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

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).

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.

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.

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.

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.