Cannabis use among women with pelvic pain jumped from 13% to 22% after Canadian legalization

14.9% of all patients were current cannabis users. After legalization, use increased from 13.3% to 21.5% (p<0.001). Cannabis users had worse scores for depression, anxiety, pain catastrophizing, quality of life, and pain severity. Post-legalization users were more educated, had worse anxiety and pain catastrophizing, but used fewer antiinflammatories, neuroleptics, and daily opioids.

Retrospective analysis of a prospective registry at a Vancouver tertiary pelvic pain clinic, 2013-2019 (n=3,426). Compared cannabis users vs. non-users and pre-legalization (before October 17, 2018) vs. post-legalization users on demographics, clinical measures, and validated questionnaires.

Cannabis legalization significantly increased use among women with chronic pelvic pain. The shift toward more educated users with fewer opioid prescriptions suggests a changing profile of who turns to cannabis for pain management.

The post-legalization shift to more educated users with lower opioid use suggests legalization may be attracting a different population to cannabis, possibly those seeking alternatives to conventional pain management. The concurrent reduction in daily opioid use warrants further investigation.

Tertiary care sample may not represent all women with pelvic pain. Retrospective design. Cannot determine if cannabis use preceded or followed pain worsening. Post-legalization period was relatively short (about 1 year). Recreational use data only.