Cannabis use frequency and pain interference among people with HIV

Abstract

Cannabis is often used by people with HIV (PWH) for pain, yet study results are inconsistent regarding whether and how it affects pain. This study examines whether greater cannabis use frequency is associated with lower pain interference and whether cannabis use modifies the association of pain severity and pain interference among 134 PWH with substance dependence or a lifetime history of injection drug use. Multi-variable linear regression models examined the association between past 30-day cannabis use frequency and pain interference. Additional models evaluated whether cannabis use modified the association between pain severity and pain interference. Cannabis use frequency was not significantly associated with pain interference. However, in a model with interaction between cannabis use frequency and pain severity, greater cannabis use frequency attenuated the strength of the association between pain severity and pain interference (p = 0.049). The adjusted mean difference (AMD) in pain interference was +1.13, + 0.81, and +0.05 points for each 1-point increase in pain severity for those with no cannabis use, 15 days of use, and daily use, respectively. These findings suggest that attenuating the impact of pain severity on pain-related functional impairment is a potential mechanism for a beneficial role of cannabis for PWH.

Keywords: AIDS; HIV; cannabis; marijuana; opioid; pain.

Figure 1.

Change in association between pain severity and pain interference when accounting for cannabis use frequency Lines in the figure are the adjusted association (slope) between pain severity and pain interference with 95% confidence bands, for those with 0, 15 and 30 days of cannabis use. Adjusted associations were obtained from a multiple linear regression model that includes interaction between cannabis use and pain severity adjusted for age, sex, race/ethnicity and opioid use (Table 3).