Evidence map›Paper›PMID 33933061›Full record

ArticleBMC public health2021

Opioid use in medical cannabis authorization adult patients from 2013 to 2018: Alberta, Canada.

Cerina Lee, Mu Lin, Karen J B Martins, Jason R B Dyck, Scott Klarenbach, Lawrence Richer, Ed Jess, John G Hanlon, Elaine Hyshka, Dean T Eurich

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
4.0field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

  1. Pooled it
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  5. Article
  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Cerina LeeSchool of Public Health, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, 11203-87 Avenue, Edmonton, AB, T6G 2E1, Canada.
Mu LinSPOR (Strategy for Patient Oriented Research) Data Platform, Alberta Health Services, Edmonton, Alberta, Canada.
Karen J B MartinsFaculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Jason R B DyckCardiovascular Research Centre, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Scott KlarenbachFaculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Lawrence RicherFaculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Ed JessCollege of Physicians & Surgeons of Alberta, Edmonton, Alberta, Canada.
John G HanlonSt. Michael's Hospital Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.
Elaine HyshkaSchool of Public Health, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, 11203-87 Avenue, Edmonton, AB, T6G 2E1, Canada.
Dean T EurichSchool of Public Health, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, 11203-87 Avenue, Edmonton, AB, T6G 2E1, Canada. deurich@ualberta.ca.
University of Alberta · CAAlberta Health Services · CACollege of Physicians and Surgeons of Ontario · CASt. Michael's Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe opioid overdose epidemic in Canada and the United States has become a public health crisis - with exponential increases in opioid-related morbidity and mortality. Recently, there has been an increasing body of evidence focusing on the opioid-sparing effects of medical cannabis use (reduction of opioid use and reliance), and medical cannabis as a potential alternative treatment for chronic pain. The objective of this study is to assess the effect of medical cannabis authorization on opioid use (oral morphine equivalent; OME) between 2013 and 2018 in Alberta, Canada.

methodsAll adult patients defined as chronic opioid users who were authorized medical cannabis by their health care provider in Alberta, Canada from 2013 to 2018 were propensity score matched to non-authorized chronic opioid using controls. A total of 5373 medical cannabis patients were matched to controls, who were all chronic opioid users. The change in the weekly average OME of opioid drugs for medical cannabis patients relative to controls was measured. Interrupted time series (ITS) analyses was used to assess the trend change in OME during the 26 weeks (6 months) before and 52 weeks (1 year) after the authorization of medical cannabis among adult chronic opioid users.

resultsAverage age was 52 years and 54% were female. Patients on low dose opioids (< 50 OME) had an increase in their weekly OME per week (absolute increase of 112.1 OME, 95% CI: 104.1 to 120.3); whereas higher dose users (OME > 100), showed a significant decrease over 6 months (- 435.5, 95% CI: - 596.8 to - 274.2) compared to controls.

conclusionsThis short-term study found that medical cannabis authorization showed intermediate effects on opioid use, which was dependent on initial opioid use. Greater observations of changes in OME appear to be in those patients who were on a high dosage of opioids (OME > 100); however, continued surveillance of patients utilizing both opioids and medical cannabis is warranted by clinicians to understand the long-term potential benefits and any harms of ongoing use.

Indexed as

CannabisMedical MarijuanaOpioid-Related DisordersAdultAlbertaAnalgesics, OpioidFemaleHumansMaleMiddle AgedUnited StatesAnalgesics, OpioidMedical MarijuanaChronic painCohort studyEpidemiologyMedical cannabisOpioidOpioid morphine equivalence

Identifiers

PMID33933061
PMCPMC8088205
OpenAlexW3131369491

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.