Kaleb Michaud, PhD, on Skyrocketing Cannabis Use Among People with Rheumatic Diseases

Cannabis use has skyrocketed in the US among people with rheumatic diseases. The increased cannabis exposure may alter patients’ disease course, including reducing pain and inflammation while increasing movement function.

Kaleb Michaud, PhD, on Skyrocketing Cannabis Use Among People with Rheumatic Diseases



Cannabis usage has risen in the United States, according to a research; this may point to unmet requirements in pain management and mental health.

Between 2014 and 2019, cannabis usage among patients with rheumatic illnesses (RMDs) increased.

That’s according to the first research of its kind in the United States, which looked at the prevalence of cannabis usage in a large group of persons with RMDs. The results were published in the journal Arthritis Care & Research.

Cannabis consumption grew from 6.3 percent in 2014 to 18.4 percent in 2019 among 11,006 survey respondents. The states with the highest rates of cannabis usage were those that had legalized the drug.

In both years, a large majority of users (74 percent in 2014 and 62 percent in 2019) said cannabis helped them reduce arthritic symptoms.

Cannabis users were more likely to be on mild opioids (OR 1.2 [1.0, 1.5]; P=0.03) and to have smoked tobacco in the past (OR 1.7 [1.5, 2.1]; P0.001).

A study coauthor was Kaleb Michaud, PhD, a rheumatology researcher at the University of Nebraska Medical Center. He spoke with MedPage Today about the research and its results. For length and clarity, the conversation has been modified.

What knowledge gap did your research aim to fill, and why did you think now was the ideal moment to look into cannabis usage among persons with RMDs?

Michaud: The usage of cannabis, which is often described as a technique of dealing with pain, has skyrocketed. We also know that persons with RMDs often suffer from chronic pain that isn’t always properly managed.

There were no solid studies that addressed cannabis usage patterns in persons with RMDs or how many people with RMDs use cannabis.

What were the most important discoveries you discovered?

Michaud: In our US-wide sample, cannabis ever-use in adults with RMDs increased. People who said they used cannabis had greater RMD symptoms overall, indicating that there are unmet requirements in pain relief and pain treatment choices.

Was there anything about the research or its results that surprised you?

Michaud: Cannabis users had lower mental health than non-cannabis users, which may come as no surprise to some. This points to a different set of unmet needs: dealing with the worry and sadness that often accompany chronic pain.

Do you feel there is still a stigma associated with cannabis that is preventing people with RMDs from using it more widely?

Michaud: Without a doubt. Many doctors see cannabis usage as either a harmless herbal supplement or an unlawful substance that they should avoid discussing. I don’t condone the use of cannabis since we don’t yet fully understand its effects in terms of safety and effectiveness, but I don’t condemn individuals for trying to find relief.

What impact will the changing landscape of cannabis usage have on people’s attitudes and use of the drug?

Michaud: In jurisdictions where medicinal and recreational cannabis usage is permitted, rheumatologists and doctors are catching up with what their patients are taking. They’ve discovered some benefits and drawbacks, but they need additional information outside of their own personal experience to assist them make therapy recommendations.

Based on these results, what recommendations do you have for clinicians?

Michaud: It’s critical to understand whether your patients are using cannabis and why, since this may necessitate adjusting treatment objectives or seeking extra assistance to enhance sleep and mental health that may not be addressed during routine clinic sessions.

It’s excellent if you can document the cannabis’s form (smoked, vaped, ingested, etc.) and content (THC percent versus CBD percent). Some research is starting to reveal the significance of these factors.

Where does further research on cannabis usage in persons with RMDs need to be done?

Michaud: Many cannabis products on the market in the United States have serious quality control difficulties. As a result, determining which portion of cannabis gives treatment to persons suffering from RMDs is challenging. Clinical research, as well as greater monitoring of cannabis usage within the medical system, are required.

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