Evidence map›Paper›PMID 40838875›Full record

ArticlePain medicine (Malden, Mass.)2026

Medical cannabis authorization and opioid milligram equivalents over time in patients with chronic pain: a retrospective analysis.

Michelle Sexton, Nicholas C Glodosky, Michael Cleveland, Carrie Cuttler, Euyhyun Lee, Gregory R Polston, Timothy Furnish, Imanuel Lerman, Nathaniel M Schuster, Mark S Wallace

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pain medicine (Malden, Mass.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Michelle SextonCenters for Integrative Health, University of California San Diego, San Diego, CA 92037, United States.ORCID 0000-0002-0443-8355
Nicholas C GlodoskyDepartment of Psychology, Washington State University, Pullman, WA 99164, United States.
Michael ClevelandDepartment of Psychology, Washington State University, Pullman, WA 99164, United States.
Carrie CuttlerDepartment of Psychology, Washington State University, Pullman, WA 99164, United States.
Euyhyun LeeAltman Clinical and Translational Research Institute, University of California San Diego, San Diego, CA 92093, United States.
Gregory R PolstonDepartment of Anesthesiology, Division of Pain Medicine, University of California San Diego, San Diego, CA 92037, United States.
Timothy FurnishDepartment of Anesthesiology, Division of Pain Medicine, University of California San Diego, San Diego, CA 92037, United States.ORCID 0000-0002-4615-3366
Imanuel LermanDepartment of Anesthesiology, Division of Pain Medicine, University of California San Diego, San Diego, CA 92037, United States.
Nathaniel M SchusterDepartment of Anesthesiology, Division of Pain Medicine, University of California San Diego, San Diego, CA 92037, United States.
Mark S WallaceDepartment of Anesthesiology, Division of Pain Medicine, University of California San Diego, San Diego, CA 92037, United States.ORCID 0000-0001-5647-6233

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveStrategies are needed for patients with chronic pain who are using opioids to safely and effectively wean opioids without worsening of pain. The objective was to measure associations between medical cannabis authorization (MCA) and opioid milligram equivalents (OME) in patients with chronic non-cancer pain.

designA longitudinal, retrospective cohort analysis from July 2016 to August 2019.

settingElectronic health record data were analyzed. SUBJECTS: Adult patients (≥18 years) seen in a university-based pain clinic.

methodsLongitudinal multilevel modeling with maximum likelihood estimation.

resultsAverage overall OME at the final time point was 33.4 mg/day (SE = 1.18) with increase over time of 0.45 mg/day per quarter (not statistically significant). Average OME in those without MCA was 32.60 mg/day (SE = 1.11) versus 38.51 mg/day (SE = 4.81) in those with MCA, not significantly different. Medical cannabis consultation predicted a nonsignificant decrease of 14.25 mg/day OME. Long-term opioid use was a significant predictor with a mean OME of 85.34 mg/day, 63 mg/day higher than the rest of the cohort at the final quarter (t = 5.77, SE = 10.93, P < 0.0001).

conclusionsIn this longitudinal study of electronic health record data, MCA was not associated with a statistically significant decrease in OME over time. However, patients with long-term opioid use diagnostic code demonstrated a significantly higher endpoint OME. Future prospective research is needed to establish whether there are opioid-sparing effects of cannabis in humans.

Indexed as

Analgesics, OpioidChronic PainMedical MarijuanaAdultAgedElectronic Health RecordsFemaleHumansLongitudinal StudiesMaleMiddle AgedRetrospective StudiesAnalgesics, OpioidMedical Marijuanacannabischronic painmorphine milligram equivalentsopioidsopioid-sparingopioid-tapering

Identifiers

PMID40838875
PMCPMC12865101

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.