Kendall Robinson
University of Florida
Co-Authors: Kimberly Sibille1, Zhigang Li1, Rene Przkora1, Siegfried Schmidt1, Margaret C Lo1, Robert L Cook1, Deepthi S Varma1, Yan Wang1
1University of Florida
Background: Medical marijuana (MM) use for chronic pain has become more common among older adults. Evaluating the contributory factors on the decision to use MM can help elucidate the differences between those who choose or choose not to use MM.
Objective: This study aims to explore reasons for interest or non-interest in using medical marijuana among older adults with chronic pain.
Methods: A total of 139 participants aged 50 and older with non-cancer chronic pain from an ongoing 12-month prospective cohort Study on Medical marijuana and Its Long-Term Effects (SMILE study) answered open-ended questions assessing the decision whether to use MM at baseline. Responses were analyzed using NVivo software. Responses were evaluated by the first author to generate initial codes. Next, aligning codes were compiled collaboratively with the senior author to generate themes and sub themes. Two groups of participants were identified, those with: interest (n=92) and non-interest (n=47) in MM.
Results: Among those interested in MM (n=92), the main reasons included the desire to use MM as an alternative treatment or to reduce the use of other medications (45.7%) and the lack of options for pain treatments (16.3%); a lower perception of harm (15.2%) and the potential effectiveness of MM (15.2%) compared to other treatments; the potential to improve pain (50%), mental health (5.4%), sleep (5.4%), physical health (3.3%), and quality of life (1.1%). Among those not interested in MM (n=47), the main reason included concerns with the potential side effects (25.5%), safety (12.8%), and efficacy (12.8%) of MM; challenges with employment (14.9%) and legality and cultural concerns (8.5%); negative past experiences with marijuana use (12.8%) and negative perceptions of drugs (10.6%); the belief that current treatments are sufficient (8.5%) or that MM is not needed (6.4%). Affordability of MM was also discussed (6.4%).
Conclusions: These findings suggest that those interested in using MM tended to have more positive perceptions of MM than those who were not interested. Satisfaction with the current treatment regime and legal concerns also seemed to influence acceptance of MM treatments. This is consistent with the health belief model, where individuals weigh potential benefits and harms with the perceived need to try new treatments. Our findings help inform on the potential need for educational interventions (e.g., health benefits and safety of MM) and patient-support tools (e.g., financial and/or employment support). Observational studies examining effectiveness of MM should consider adjusting for pre-existing attitudes and beliefs.