894 - Prevalence and Impact of Cannabinoid Use in Patients with Spinal Disorders for Pain Management and Rehabilitation

Objectives: One in four Americans suffer from chronic back pain, with 40% reporting trauma or surgery as its origin. Cannabis is becoming legalized for medical use, though there is minimal literature focused on pain in patients with spinal disorders and in patients recovering from spinal trauma in the acute rehabilitation setting. The objectives of this observational study were to address whether cannabinoid use provided meaningful pain relief, decreased pain medication consumption, and allowed patients to participate in rehabilitation without limitations of pain.

Design: Patients 18 years or older with a history of spinal fusion or spinal pathology requiring rehabilitation being treated at a large academic spine center since 2013 completed a questionnaire regarding medical use of marijuana and cannabis products for pain reduction. Patients were asked for quality-of-life scores via Patient Reported Outcomes Measurement Information System (PROMIS) scores.

Results: A total of 7,371 patients were sent surveys, with 118 responding (1.6% response rate), with 61 patients identified as using cannabis for pain. Of the respondents, 23.1% of patients reported using cannabis once or more daily; 47% reported using cannabis for pain more than once a month. Among spine patients, 55.5% reported a 50% or greater reduction in prescription pain medication use, specifically opioids, after using cannabis.

Conclusions: It was subjectively perceived that cannabis use reduced pain medication use among patients with spinal disorders, though cannabis users did not have reduced pain levels based on PROMIS scores. There was no statistical difference in PROMIS scores between users and nonusers, differing from the association with reported quantity of pain medication used. This continued research will be pioneering in determining if cannabis can decrease narcotic pain medication prescription, providing alternative pain management therapies and pain reduction for patients undergoing physical therapy and rehabilitation. This research will also allow for the expansion of future personalized pain management plans.