Cannabis Expectancies Predict Use Patterns in Chronic Pain Patients More Than Pain Severity Does
A survey of 258 chronic pain patients found that positive expectations about cannabis effects — not pain severity — were the strongest predictor of cannabis use frequency and problematic use.
Quick Facts
What This Study Found
Positive cannabis expectancies (believing cannabis will help with pain, sleep, mood) were significantly associated with higher use frequency and cannabis use disorder symptoms, even after controlling for pain severity, anxiety, and depression. Pain severity itself was not a significant predictor of use patterns.
Key Numbers
258 chronic pain patients surveyed. Positive expectancies predicted use frequency (p<0.01) and CUD symptoms (p<0.001). Pain severity was not a significant predictor.
How They Did This
Cross-sectional survey of 258 adults with chronic pain who used cannabis. Validated measures for cannabis expectancies, pain severity, mental health, and cannabis use disorder.
Why This Research Matters
Clinicians often assume chronic pain patients use cannabis because of pain severity. This study suggests beliefs about cannabis matter more, which has implications for patient education and screening.
The Bigger Picture
Understanding why people use cannabis is as important as understanding whether it works. If expectancies drive use more than symptoms, targeted education about realistic outcomes could help patients make more informed decisions.
What This Study Doesn't Tell Us
Cross-sectional design cannot determine causation. Self-selected sample of cannabis users. Expectancies and use measured simultaneously. No longitudinal follow-up.
Questions This Raises
- ?Could correcting unrealistic cannabis expectancies reduce problematic use in pain patients?
- ?Do expectancies change after prolonged cannabis use for pain?
Trust & Context
- Key Stat:
- Evidence Grade:
- Well-powered cross-sectional study with validated measures, but cannot establish causal direction between expectancies and use.
- Study Age:
- 2025 study examining psychological drivers of cannabis use in chronic pain.
- Original Title:
- Cannabis expectancies and associations with cannabis use and health functioning among adults with chronic pain.
- Published In:
- Addictive behaviors, 160, 108166 (2025)
- Authors:
- Tomlinson, Devin C, Coughlin, Lara N(2), Bohnert, Kipling M(4), Ilgen, Mark A
- Database ID:
- RTHC-07809
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Why do chronic pain patients use cannabis?
This study found beliefs about cannabis benefits mattered more than actual pain severity in predicting use patterns, suggesting psychological expectations drive use more than symptom relief needs.
Can expecting cannabis to help lead to overuse?
Yes — higher positive expectancies were associated with both more frequent use and more symptoms of cannabis use disorder in this chronic pain sample.
Read More on RethinkTHC
- CBD-oil-quality-guide
- anxiety-medication-after-quitting-weed
- cannabis-chemotherapy-nausea
- cannabis-chronic-pain-research
- cannabis-epilepsy-CBD-Epidiolex
- cbd-anxiety-research-evidence
- cbd-for-weed-withdrawal
- cbd-vs-thc-difference
- medical-benefits-of-cannabis
- quitting-weed-before-surgery
- quitting-weed-medication-interactions
- quitting-weed-pregnancy
- quitting-weed-pregnant
- seniors-older-adults-cannabis-risks-medications
- weed-breastfeeding-THC-breast-milk
Cite This Study
https://rethinkthc.com/research/RTHC-07809APA
Tomlinson, Devin C; Coughlin, Lara N; Bohnert, Kipling M; Ilgen, Mark A. (2025). Cannabis expectancies and associations with cannabis use and health functioning among adults with chronic pain.. Addictive behaviors, 160, 108166. https://doi.org/10.1016/j.addbeh.2024.108166
MLA
Tomlinson, Devin C, et al. "Cannabis expectancies and associations with cannabis use and health functioning among adults with chronic pain.." Addictive behaviors, 2025. https://doi.org/10.1016/j.addbeh.2024.108166
RethinkTHC
RethinkTHC Research Database. "Cannabis expectancies and associations with cannabis use and..." RTHC-07809. Retrieved from https://rethinkthc.com/research/tomlinson-2025-cannabis-expectancies-and-associations
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.