Reasons for, and outcomes of, medicinal cannabis use among Canadian Veterans who live with pain: A cross-sectional study

Introduction: It is not known whether medical cannabis reimbursement is producing a net benefit for Veterans living with pain. The aims of this study were to compare never, past, and current cannabis users and to understand current use behaviours. Methods: Canadian Veterans (N = 589) living with chronic pain were administered an online survey. Descriptive statistics were calculated and inferential analyses conducted using chi-square tests of association, extended McNemar-Bowker tests, and an ordinal logistic regression. Results: 1) Over a quarter of never users report stigma as their reason for non-use, 2) 34% of past users discontinued due to lack of symptomatic improvement, 3) the predominant reasons for cannabis use are symptom relief (83%), medication substitution (59%), and avoiding side effects from prescription opioids (45%), 4) 89% of male current users found cannabis helpful in reducing the intensity of chronic pain, while only 70% of female current users reported the same, χ 2 (1, N = 310) = 15.92, p < 0.001, 5) 50% of current users endorse neuropathic pain compared to 40% of those not currently using cannabis, χ 2 (1, N = 522) = 5.71, p = 0.017, and 6) a majority of Veterans prescribed 0.5 to 2 grams per day or 4 or more grams per day of cannabis reported using the full amount; however, less than 40% of Veterans prescribed 3 grams per day use the full amount regardless of sex, age, or pain category, χ 2 (3, N = 248) = 64.33, p < 0.001, g = 0.37. Discussion: Many Veterans report a net benefit from medical cannabis use, though this result is less consistent for female participants. Some Veterans do not use their full reimbursed amount.