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. 2022 Apr;34(4):469-477.
doi: 10.1080/09540121.2021.1944597. Epub 2021 Jun 28.

Cannabis use, pain interference, and prescription opioid receipt among persons with HIV: a target trial emulation study

William C Becker  1   2 , Yu Li  3 , Ellen C Caniglia  4 , Rachel Vickers-Smith  5   6 , Termeh Feinberg  1   2 , Brandon D L Marshall  3 , E Jennifer Edelman  2   7
Affiliations

Cannabis use, pain interference, and prescription opioid receipt among persons with HIV: a target trial emulation study

William C Becker et al. AIDS Care. 2022 Apr.

Abstract

Concomitant with expanded legalization, cannabis is increasingly used to treat chronic pain among persons with HIV (PWH), despite equivocal benefit in research limited by small sample sizes and short duration of follow-up. To address these limitations, among a sample of PWH with pain interference enrolled in the Veterans Aging Cohort Study, we performed a target trial emulation study to compare the impact of four cannabis use strategies on pain interference. Among those receiving long-term opioid therapy (LTOT), we also explored impact of these strategies on ≥ 25% LTOT dose reduction. Among the analytic sample (N = 1284), the majority were men with a mean age of 50. Approximately 31% used cannabis and 12% received LTOT at baseline. Adjusting for demographic and clinical factors, cannabis use in any of 4 longitudinal patterns was not associated with resolved pain interference over 12- to 24-month follow-up. Among 153 participants receiving LTOT at baseline, cannabis use at both baseline and follow-up was negatively associated with LTOT dose reduction compared to no use at both baseline and follow-up. These findings support other observational studies finding no association between cannabis use and improved chronic pain or LTOT reduction among PWH.

Keywords: Chronic pain; cannabis use; long-term opioid therapy; target trial emulation study.

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Conflict of interest statement

Declaration of interest statement

The authors have no conflicts of interest to report.

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