Among cancer patients at four NCI-designated cancer centers, Black patients were less likely to use opioids for pain and more likely to report cannabis as more effective than opioids, though racial differences were partly explained by socioeconomic factors.
Cancer patients managing pain, oncologists, health equity researchers
OR 2.46 for viewing cannabis as more effective
What the researchers found
Black patients were less likely to use opioids for pain (OR 0.66, p=0.035) and more likely to report cannabis was more effective than opioids (OR 2.46, p=0.03) compared to White patients. Race effects were mitigated after controlling for socioeconomic factors.
Why it matters
Racial disparities in opioid prescribing for cancer pain are well-documented. Understanding how cannabis fits into pain management for underserved populations could help address inequities in cancer symptom management.
The numbers in context
1,220 patients across 4 NCI centers in 3 states. Black patients: OR 0.66 for opioid use (p=0.035). Black patients: OR 2.46 for viewing cannabis as more effective (p=0.03). Race effects not significant after socioeconomic adjustment.
How the study worked
Survey of 1,220 patients across 4 NCI-designated cancer centers in 3 states assessing perceptions, use of cannabis and opioids for pain, substitution patterns, and racial/ethnic differences.
What this study cannot tell us
Cross-sectional survey cannot establish causation. NCI cancer center patients may not represent all cancer patients. Self-reported perceptions may not reflect actual efficacy. Cannot determine whether cannabis substitution improves or worsens pain outcomes.
How to read the evidence
Multi-center survey with statistical adjustment for confounders, but cross-sectional design limits causal conclusions.
When this study was published
2024 survey from 4 NCI-designated cancer centers
The bigger picture
The finding that socioeconomic factors mediate the racial differences suggests that access barriers to opioids (insurance, provider bias, pharmacy availability) may drive Black patients toward cannabis as a pain management alternative, rather than pure preference.
Questions still open
- Are Black cancer patients achieving adequate pain control through cannabis use? Would equitable opioid access change cannabis use patterns among Black patients?
Common questions
Why might Black cancer patients prefer cannabis over opioids?
Is cannabis actually more effective than opioids for cancer pain?
Read the original research
Cannabis and opioid perceptions, co-use, and substitution among patients across 4 NCI-Designated Cancer Centers.
Journal of the National Cancer Institute. Monographs, 2024(66), 267-274
Citation
Ashare, Rebecca L; Worster, Brooke; Nugent, Shannon M; Smith, Danielle M; Morasco, Benjamin J; Leader, Amy E; Case, Amy A; Meghani, Salimah H. (2024). Cannabis and opioid perceptions, co-use, and substitution among patients across 4 NCI-Designated Cancer Centers.. Journal of the National Cancer Institute. Monographs, 2024(66), 267-274. https://doi.org/10.1093/jncimonographs/lgad027
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