One-third of fibromyalgia patients used medical cannabis despite limited evidence-based guidance | Research

The takeaway

Among 63 fibromyalgia patients in Quebec, 35% used medical cannabis and 18% used pharmaceutical cannabinoids for pain, alongside widespread use of opioids (33%) and NSAIDs (54%) that conflict with clinical guidelines.

Pain management specialists, fibromyalgia clinicians, medical cannabis researchers

35% of fibromyalgia patients used medical cannabis despite limited evidence

What the researchers found

Among 63 fibromyalgia patients, medical cannabis was used by 34.9% and pharmaceutical cannabinoids by 17.5%. Despite guidelines recommending against opioids for fibromyalgia, 33% used them. NSAIDs, also not recommended due to lack of efficacy, were used by 54%. Recommended medications were underused: anticonvulsants (36.5%), SNRIs (55.6%), and tricyclic antidepressants (22.2%). Medication subclasses perceived as highest risk were the least used.

Why it matters

The gap between what guidelines recommend and what fibromyalgia patients actually use reveals a disconnect between clinical evidence and patient experience that drives people toward cannabis and other non-recommended options.

The numbers in context

63 patients; 34.9% medical cannabis; 17.5% pharmaceutical cannabinoids; 33% opioids; 54% NSAIDs; 55.6% SNRIs; 36.5% anticonvulsants; 22.2% tricyclics; 23.8% tramadol

How the study worked

Directive telephone interviews with 63 individuals self-reporting fibromyalgia in Quebec, Canada. Assessed all pain medications including prescribed, over-the-counter, and cannabis products. Compared use patterns to Canadian Fibromyalgia Clinical Practice Guidelines.

What this study cannot tell us

Small sample of 63 self-reported fibromyalgia patients. Telephone interviews may introduce social desirability bias. Quebec-specific healthcare context may not generalize. No clinical verification of fibromyalgia diagnosis.

How to read the evidence

Structured interviews with guideline comparison provide useful real-world data, but small sample and self-reported diagnosis limit generalizability.

When this study was published

Published 2023

The bigger picture

When patients with a difficult-to-treat condition like fibromyalgia turn to cannabis and opioids despite guideline recommendations against them, it suggests that recommended treatments may not be providing adequate relief.

Questions still open

Are fibromyalgia patients using cannabis because recommended medications failed? Would better access to recommended treatments reduce reliance on cannabis and opioids?

Common questions

Do fibromyalgia patients use cannabis for pain?

Yes. In this Quebec survey, about 35% used medical cannabis and 18% used pharmaceutical cannabinoids, making cannabis one of the most commonly used treatments despite limited guideline support.

Are fibromyalgia patients following clinical guidelines?

Largely not. Over half used NSAIDs (not recommended) and a third used opioids (recommended against), while guideline-recommended medications like anticonvulsants and tricyclic antidepressants were underused.

Read the original research

Pain Medications Used by Persons Living With Fibromyalgia: A Comparison Between the Profile of a Quebec Sample and Clinical Practice Guidelines.

Canadian journal of pain = Revue canadienne de la douleur, 7(2), 2252037

View on PubMed ↗Publisher’s paper ↗

Citation

De Clifford-Faugère, Gwenaelle; Nguena Nguefack, Hermine Lore; Godbout-Parent, Marimée; Diallo, Mamadou Aliou; Guénette, Line; Pagé, M Gabrielle; Choinière, Manon; Beaudoin, Sylvie; Boulanger, Aline; Pinard, Anne Marie; Lussier, David; De Grandpré, Philippe; Deslauriers, Simon; Lacasse, Anaïs. (2023). Pain Medications Used by Persons Living With Fibromyalgia: A Comparison Between the Profile of a Quebec Sample and Clinical Practice Guidelines.. Canadian journal of pain = Revue canadienne de la douleur, 7(2), 2252037. https://doi.org/10.1080/24740527.2023.2252037