Study into Deprescription

Background

Chronic pain (CP) is a debilitating condition for patients and makes up a significant part of patient morbidity in Australia. Some pharmaceutical treatments recommended for CP, including opioids, antidepressants, and benzodiazepines, involve numerous side effects. While many international studies support the use of medicinal cannabis (MC) in improving the quality of life (QoL) of CP patients, this study is the first in Australia that examines the deprescribing of opioids, benzodiazepines and antidepressants using MC.

Aim

This study aimed to examine the effectiveness of MC in deprescribing opioids, benzodiazepines, and antidepressants for CP patients in an Australian context. The secondary aim was ad to explore if MC treatment improved QoL.

Methods

Patient data (n=156) collected by a Cannabis clinic in NSW between March 2019 to January 2020, was analysed retrospectively. Data from before MC use was compared to data after MC treatment. Analyses focused on comparing change in patient reported pain and QoL scores. Changes in medication doses for opioids, benzodiazepines and anti-depressants were examined to see if MC causes deprescribing.

Results

Patients in the study had a mean age of 56 years. The main reasons patients required MC was for CP, mental health reasons and insomnia. The results confirm an association between MC and improvements in pain and QoL scores in patients with CP. There was a significant reduction in pain scores after MC treatment (M=5, SE = 0.16) than before using MC (M=8, SE=0.15), t(119)=14.67, p<0.001. Patients reported significant improvements in their QoL after commencing MC treatment (M=3, SE=0.13) than before using MC (M=5, SE=0.21), t(126)=7.94, p<0.001. Deprescribing trends were promising but inconclusive due to issues with data collection.

Conclusion

This study adds to the evidence in support for MC as a mainstream option for CP management and a potential substitute or adjuvant for opioids, benzodiazepine, and antidepressants.