Pain Did Not Predict Cannabis Use Among People with Psychotic Disorders

Pain and interference from pain were not significant predictors of cannabis use (yes/no) or amount of cannabis use in people with psychotic disorders. However, use of antipsychotics with low sedating effects was associated with greater cannabis use (p=0.028). 59% of the sample experienced some pain and 18.5% used cannabis.

Cross-sectional analysis of 108 Dutch people with psychotic disorders from the VAT observational cohort. Regression models tested whether pain (RAND-36-SF items) predicted cannabis use, controlling for age, sex, psychosis severity, and sedating antipsychotic use.

The assumption that people with psychosis might use cannabis to self-medicate pain was not supported. Instead, the link between less-sedating antipsychotics and greater cannabis use raises questions about whether some patients use cannabis for sedation or relaxation that their medications do not provide.

The antipsychotic sedation finding suggests cannabis use in psychosis may be driven more by a desire for subjective effects that less-sedating medications do not provide, rather than by pain management. This could influence medication selection decisions.

Small sample size (108). Cross-sectional design. Self-reported pain and cannabis use. Dutch sample may not generalize. Cannabis may effectively suppress pain, making users report less pain (reverse causation). Single-site cohort study.