Utilization of medicinal cannabis for pain by individuals with spinal cord injury.

Study design: A cross-sectional multi-center study using an on-line survey addressing utilization, knowledge, and perceptions of medicinal cannabis (MC) by people with spinal cord injury (SCI). Objective: To characterize differences between current (CU), past (PU), and never users (NU) of MC with SCI; to determine why people with SCI use MC; to examine reports of MCs' efficacy and tolerability by individuals with SCI. Setting: Three academic medical centers in the United States. Methods: Comparison of demographic and attitudinal differences between CU, PU, and NU and differences in the groups' reports of pain, health, and quality of life (QOL). Evaluation of utilization patterns and perceived efficacy of MC among CU and PU and reports of side effects of MC versus prescription medications. Data were analyzed using either Chi Square, distribution-free exact statistics, or t-tests for continuous data. Results: Among a nationwide sample (n = 353) of individuals with SCI, NU were less likely than CU and PU to believe that cannabis ought to be legalized and more likely to endorse risks of use. Current users and PU reported greater pain interference in daily life than did NU, but there were no between group differences in QOL or physical or emotional health. Current users and PU took MC to address pain (65.30%), spasms (63.30%), sleeplessness (32.70%), and anxiety (24.00%), and 63.30% reported it offered "great relief" from symptoms. Participants reported that MC is more effective and carries fewer side effects than prescription medications. Conclusions: Medicinal cannabis is an effective and well-tolerated treatment for a number of SCI-related symptoms.

Attitudes toward and knowledge of medical cannabis among individuals with spinal cord injury.

Study design: An observational study based on an online survey addressing attitudes toward and knowledge of cannabis among people living with spinal cord injury (SCI). Objectives: To characterize attitudes toward and knowledge of cannabis among a nationwide sample (n = 353) of people with SCI. To determine if knowledge and attitudes are influenced by socio-demographic and injury-specific factors. Setting: Three academic medical centers in the US. Methods: Distribution of an online survey through email lists maintained by 3 SCI centers. Results: Participants largely believed that cannabis use is safe, has potential therapeutic benefits, and ought to be legal. Substantial pluralities felt that cannabis use is attended by moderate to great health-related and social risks (15.5% and 25.5%, respectively), and a majority (55.9%) felt it is attended by moderate to great legal risks. Subjects' duration of injury, employment status, and personal history of controlled or illicit substances influenced certain beliefs and attitudes. Conclusions: This study is the first to assess beliefs about and attitudes toward cannabis use among a nationwide sample of people with SCI. While limited, it provides a roadmap for future research. It also offers medical providers an initial understanding of which factors may encourage or dissuade their patients with SCI from seeking medical cannabis treatment.