63% of medical cannabis users with rheumatic conditions substituted it for other medications | Research

The takeaway

Among 763 people with rheumatic conditions using medical cannabis, 62.5% substituted it for other medications including NSAIDs (55%), opioids (49%), and sleep aids (30%), reporting fewer side effects and better symptom management.

Rheumatology patients using medical cannabis, rheumatologists, pain management providers

49% substituted for opioids

What the researchers found

62.5% substituted medical cannabis for medications: NSAIDs (54.7%), opioids (48.6%), sleep aids (29.6%), muscle relaxants (25.2%). Substitution was associated with THC use, inhalation routes, and significantly higher symptom improvements (pain, sleep, anxiety, joint stiffness). Most reported decreased or ceased medication use after substitution.

Why it matters

Nearly half of rheumatic disease patients who substituted were replacing opioids, a significant finding given the opioid crisis. Understanding substitution patterns helps clinicians anticipate and manage medication transitions.

The numbers in context

763 participants. 62.5% substituted. NSAIDs: 54.7%. Opioids: 48.6%. Sleep aids: 29.6%. Muscle relaxants: 25.2%. Reasons: fewer adverse effects, better symptom management, withdrawal concerns. THC-containing products and inhalation most common among substitutors.

How the study worked

Secondary analysis of cross-sectional survey conducted with US and Canadian patient advocacy groups. 763 participants with rheumatic conditions using medical cannabis, compared substitution vs. non-substitution groups.

What this study cannot tell us

Cross-sectional survey cannot establish causation. Self-selected sample from advocacy groups. Self-reported medication changes. Cannot verify actual medication reductions. Substitution may reflect dissatisfaction with previous medications rather than cannabis efficacy.

How to read the evidence

Advocacy group survey provides self-reported substitution data but cannot verify medication changes or establish efficacy.

When this study was published

2024 secondary analysis of US and Canadian rheumatic disease patient survey

The bigger picture

The finding that substitutors reported higher symptom improvements may reflect selection bias (those who benefit substitute more), but it also suggests that for a subgroup of rheumatic disease patients, cannabis may address symptoms that conventional medications do not adequately manage.

Questions still open

Are patients who substitute cannabis for opioids maintaining adequate pain control? Should rheumatologists proactively discuss cannabis substitution to ensure safe medication transitions?

Common questions

Are people with arthritis replacing medications with cannabis?

In this survey, 63% of medical cannabis users with rheumatic conditions reported substituting cannabis for medications, most commonly NSAIDs (55%) and opioids (49%).

Why do patients substitute cannabis for medications?

Top reasons were fewer adverse effects, better symptom management, and concerns about withdrawal from current medications. Those who substituted reported greater improvements in pain, sleep, and anxiety.

Read the original research

Substituting Medical Cannabis for Medications Among Patients with Rheumatic Conditions in the United States and Canada.

ACR open rheumatology, 6(12), 826-835

View on PubMed ↗Publisher’s paper ↗

Citation

Boehnke, Kevin F; Scott, J Ryan; Martel, Marc O; Smith, Tristin; Bergmans, Rachel S; Kruger, Daniel J; Williams, David A; Fitzcharles, Mary-Ann. (2024). Substituting Medical Cannabis for Medications Among Patients with Rheumatic Conditions in the United States and Canada.. ACR open rheumatology, 6(12), 826-835. https://doi.org/10.1002/acr2.11717