Dr. Fitzcharles has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Janssen, Lilly, Pfizer, and Purdue, and has given expert testimony for various medicolegal and law firms on matters of chronic rheumatic pain.
Association of herbal cannabis use with negative psychosocial parameters in patients with fibromyalgia
Version of Record online: 27 JUL 2012
Copyright © 2012 by the American College of Rheumatology
Arthritis Care & Research
Volume 64, Issue 8, pages 1202–1208, August 2012
How to Cite
Ste-Marie, P. A., Fitzcharles, M.-A., Gamsa, A., Ware, M. A. and Shir, Y. (2012), Association of herbal cannabis use with negative psychosocial parameters in patients with fibromyalgia. Arthritis Care Res, 64: 1202–1208. doi: 10.1002/acr.21732
- Issue online: 27 JUL 2012
- Version of Record online: 27 JUL 2012
- Accepted manuscript online: 21 JUN 2012 12:40PM EST
- Manuscript Accepted: 27 APR 2012
- Manuscript Received: 1 NOV 2011
- Louise and Alan Edwards Foundation
Patients with chronic pain, including fibromyalgia (FM), may seek treatments outside of mainstream medicine. Medicinal cannabinoids are popularly advocated for pain relief but with limited evidence for efficacy in FM. The extent of use of cannabinoids in FM is unknown.
We have documented the self-reported prevalence of cannabinoid use in 457 patients with the diagnosis of FM and referred to a tertiary care pain center. We validated the diagnosis of FM and examined the associations of cannabinoid use in these patients.
Cannabinoids were being used by 13% of all patients, of whom 80% used herbal cannabis (marijuana), 24% used prescription cannabinoids, and 3% used both herbal cannabis and prescription cannabinoids. One-third of all men used cannabinoids. Current unstable mental illness (36% versus 23%; P = 0.002), opioid drug–seeking behavior (17% versus 4%; P = 0.002), and male sex (26% versus 7%; P = 0.0002) were all associated with herbal cannabis use. There was a trend for cannabinoid users to be unemployed and receiving disability payments. The diagnosis of FM was validated in 302 patients, with 155 assigned another primary diagnosis. When the FM group was analyzed separately, significant associations were lost, but trends remained.
Cannabinoids were used by 13% of patients referred with a diagnosis of FM. The association of herbal cannabis use with negative psychosocial parameters raises questions regarding the motive for this self-medication practice. Although cannabinoids may offer some therapeutic effect, caution regarding any recommendation should be exercised pending clarification of general health and psychosocial problems, especially for those self-medicating.