Most Patients with Chronic Pain Stop Using Medical Cannabis Within a Year

Recent research from Philadelphia reveals that over half of individuals prescribed medical cannabis for managing chronic musculoskeletal pain discontinue its use within the first year. This study, conducted by the Rothman Institute Foundation for Opioid Research & Education and published in PLOS One, examined the certification and continuation rates among 78 patients from Pennsylvania. Findings showed that 57.9% chose to stop using medical cannabis within twelve months, with nearly 45% quitting within the first three months.

The analysis tracked patients newly certified through the state's medical marijuana program, assessing their renewal or alternative treatment choices over a two-year span. The only notable factor linked to discontinuation was age; patients who stopped were, on average, about seven years older—averaging 71.5 years—compared to 64.5 years for those who persisted.

Interestingly, initial health assessments and baseline physical and mental health scores did not differ significantly between groups, indicating that the decision to cease cannabis use was not related to overall health status at baseline. Moreover, the origin of pain—whether in the low back, neck, or joints—did not significantly influence discontinuation rates, although a slightly higher proportion of those who quit experienced low back pain.

The reasons behind these high drop-out rates appear complex, potentially involving dissatisfaction with treatment outcomes, side effects, or a preference for other interventions such as injections or surgery. Dr. Asif M. Ilyas, co-author of the study and President of the Rothman Opioid Foundation, emphasizes that despite increasing popularity, medical cannabis may not meet the expectations of a significant subset of chronic pain patients.

Lead researcher Dr. Mohammad Khak suggests that factors beyond pain type and baseline health, including perceptions of effectiveness, daily functioning, cost, and product quality, may influence whether patients continue therapy. The study also highlights gaps, as detailed information about cannabis formulations, dosages, side effects, or patient-reported benefits and satisfaction was not consistently recorded.

Given these findings, the study calls for larger, more comprehensive prospective research that evaluates dosing, delivery methods, side effects, and patient satisfaction to better identify who benefits most from medical cannabis and for how long. Until more evidence is available, clinicians and patients should set realistic expectations and be prepared to adjust treatment plans early based on individual responses.

This research underscores the importance of personalized approaches in pain management and signals a need to understand better the reasons why some patients discontinue cannabis, particularly among older adults. The findings serve as a reminder that while cannabis is gaining acceptance, it may not be a one-size-fits-all solution for long-term pain relief.