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The findings can lead to an alternative pain option for patients with sickle cell disease.
Medical marijuana may reduce hospital visits in patients with sickle cell disease.
In fact, those with the condition who requested and obtained medical marijuana to treat pain were admitted to the hospital less frequently than those who did not. The findings suggested medical marijuana may be an effective resource in reducing pain at home for patients with sickle cell disease. Further, the findings emphasized the need for additional research to understand the efficacy, side effects, and drug interactions of various cannabis products on disease treatment.
“We need controlled trials to look at each product, and the effects of how it is taken, so that we can offer regulated, pharmaceutical-grade treatment options,” lead study author Susanna Curtis, MD, of Yale School of Medicine and Yale Cancer Center, said in a statement.
Curtis and colleagues examined data from 50 patients with sickle cell disease at the Adult Sickle Cell Program at Yale New Haven Hospital. Patients were certified for medical marijuana use. Among certified patients, 29 obtained medical marijuana and 21 did not.
The primary study outcome was change in healthcare use and opioids dispensation. The team obtained data including the number of inpatient hospitalizations, number of emergency room visits not resulting in admission, and number of infusion center visits for pain crisis. Opioid dispensation was measured as the average daily oral morphine equivalents. For those with medical marijuana, the investigators compared outcomes from 6 months before the date of the first reported episode of medical marijuana products dispensed in CPMRS to 6 months after. In patients without medical marijuana, they compare outcomes from 6 months before the date of certification to 6 months after the date.
Secondary outcomes included age, sex, sickle cell disease genotype, hydroxyurea use, insurance status, and previous cannabis use, among other measures.
The investigators created a study for patients who presented to regularly scheduled clinic visits who had previously been certified for medical marijuana. Patients were asked if they had used illicit cannabis and at what frequency, along with whether they continued illicit marijuana use after being certified for medical marijuana. Further, patients were asked reasons for their medical marijuana use and how they thought it impacted their pain and their opioid use.
Overall, patients with medical marijuana showed a reduction in median six-month hospital admissions compared with those who did not get medical marijuana. A majority of the changes in admission were by 1 visit, but in those who obtained medical marijuana, 2 patients reduced by 2 visits, 2 patients reduced by 3 visits, 1 patient by 4 visits, and 1 patient by 5 visits. For those who did not obtain, only 1 patient reduced admissions by 2 visits.
A reason for reduced hospitalization rates could be because medical marijuana helped patients better tolerate their pain at home, Curtis suggested.
The team used the survey to understand why patients were unable to access medical marijuana and why some continued to occasionally use illicit cannabis. Those who obtained medical marijuana reported they felt it was safer than illicit marijuana. They also said it was effective at controlling their pain, but barriers existed such as a greater expense and difficulty accessing medical cannabis.
"About 80% of our clinic population identifies as Black, and another 15% as Latinx, and unfortunately people of color who visit the hospital with pain are often not believed or accused of being drug-seeking,” Curtis said. “Medical marijuana is associated with significant stigma, and stigma is already a big part of the life of a person with sickle cell.”
The findings could lead to an alternative pain option for patients with sickle cell disease.
The study, “Medical marijuana certification for patients with sickle cell disease: a report of a single center experience,” was published online in the journal Blood Advances.