P-095 - (Poster #95) Integrating Medical Marijuana into Chronic Pain Management: Efficacy, Barriers, and Functional Outcomes

Recent evidence has recognized the benefits of medical marijuana (MM) in managing various disorders including chronic pain, establishing its role as a valuable adjunct therapy. MM offers pain relief with minimal side effects, improving patients' overall quality of life. However, despite its growing acceptance, policy-related barriers limit its accessibility, as it remains a Schedule I drug under the Drug Enforcement Administration (DEA), stating that “marijuana has no federally approved medical use for treatment in the United States”. Nevertheless, ongoing research continues to highlight MM's potential to help patients discontinue high-dose opioids, reducing their risk of opioid dependence and addiction. Patients using MM reported a significant reduction in pain, increase in appetite, improved sleep, decreased nausea, lower frequency of severe seizures, among other benefits. 

Despite the persistent stigma surrounding its use, MM has demonstrated significant medical potential and is gradually gaining recognition at both the state and federal levels. The Compassionate Care Act was signed on July 7th, 2014, making New York the 23rd state to recognize and utilize the medicinal benefits. As of February 1, 2025, the Medical Marijuana Data Management System (MMDMS) has registered 97,922 patients and 4,504 certifying practitioners in the state of New York.

Purpose/Objectives: The focus of this study is to evaluate the efficacy of MM among a diverse patient population within a neurology practice in Brooklyn, New York. We assessed how patient experiences influence treatment adherence, and highlighted the impact of current policies on access and compliance. We aim to emphasize the importance of identifying and addressing barriers to access, ensuring comprehensive and inclusive patient care.

Methods:

We conducted telephone surveys with 123 patients prescribed MM between August 2022 and August 2023 at a neurology clinic certified to prescribe MM under New York State regulations. Patients who had been enrolled in the program for one to 24 months were surveyed to assess treatment efficacy, adherence, financial burden, and barriers to access. We assessed changes in pain scores, daily functioning, affordability, and ease of dispensary access to identify key barriers to compliance.

To provide supplemental context, we reviewed peer-reviewed articles related to the use of medical marijuana in chronic pain management. Keywords included "Medical Marijuana", "Chronic Pain", "Opioid Alternatives", "Patient Adherence", "Barriers to Access", "Holistic Care", and "New York State Medical Marijuana Program". Inclusion criteria encompassed peer-reviewed articles, with studies meeting the defined eligibility criteria.

Results:

This survey provided valuable insight on the role of MM therapy in the management of chronic pain, demonstrating notable reductions in reported pain levels within our patient population. Among respondents, 90.2% (n=111) reported using MM to manage chronic pain, with chronic pain serving as either their primary or secondary diagnosis. Patients reported a decrease in pain severity from an average of 8.57 to 5.54 on a 10-point scale following the use of MM. A total of 78% of patients (n=96) reported experiencing pain reduction, and 26.1% (n=32) reported improvements in sleep quality. Treatment compliance data indicated that 45.5% of patients (n=56) adhered to their MM therapy, while 54.5% (n=67) were either non-compliant or had discontinued use at the time of data collection. The most frequently cited reason for non-compliance was affordability (34.8%), followed by challenges related to dispensary access, including distance and transportation limitations (14.9%). Among patients in our 2022–2023 study cohort, the average out-of-pocket costs for MM were $212 per month. The out-of-pocket expenses and limited dispensary accessibility present significant barriers to patient access to MM in New York state.

Among our patient cohort, findings indicate that MM use is associated with reduced opioid consumption, with most patients reporting decreased pain severity, improved sleep quality, and enhanced daily functioning. MM has demonstrated clinical efficacy in pain relief, exhibiting fewer reported adverse effects compared to traditionally prescribed analgesics, making it a viable option for long-term pain management. Patients have reported reduced nausea and increased appetite as additional therapeutic benefits during treatment. Moreover, its ability to decrease opioid dependence further supports its inclusion into pain management protocols, reducing reliance on pharmaceutical interventions in favor of a more integrative approach. These factors, combined with its novelty, contribute to MM's growing preference among patients experiencing chronic pain.

Conclusions/Implications for future research and/or clinical care: The use of MM has gained significant popularity, as it offers a natural, non-opioid alternative for chronic pain management, addressing both the physiological and psychological dimensions of pain. Despite these benefits, the continued classification of cannabis as a Schedule I drug imposes significant impediments to patient compliance and adherence, limiting physician prescribing, insurance coverage, and overall accessibility. Patients continue to encounter barriers including high costs, limited dispensary accessibility, and persistent stigma, which hinder their ability to maintain long-term therapy. Our findings underscore the need for policy reforms, including health insurance coverage for MM, expanded dispensary accessibility, increased physician education on prescribing indications, and the reclassification of cannabis to support broader medical use. Such reforms would enhance the integration of MM into conventional medical practice by promoting a holistic, patient-centered approach to care that addresses both physical and systemic barriers to treatment.