Abstract
BACKGROUND: Medical cannabis (MC) is being used with greater frequency in the management of chronic pain. While its efficacy in pain relief is promising, questions about patterns of use and efficacy warrant further investigation. This study aimed to evaluate long-term MC use patterns, perceived efficacy, and its impact on cognition among patients with chronic musculoskeletal noncancer pain. METHODS: This prospective study included patients who were certified for MC between October 2022 and December 2024. Patients who were certified for MC under Pennsylvania state guidelines for a minimum of one year were tracked, yielding 129 patients for analysis. The patients completed an Inventory of Medical Cannabis Use (IMCU) questionnaire assessing usage patterns, dosage knowledge, efficacy, cognitive effects, and tolerance changes. The responses were collected in a password-protected database. RESULTS: A total of 77.5% of patients reported using MC daily or near daily. Topical formulations were most frequently used (63.6%). Approximately half of the respondents were uncertain of their exact tetrahydrocannabinol/cannabidiol (THC/CBD) dosage, with a median oral dose of 10 mg recorded among those who provided estimates. High levels of perceived efficacy were reported, with over 93% of respondents agreeing or strongly agreeing that MC improved their primary symptoms. Cognitive and motor effects were minimal for most users, with 72.1% reporting no impact. Furthermore, 79.8% of respondents indicated stable usage patterns over the prior three months, and very few reported a need or external suggestion to reduce MC intake. CONCLUSIONS: Long-term MC use is a stable and well-tolerated option for managing chronic musculoskeletal pain, with high patient-reported efficacy and minimal cognitive impact. These findings support its role in pain management while highlighting the need for further research on optimal dosing and long-term safety.