Study, May/19:Effects of Medical Cannabis on Opioid & Benzo Use For Pain Control

The full title of this American study is "Medical Cannabis: Effects on Opioid and Benzodiazepine Requirements for Pain Control".

https://www.ncbi.nlm.nih.gov/pubmed/31129977 

Abstract

BACKGROUND:

There is currently little evidence regarding the use of medical cannabis for the treatment of intractable pain. Literature published on the subject to date has yielded mixed results concerning the efficacy of medical cannabis and has been limited by study design and regulatory issues.

OBJECTIVE:

The objective of this study was to determine if the use of medical cannabis affects the amount of opioids and benzodiazepines used by patients on a daily basis.

METHODS:

This single-center, retrospective cohort study evaluated opioid and benzodiazepine doses over a 6-month time period for patients certified to use medical cannabis for intractable pain. All available daily milligram morphine equivalents (MMEs) and daily diazepam equivalents (DEs) were calculated at baseline and at 3 and 6 months.

RESULTS:

A total of 77 patients were included in the final analysis. There was a statistically significant decrease in median MME from baseline to 3 months (-32.5 mg; P = 0.013) and 6 months (-39.1 mg; P = 0.001). Additionally, there was a non-statistically significant decrease in median DE at 3 months (-3.75 mg; P = 0.285) and no change in median DE from baseline to 6 months (-0 mg; P = 0.833). Conclusion and Relevance: Over the course of this 6-month retrospective study, patients using medical cannabis for intractable pain experienced a significant reduction in the number of MMEs available to use for pain control. No significant difference was noted in DE from baseline. Further prospective studies are warranted to confirm or deny the opioid-sparing effects of medical cannabis when used to treat intractable pain.

Not surprising that the study showed that "patients using medical cannabis for intractable pain experienced a significant reduction in the number of MMEs", but wondering about the use of benzos for pain control?  Since when?

Here's the full study:  https://sci-hub.tw/https://www.ncbi.nlm.nih.gov/pubmed/31129977

"These calculations were made using standardized opioid and benzodiazepine equivalence calculators and were based on medication lists found in the patient’s electronic medical record at the closest possible time to each of the study intervals.13 Benzodiazepines with an as-needed indication specifically for anxiety or sleep were not included in the dosage calculations. As-needed doses of benzodiazepines were included if they were prescribed for indications such as muscle spasms or if there was no specific indication

noted in the medical record. This was done in an attempt to prevent inaccurate results based on benzodiazepine doses that were not being used for pain."

In an attempt to prevent inaccurate results, they decided to include benzos prescribed for reasons unknown.