Millennials lead the escalating interest in marijuana and cannabinoid compounds for managing pain — with older generations not far behind — yet most are unaware of potential risks. Three-quarters (75%) of Americans who expressed interest in using marijuana or cannabinoids to address pain think they are safer or have fewer side effects than opioids or other medications, according to a nationwide survey commissioned by the American Society of Anesthesiologists (ASA).
More than two-thirds of those surveyed said they have used or would consider using marijuana or cannabinoid compounds — including cannabidiol (CBD) and tetrahydrocannabinol (THC) — to manage pain. Nearly three-quarters of millennials fall in that category, with 37% noting they have used them for pain. Two-thirds of Gen Xers and baby boomers expressed interest, with 25% of Gen Xers and 18% of baby boomers saying they have used them for pain.
“As experts in managing pain, physician anesthesiologists are concerned about the lack of research regarding the safety and effectiveness of marijuana and cannabinoids,” said ASA Immediate Past President Linda J. Mason, M.D., FASA. “The good news is that until the research is completed and we fully understand the risks and potential benefits, physician anesthesiologists today can develop a personalized plan for patients’ pain drawing from effective alternatives such as non-opioid medications and other therapies, including injections, nerve blocks, physical therapy, radio waves and spinal cord stimulation.”
ASA members point out that marijuana and cannabinoids may not be safer than other medications and can have side effects. Equally disturbing, these products are not regulated or monitored for quality.
Marijuana and cannabinoid safety and oversight
Results of the nationwide survey of adults 18 or older confirm physician anesthesiologists’ concerns. When respondents who said they have used or would consider using marijuana or cannabinoids were asked why, the majority (62%) said they believe them to be safer than opioids and 57% believe they have fewer side effects than other medications.
Even though it is widely available, CBD is not regulated. The U.S. Food and Drug Administration (FDA) has approved only one prescription version of CBD for patients with one of two rare forms of epilepsy. (No form of marijuana is approved by the FDA and the federal government considers it a controlled substance and illegal.) Thirty-three states and Washington, D.C., have legalized marijuana in some form (for recreational or medical use) but all set their own regulations, which vary. Studies have shown that no matter what the label says, the actual ingredients may differ, and may contain dangerous synthetic compounds, pesticides and other impurities.
Yet the survey results reflect a misunderstanding of that reality. Among all surveyed (including those who said they would never use marijuana or cannabinoids):
- 57% believe more research is needed;
- More than one-third (34%) don’t feel the need to discuss using these products with their doctor;
- Nearly three out of five (58%) think they have fewer side effects than other medications;
- Nearly half (48%) think they know what they are getting with marijuana or cannabinoids; and
- 40% believe CBD sold at grocery stores, truck stops, health food stores or medical marijuana dispensaries is approved by the FDA. The younger the generation, the more likely they were to believe that is the case.
The ASA recently endorsed two bills that seek to expand research on CBD and marijuana: H.R. 601, the “Medical Cannabis Research Act of 2019” and S. 2032, the “Cannabidiol and Marihuana Research Expansion Act.”
The five-question Caravan Survey was conducted online by Engine, Aug. 5-7, 2019, among 1,005 adults, comprising 503 men and 502 women, 18 years or older. For more information about pain management alternatives visit https://www.asahq.org/whensecondscount/pain-management/non-opioid-treatment/. To learn more about the role physician anesthesiologists play in medical care, including surgery, visit www.asahq.org/WhenSecondsCount.