Of 969 chronic pain patients surveyed, 46% currently used cannabinoids with large reported improvements in pain and comorbid symptoms, while 32% never tried them — mainly due to lack of clinician approval or legal barriers.
Read this if you have chronic pain and are considering cannabinoids, or if you are a clinician navigating patient requests for cannabinoid therapy.
40% barrierProportion of non-users who never tried cannabinoids due to lack of clinician suggestion or approval
What the researchers found
Among 969 respondents, 444 (46%) currently used cannabinoids, 213 (22%) previously used, and 312 (32%) never used them. Current users reported larger improvements than previous users across all pain types, including difficult-to-treat overlapping pain conditions. Current users also reported improvements in comorbid symptoms (sleep) and lower side effect interference. Current users had more frequent and satisfactory clinician communication about cannabinoids. Non-users cited lack of clinician suggestion (40%), illegality (25%), and lack of FDA regulation (19%) as barriers.
Why it matters
The disconnect between positive observational reports and mixed clinical trial results is a central tension in cannabinoid pain medicine. This survey helps explain it: patients who find cannabinoids effective continue using them, creating selection bias in observational data.
The numbers in context
- 969 respondents total
- 444 (46%) currently using cannabinoids
- 213 (22%) previously used
- 312 (32%) never tried
- Barriers: no clinician approval (40%), illegality (25%), no FDA regulation (19%)
- Current users reported large improvements across pain types
How the study worked
Cross-sectional web-based survey distributed through chronic pain patient advocacy groups and foundations. Self-reported chronic pain, cannabinoid use, experiences, and attitudes.
Who was studied
969 individuals with self-reported chronic pain recruited through patient advocacy groups
What this study cannot tell us
Self-selected sample via advocacy groups introduces bias. Self-reported outcomes without verification. Survivorship bias — current users may be those who responded well. No standardized pain outcome measures.
How to read the evidence
Cross-sectional survey with self-selected sample. Provides patient perspective data but subject to significant selection and reporting bias.
When this study was published
Published in 2023. Reflects current patient experiences and barriers in the evolving legal landscape.
The bigger picture
The call for FDA-approved cannabinoid products for pain is central to this study's conclusions. Without regulatory approval, patients face barriers (clinician hesitancy, legal concerns) that limit access, and clinicians lack the prescribing framework they need.
Questions still open
- Would FDA-approved cannabinoid pain products increase clinician willingness to recommend them?
- How much of the reported benefit is due to survivorship bias vs genuine efficacy?
- Which chronic pain conditions respond best to cannabinoid treatment?
Read the original research
Cannabinoid Therapy: Attitudes and Experiences of People With Chronic Pain.
The Clinical journal of pain, 39(6), 249-258
Citation
Gewandter, Jennifer S; Edwards, Robert R; Hill, Kevin P; Wasan, Ajay D; Hooker, Julia E; Lape, Emma C; Besharat, Soroush; Cowan, Penney; Le Foll, Bernard; Ditre, Joseph W; Freeman, Roy. (2023). Cannabinoid Therapy: Attitudes and Experiences of People With Chronic Pain.. The Clinical journal of pain, 39(6), 249-258. https://doi.org/10.1097/AJP.0000000000001109