First-year trajectories of medical cannabis use among adults taking opioids for chronic pain: an observational cohort study.

Abstract

OBJECTIVE\nTo describe first-year trajectories of medical cannabis use and identify characteristics associated with patterns of use in a cohort of adults using opioids for chronic pain.\n\n\nDESIGN\nLatent class trajectory analysis of prospective cohort study using data on 14-day frequency of medical cannabis use.\n\n\nSETTING\nLarge academic medical center and four medical cannabis dispensaries in the New York City metropolitan area.\n\n\nSUBJECTS\nAdults with chronic pain using opioids and newly certified for medical cannabis in New York between 2018-2020.\n\n\nMETHODS\nUsing latent class trajectory analysis, we identified clusters of participants based on 14-day frequency of medical cannabis use. We used logistic regression to determine factors associated with cluster membership including sociodemographic characteristics, pain, substance use, and mental health symptoms.\n\n\nRESULTS\nAmong 99 participants, mean age was 53\u2009years; 62% were women and 52% were White. We identified three clusters of medical cannabis use: infrequent use (n\u2009=\u200930, mean use\u2009=\u20091.5\u2009days/14-day period), occasional use (n\u2009=\u200928, mean\u2009=\u20095.7\u2009days/14-day period), and frequent use (n\u2009=\u200941, mean\u2009=\u200912.1\u2009days/14-day period). Within clusters, use patterns did not vary significantly over 52\u2009weeks. Differences were observed in two sociodemographic variables: frequent (vs. infrequent) use was associated with non-Hispanic White race/ethnicity (aOR 4.54, 95% CI 1.49-14.29), while occasional (vs. infrequent) use was associated with employment (aOR 13.84, 95% CI 1.21-158.74).\n\n\nCONCLUSIONS\nThree clusters of medical cannabis use patterns emerged and were stable over time. Results suggest that structural factors related to race/ethnicity and employment may be a major driver of medical cannabis utilization, even among adults certified for use.