Cannabis Use Patterns Among Adults Living With Chronic Pain Before and During the COVID Pandemic: Insights From the COVID-19 Cannabis Health Study.

Background: This study aims to identify sociodemographic factors associated with cannabis use for chronic pain management before and after COVID-19 was declared a pandemic. Furthermore, it seeks to compare cannabis use patterns in adults with and without chronic pain. Methods: We analyzed US-based responses from the COVID-19 Cannabis Health Study, a cross-sectional online survey administered via REDCap between March 2020 and March 2022. All respondents were cannabis consumers in the past year. Cannabis use patterns and chronic pain were self-reported via the COVID-19 Cannabis Health Questionnaire. Statistical analysis included Chi-square tests, Fisher's exact tests, Results: Among 2243 participants, 50.3% consumed cannabis to manage chronic pain. Younger age (< 40 years; aOR: 3.20, 95% CI: 2.59-3.96), Hispanic/Latino ethnicity (aOR: 2.20, 95% CI: 1.56-3.05), and higher income levels (> $100,000 annually; aOR: 1.69, 95% CI: 1.25-2.29) were associated with higher odds of consuming cannabis to manage chronic pain. Participants using cannabis for chronic pain were more likely to use a CBD/THC ratio. The pandemic led to increased dosages and changes in consumption methods: 40.5% increased their cannabis dose, smoking as the primary method declined from 62.2% before the pandemic to 34.5% afterward, while edibles rose from 7.9% to 30.9%, and tinctures from 3.2% to 8.6%. Route changes varied with chronic pain status. Conclusion: There was a shift from smoking to nonsmoking methods to manage chronic pain. Those who were younger and those of Hispanic/Latino ethnicity had higher odds of using cannabis for chronic pain.