01 January 0001

People with sickle cell disease who obtain medical marijuana for pain relief have fewer hospital visits than others, according to a new US study.

Previous studies have shown that cannabis and cannabinoid products can effectively treat chronic pain. Dr Susanna Curtis, of the Yale School of Medicine and Yale Cancer Center, and her team said that many patients who were offered medical marijuana at their center were already using illegal cannabis for pain relief.

“Illicit marijuana is not regulated, so its quality and contents are not standardised,” she said. “And particularly for people with sickle cell disease, many of whom identify as black, we know that while black and white people use marijuana at similar rates, black people are four times more likely to be arrested for possession. We didn't want our patients using unsafe products or being arrested for trying to control the pain of their condition.”

Dr Curtis and her team retrospectively examined data from 50 individuals with sickle cell disease at the Adult Sickle Cell Program at Yale New Haven Hospital who had been certified for medical marijuana use.

Of those 50 people, 29 obtained medical marijuana from a certified dispensary, and 21 did not. Those who took medical marijuana visited the hospital less frequently on average over the following six months, with several patients reducing their hospital admission rates by three to five visits.

However, taking medical marijuana was not associated with a change in emergency room or infusion centre visits or opioid use.

The researchers also surveyed patients to try to understand why many were unable to access medical marijuana, and why some continued to occasionally use illicit cannabis even after obtaining certification for medical marijuana.

They found that those who took medical marijuana reported they felt it was safer to take than illicit marijuana and that it was effective at pain relief. However, they also cited barriers such as greater expense and difficulty of access.

Race and socioeconomic status may also be barriers for patients with sickle cell disease, say the researchers.

“About 80% of our clinic population identifies as black, and another 15% as Latinx, and unfortunately people of colour who visit the hospital with pain are often not believed or accused of being drug-seeking,” said Dr Curtis. “Medical marijuana is associated with significant stigma, and stigma is already a big part of the life of a person with sickle cell.”

In the study, patients who obtained medical marijuana were more likely to use edible products, rather than inhaled products, which, according to previous research, has a slower onset but a longer lasting pain relief effect than inhaled products.

Source: Curtis SA, Lew D, Spodick J, Hendrickson JE, Minniti CP, Roberts JD (2020) “Medical marijuana certification for patients with sickle cell disease: a report of a single center experience.” Blood Advances, doi: 10.1182/bloodadvances.2020002325


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