NIH RePORTERrelevance policy v2
State Medical Cannabis Laws, Chronic Pain, and Opioids: A Mixed-Methods Approach
PROJECT NARRATIVE Policymakers are increasingly considering state medical cannabis laws as a potential solution to the U.S. opioid crisis, but rigorous evidence is lacking. In this project, we study the effects of state medical cannabis laws on receipt of prescription opioid and guideline-concordant non-opioid treatment, as well as treatment for opioid use disorder, opioid overdose, cannabis use disorder, and cannabis poisoning, among patients with chronic non-cancer pain.
NIH RePORTERrelevance policy v2
Highs or Lows? Evaluating the Benefits and Consequences of Medical Marijuana Use in Older Adults with Chronic Pain and Opioid Use
Over the next 35 years, the “50+” population will more than double, and as greater than 50% of adults over 65 report bothersome pain within the past month, the prevalence of chronic pain will increase dramatically in the coming years. Opioid use for pain is highest among older adults, yet many complain of inadequate relief, significant side effects and increased risk of opioid-related consequences. Medical marijuana (MMJ) use is increasingly common among older adults for pain relief; however, the potential benefits, risks, and negative consequences of MMJ in this population have not been assessed, raising serious public health concerns addressed in this proposal.
NIH RePORTERrelevance policy v2
STATE MEDICAL CANNABIS LAWS, CHRONIC PAIN, AND OPIOIDS: A MIXED-METHODS APPROACH
PROJECT NARRATIVE Policymakers are increasingly considering state medical cannabis laws as a potential solution to the U.S. opioid crisis, but rigorous evidence is lacking. In this project, we study the effects of state medical cannabis laws on receipt of prescription opioid and guideline-concordant non-opioid treatment, as well as treatment for opioid use disorder, opioid overdose, cannabis use disorder, and cannabis poisoning, among patients with chronic non-cancer pain.
NIH RePORTERrelevance policy v2
Cannabis Use for Chronic Pain: Advancing Knowledge and Cannabis Use Disorder Assessment with a Mixed Methods Approach
Valid, accurate diagnoses are critical for many purposes: indicating referrals to appropriate treatment; determining eligibility for clinical trials; making accurate prevalence estimates, training clinicians; and for improving DSM-5-TR and potentially DSM-6. Despite the rapidly changing cannabis landscape and increasing use of cannabis for pain, the DSM-5-TR CUD criteria have not been updated since 2013, and the changed legal status of cannabis has left gaps in knowledge about how it is used medically and how existing DSM-5 guidelines for diagnosing substance use disorders for prescribed substances should be adapted for cannabis, which cannot be prescribed but only ‘authorized’. This project will fill major gaps in knowledge about medical use; adapt DSM- 5 CUD criteria and diagnosis using this knowledge; and test the adapted criteria and diagnoses to determine if they improve reliability and validity over the existing DSM-5-TR CUD.
NIH RePORTERrelevance policy v2
STATE MEDICAL CANNABIS LAWS, CHRONIC PAIN, AND OPIOIDS: A MIXED-METHODS APPROACH
PROJECT NARRATIVE Policymakers are increasingly considering state medical cannabis laws as a potential solution to the U.S. opioid crisis, but rigorous evidence is lacking. In this project, we study the effects of state medical cannabis laws on receipt of prescription opioid and guideline-concordant non-opioid treatment, as well as treatment for opioid use disorder, opioid overdose, cannabis use disorder, and cannabis poisoning, among patients with chronic non-cancer pain.
NIH RePORTERrelevance policy v2
State Medical Cannabis Laws, Chronic Pain, and Opioids: A Mixed-Methods Approach
PROJECT NARRATIVE Policymakers are increasingly considering state medical cannabis laws as a potential solution to the U.S. opioid crisis, but rigorous evidence is lacking. In this project, we study the effects of state medical cannabis laws on receipt of prescription opioid and guideline-concordant non-opioid treatment, as well as treatment for opioid use disorder, opioid overdose, cannabis use disorder, and cannabis poisoning, among patients with chronic non-cancer pain.
NIH RePORTERrelevance policy v2
Cannabidiol Pharmacotherapy for Comorbid Opioid Addiction and Chronic Pain
PROJECT NARRATIVE The aims of this proposal are to determine the safety and efficacy of Cannabidiol (CBD) to alleviate pain and opioid craving among people living with both opioid addiction and chronic pain. Results will provide evidence as to whether CBD might aid as a novel treatment for this especially vulnerable population. This proposal will accelerate the development of novel therapeutics targeting the endogenous cannabinoid system for opioid addiction and chronic pain, a strategy that is likely to reduce persistently high rates of relapse and save lives.
NIH RePORTERrelevance policy v2
Cannabidiol Pharmacotherapy for Comorbid Opioid Addiction and Chronic Pain
PROJECT NARRATIVE The aims of this proposal are to determine the safety and efficacy of Cannabidiol (CBD) to alleviate pain and opioid craving among people living with both opioid addiction and chronic pain. Results will provide evidence as to whether CBD might aid as a novel treatment for this especially vulnerable population. This proposal will accelerate the development of novel therapeutics targeting the endogenous cannabinoid system for opioid addiction and chronic pain, a strategy that is likely to reduce persistently high rates of relapse and save lives.
NIH RePORTERrelevance policy v2
Examining the synergistic effects of cannabis and prescription opioid policies on chronic pain, opioid prescribing, and opioid overdose
Narrative Drug overdose is the country's leading cause of injury-related death, driven overwhelmingly by a rise in opioid overdoses. Unprecedented changes in cannabis and opioid policies over the last 20 years have placed restrictions on opioid prescriptions and increased legal access to cannabis. This study will inform policymakers about the types and combinations of prescription opioid and cannabis policies that are likely to lead to the greatest reductions in opioid-related harm, with and without benzodiazepines.
NIH RePORTERrelevance policy v2
Highs or Lows? Evaluating the Benefits and Consequences of Medical Marijuana Use in Older Adults with Chronic Pain and Opioid Use
Over the next 35 years, the “50+” population will more than double, and as greater than 50% of adults over 65 report bothersome pain within the past month, the prevalence of chronic pain will increase dramatically in the coming years. Opioid use for pain is highest among older adults, yet many complain of inadequate relief, significant side effects and increased risk of opioid-related consequences. Medical marijuana (MMJ) use is increasingly common among older adults for pain relief; however, the potential benefits, risks, and negative consequences of MMJ in this population have not been assessed, raising serious public health concerns addressed in this proposal.
NIH RePORTERrelevance policy v2
Dronabinol for the reduction of chronic pain and inflammation in people with sickle cell disease
Project Narrative: Over a third of patients with sickle cell disease use some form of cannabinoids to treat their uncontrolled pain, but there is little data to support this and little data on the adverse effects of cannabinoids in patients with sickle cell disease. However, cannabinoids have been shown to treat pain and to reduce markers of inflammation (which contributes to pain itself and to end organ damage) in other diseases of chronic pain and in mouse models of sickle cell disease. This project will study the possible efficacy study of an FDA approved cannabinoid containing product to treat pain and/or reduce inflammation in people living with sickle cell disease while also contributing to the understanding of the possible risks of this use.
NIH RePORTERrelevance policy v2
Examining the synergistic effects of cannabis and prescription opioid policies on chronic pain, opioid prescribing, and opioid overdose
Narrative Drug overdose is the country's leading cause of injury-related death, driven overwhelmingly by a rise in opioid overdoses. Unprecedented changes in cannabis and opioid policies over the last 20 years have placed restrictions on opioid prescriptions and increased legal access to cannabis. This study will inform policymakers about the types and combinations of prescription opioid and cannabis policies that are likely to lead to the greatest reductions in opioid-related harm, with and without benzodiazepines.
NIH RePORTERrelevance policy v2
Exploring Reactivity Among Patients with Chronic Pain Using Cannabis and Opioids: Mixed-Method Evidence of Promising Intervention Strategies
PROJECT NARRATIVE In the current proposal, I devised a mixed-methods study to expedite the development of interventions addressing the negative consequences of opioid or cannabis use among patients with chronic pain. This project involves advanced secondary quantitative analyses of real-time smartphone-based ecological momentary assessment data from my primary sponsor’s NIDA R21 (DA048175; PI: Thrul), followed by an original semi-structured interview-based qualitative study of local expert substance use clinicians working with patients with chronic pain who use cannabis and opioids for their analgesic properties. This proposed project establishes a foundation for developing interventions for patients with chronic pain at risk of consequences from their cannabis or opioid use.
NIH RePORTERrelevance policy v2
Cannabinoid and opioid modulation of descending pain circuits in chronic pain
PROJECT NARRATIVE We now recognize that the brain actively controls our sensitivity to pain. However, we are only beginning to understand how the pain circuit changes during chronic pain. The studies in this proposal will allow study of an identified pain-modulating circuit, focusing on how pain-related inputs are modulated by cannabinoids and opioids, and the synaptic mechanisms involved in the transition from acute to chronic pain in a persistent inflammatory model.
NIH RePORTERrelevance policy v2
Cannabidiol Pharmacotherapy for Comorbid Opioid Addiction and Chronic Pain
PROJECT NARRATIVE The aims of this proposal are to determine the safety and efficacy of Cannabidiol (CBD) to alleviate pain and opioid craving among people living with both opioid addiction and chronic pain. Results will provide evidence as to whether CBD might aid as a novel treatment for this especially vulnerable population. This proposal will accelerate the development of novel therapeutics targeting the endogenous cannabinoid system for opioid addiction and chronic pain, a strategy that is likely to reduce persistently high rates of relapse and save lives.
NIH RePORTERrelevance policy v2
Cannabinoid and opioid modulation of descending pain circuits in chronic pain
PROJECT NARRATIVE We now recognize that the brain actively controls our sensitivity to pain. However, we are only beginning to understand how the pain circuit changes during chronic pain. The studies in this proposal will allow study of an identified pain-modulating circuit, focusing on how pain-related inputs are modulated by cannabinoids and opioids, and the synaptic mechanisms involved in the transition from acute to chronic pain in a persistent inflammatory model.
NIH RePORTERrelevance policy v2
Examining the synergistic effects of cannabis and prescription opioid policies on chronic pain, opioid prescribing, and opioid overdose
Narrative Drug overdose is the country's leading cause of injury-related death, driven overwhelmingly by a rise in opioid overdoses. Unprecedented changes in cannabis and opioid policies over the last 20 years have placed restrictions on opioid prescriptions and increased legal access to cannabis. This study will inform policymakers about the types and combinations of prescription opioid and cannabis policies that are likely to lead to the greatest reductions in opioid-related harm, with and without benzodiazepines.
NIH RePORTERrelevance policy v2
State Medical Cannabis Laws, Chronic Pain, and Opioids: A Mixed-Methods Approach
PROJECT NARRATIVE Policymakers are increasingly considering state medical cannabis laws as a potential solution to the U.S. opioid crisis, but rigorous evidence is lacking. In this project, we study the effects of state medical cannabis laws on receipt of prescription opioid and guideline-concordant non-opioid treatment, as well as treatment for opioid use disorder, opioid overdose, cannabis use disorder, and cannabis poisoning, among patients with chronic non-cancer pain.
NIH RePORTERrelevance policy v2
Examining the synergistic effects of cannabis and prescription opioid policies on chronic pain, opioid prescribing, and opioid overdose
Narrative Drug overdose is the country's leading cause of injury-related death, driven overwhelmingly by a rise in opioid overdoses. Unprecedented changes in cannabis and opioid policies over the last 20 years have placed restrictions on opioid prescriptions and increased legal access to cannabis. This study will inform policymakers about the types and combinations of prescription opioid and cannabis policies that are likely to lead to the greatest reductions in opioid-related harm, with and without benzodiazepines.
NIH RePORTERrelevance policy v2
Real Time Monitoring of Prescription Opioid and Cannabis Co-Use in Patients with Chronic Pain
PROJECT NARRATIVE There is considerable interest in determining whether cannabis and cannabinoid products are viable alternatives to opioids for pain management. We propose to conduct a smartphone-based real-time observational study using Ecological Momentary Assessment to investigate the relationship between opioid use, cannabis use, and chronic pain. Findings of this study will determine feasibility of collecting intensive longitudinal data with chronic pain patients and will provide evidence for or against a potential opioid-sparing effect of cannabis on a day-by-day level, which would substantially strengthen the existing evidence base.