Only 18% of prescribed cannabinoid patients in Manitoba were still using them after one year

Among 5,452 new prescribed cannabinoid users, 18.1% continued use at 1 year. Median duration was 31 days. Nabilone had the longest median use (33 days) and nabiximols the shortest (20 days). Fibromyalgia, osteoarthritis, and substance use disorder were associated with longer use, while cancer was associated with much shorter use.

Retrospective population-based cohort study using administrative health data from the Manitoba Population Research Data Repository. Included all new cannabinoid prescription users from April 2004 to April 2016, followed for 1 year.

Real-world persistence data reveals that most prescribed cannabinoid patients stop relatively quickly. The reasons differ by condition: cancer patients may stop due to disease progression or death, while chronic pain patients may persist longer because their conditions are ongoing.

Prescription persistence is a proxy for real-world effectiveness and tolerability. The finding that most patients stop within a month suggests either the medications are not meeting expectations, side effects are problematic, or the conditions they are treating are self-limited.

Administrative data cannot capture reasons for discontinuation (inefficacy, side effects, symptom resolution, or death). Cannabis obtained outside the medical system was not tracked. The study period predated Canadian recreational legalization.