One in Four Teens with Chronic Pain Use Cannabis, and Most Use It to Self-Treat Symptoms | Research

The takeaway

Among 245 adolescents seeking treatment for chronic pain, 25% reported cannabis use, with 77% of users saying they used it specifically to manage pain, sleep, or anxiety symptoms.

Pediatric pain specialists, adolescent medicine physicians, parents of teens with chronic pain

25% of teens in pain treatment use cannabis; 77% for symptom relief

What the researchers found

25.3% of treatment-seeking adolescents with chronic pain reported lifetime cannabis use (mean first use age 15.3). Among users, 77.4% endorsed instrumental use to manage symptoms (primarily pain, sleep, anxiety). Cannabis users had higher pain interference (mean difference 2.7, p = 0.01) and depressive symptoms (difference 6.2, p < 0.001). Non-users perceived cannabis as significantly riskier (OR 2.37, p = 0.01).

Why it matters

A quarter of teens in pain treatment are using cannabis, mostly to self-treat their condition. This represents a large unaddressed clinical reality where patients are supplementing or substituting formal treatment with cannabis despite limited evidence for its efficacy in pediatric pain.

The numbers in context

245 adolescents; 25.3% lifetime cannabis use; mean first use 15.3 years; 77.4% instrumental use; past-year 90.2% of users; past-month 64.5%; higher pain interference (p = 0.01) and depression (p < 0.001) in users.

How the study worked

Cross-sectional survey of 245 adolescents (mean age 16.9, 69% female) at a pediatric pain clinic (September 2021-May 2024). Validated self-report measures of pain, substance use, and risk perceptions. Published in JAMA Network Open.

What this study cannot tell us

Cross-sectional design cannot determine whether cannabis use preceded or followed pain worsening. Single pediatric pain center. Self-reported cannabis use may be underestimated in an adolescent clinical setting. Treatment-seeking population may not represent all teens with chronic pain.

How to read the evidence

Well-designed cross-sectional study published in JAMA Network Open with validated measures, limited by single center and cross-sectional design.

When this study was published

2025 publication with 2021-2024 data

The bigger picture

Published in JAMA Network Open, this study highlights a disconnect between patient behavior and clinical guidance. Most pediatric pain specialists would not recommend cannabis, yet a quarter of their patients are already using it for symptom management.

Questions still open

Does instrumental cannabis use by teens with chronic pain improve or worsen long-term outcomes?
How should clinicians address cannabis self-medication in adolescent pain patients?

Common questions

Do teens with chronic pain use cannabis?

Yes. In this JAMA study, 25% of teens at a pediatric pain clinic reported using cannabis. Most (77%) used it instrumentally to manage pain, sleep, or anxiety, with a mean age of first use at 15.3 years.

Does cannabis help teens with chronic pain?

This study found teens who used cannabis actually had worse pain interference and more depression than non-users. While most used cannabis for symptom relief, the cross-sectional design cannot determine if cannabis helped or if worse symptoms drove cannabis use.

Read the original research

Prevalence Rates, Perceptions of Risk, and Motivations for Nonmedical Cannabis Use in Pediatric Pain.

JAMA network open, 8(5), e2512870

View on PubMed ↗Publisher’s paper ↗

Citation

Kossowsky, Joe; Greco, Christine; Nestor, Bridget A; Koike, Camila; Tacugue, Nicole; Baumer, Andreas M; Weitzman, Elissa R. (2025). Prevalence Rates, Perceptions of Risk, and Motivations for Nonmedical Cannabis Use in Pediatric Pain.. JAMA network open, 8(5), e2512870. https://doi.org/10.1001/jamanetworkopen.2025.12870