential of medical cannabis for treating pain,” said MDH Commissioner Jan Malcolm in a released statement. “We need additional and more rigorous study, but these results are clinically significant and promising for both pain treatment and reducing opioid dependence.”
Benefits and side effects
Here are the key findings from the report:
•Among patients who said they had moderate to high pain levels when they entered the medical cannabis program, 42 percent said their pain level had fallen by 30 percent in the first month, and 22 percent said they had been able to maintain that reduction in pain for at least four months. (A 30 percent pain reduction is widely used in pain studies to define a clinically meaningful improvement.)
• Although pain reduction was the benefit cited most often by patients in the study, a significant portion of them — 27 percent — said their use of marijuana had also improved their sleep.
• Of the 353 patients who said they had been taking opioid medications when they started using medical marijuana, 221 — or 63 percent — reported that they had been able to reduce or eliminate their opioid use after six months. And 58 percent of patients on other pain medications said they had reduced their use of those drugs.
• About 40 percent of the patients reported adverse side effects from the marijuana. In 90 percent of those reports, the side effects were described as “mild to moderate.” The most common side effects were dry mouth, drowsiness, fatigue and mental clouding (“foggy brain”). None of the patients reported a serious side effect — one that was life threatening or that required hospitalization.
A wide range of reactions
Of course, behind those statistics are real people with real pain. The MDH report contains an appendix with verbatim comments from the patients — comments that show a wide range of reactions to the marijuana treatments.
Here are some of the written remarks from patients who experienced a dramatic improvement in their lives:
• It’s [allowed] me to move again. Just normal cooking and laundry. [It] has also decreased my migraines. I still have some pain but nothing like before. I feel like I’m starting to get my life back.
• I have fibromyalgia. I lived my life in constant pain. [M]y daily pain on an average was an 8. I started taking medical cannabis in August. I now have a daily pain average between 2 and 3. After 2 weeks of cannabis I cooked my first meal in 15 years. My husband was doing all of the cooking and housework. I am now able to help with it.
• This has changed my life. When I used to get an episode I would be stuck at home laying in bed. Now I have something to manage my symptoms and I feel in control of my life again. Management of pain is so much easier with medical cannabis in my life.
• I have more energy. Not so depressed and sad. I feel like I have more to live for.
Not all the respondents had such positive experiences, however. “Medical cannabis has not made a difference for me,” wrote one patient. “I have never used it before and was a little hesitant to try. When I did I found that I had no relief of pain and I didn’t like the way I felt, so I discontinued use.”
“After two prescriptions I couldn’t see any effects so I am giving up on the program,” wrote another.
Most of the patients in the report were middle aged (64 percent were between the ages of 36 and 64) and lived within the Twin Cities metro region (73 percent). Slightly more than half — 52 percent — were women and 87 percent were white — percentages that roughly match the state’s demographics.
The most common causes of the patients’ pain were localized back pain (23 percent); radicular back pain, which extends into the legs (14 percent); fibromyalgia (10 percent); neuropathy (8 percent); and osteoarthritis (7 percent)