Fibromyalgia Patients Using Cannabis Had More Mental Health Problems and Drug-Seeking Behavior | Research

The takeaway

Among 457 fibromyalgia patients, 13% used cannabinoids, and herbal cannabis use was associated with unstable mental illness, opioid drug-seeking behavior, and male sex.

Read this if you have fibromyalgia and use or are considering cannabis for pain management.

36% of cannabis-using FM patients had unstable mental illness vs. 23% of non-users

What the researchers found

Researchers surveyed 457 patients referred to a tertiary pain center with a fibromyalgia diagnosis. Thirteen percent used cannabinoids, with 80% of those using herbal cannabis (marijuana) and 24% using prescription cannabinoids.

Herbal cannabis use was associated with current unstable mental illness (36% vs. 23%), opioid drug-seeking behavior (17% vs. 4%), and male sex (26% of men vs. 7% of women used cannabis). There was a trend toward cannabis users being unemployed and receiving disability payments. When the analysis was restricted to patients with validated FM diagnoses, the statistical significance was lost but the trends remained.

Why it matters

While many pain patients advocate for cannabis as treatment, this study raises questions about whether self-medication with herbal cannabis in fibromyalgia is genuinely therapeutic or whether it reflects other vulnerabilities. The associations with mental illness and drug-seeking behavior suggest some patients may be using cannabis for reasons beyond pain relief.

The numbers in context

457 patients surveyed. 13% used cannabinoids. 80% of users chose herbal cannabis. Unstable mental illness: 36% of cannabis users vs. 23% of non-users (p=0.002). Opioid drug-seeking: 17% vs. 4% (p=0.002). Male sex: 26% vs. 7% (p=0.0002). One-third of all male patients used cannabinoids.

How the study worked

Cross-sectional study of 457 patients referred with FM diagnosis to a tertiary care pain center. FM diagnosis was validated in 302 patients. Associations between cannabinoid use and psychosocial variables were examined. Self-reported prevalence of cannabinoid use was documented.

What this study cannot tell us

Cross-sectional design cannot determine whether mental health problems and drug-seeking behavior caused cannabis use or resulted from it. Tertiary care patients represent the most complex cases and may not reflect the broader FM population. The validated FM subgroup was too small to maintain statistical significance.

How to read the evidence

Cross-sectional study at a tertiary care center; cannot establish causation between cannabis use and negative psychosocial factors.

When this study was published

Published in 2012. Research on cannabis for fibromyalgia has expanded but remains inconclusive.

The bigger picture

This study complicates the narrative around cannabis for chronic pain. While cannabinoids may have therapeutic potential for fibromyalgia, the association between herbal cannabis use and negative psychosocial factors suggests that self-medication is not straightforward and may sometimes signal underlying problems that need separate attention.

Questions still open

Would supervised medical cannabis use show different psychosocial associations than self-medication? Does cannabis actually improve fibromyalgia outcomes, or are patients using it primarily for mood relief? Should mental health screening be standard before recommending cannabinoids for FM?

Common questions

Does cannabis help fibromyalgia?

This study did not directly test whether cannabis improves fibromyalgia symptoms. It found that FM patients who self-medicated with herbal cannabis had more mental health problems and drug-seeking behavior than those who did not, raising questions about whether the self-medication is beneficial or reflects other issues.

Why were men more likely to use cannabis for fibromyalgia?

One-third of male FM patients used cannabinoids compared to 7% of women. The study did not determine why, but possibilities include different attitudes toward cannabis, different pain coping strategies, and potentially different motivations for use beyond pure pain relief.

Read the original research

Association of herbal cannabis use with negative psychosocial parameters in patients with fibromyalgia.

Arthritis care & research, 64(8), 1202-8

View on PubMed ↗Publisher’s paper ↗

Citation

Ste-Marie, Peter A; Fitzcharles, Mary-Ann; Gamsa, Ann; Ware, Mark A; Shir, Yoram. (2012). Association of herbal cannabis use with negative psychosocial parameters in patients with fibromyalgia.. Arthritis care & research, 64(8), 1202-8. https://doi.org/10.1002/acr.21732