SELF-REPORTED RATES OF CANNABINOID USE IN PATIENTS WITH END-STAGE OSTEOARTHRITIS

Since 2018, cannabis usage rates in Quebec have risen from 14% to 19% following the legalization of cannabinoid use in Canada1. Although multifactorial, it seems the decrease in stigma around cannabinoid use following its recent legalization could explain the increase in usage rates2. Moreover, this decrease in stigma reduces a significant barrier for patients with osteoarthritis (OA) who considered using cannabinoids to manage their symptoms. Studies have shown that cannabinoid use in joint arthroplasty patients had positive analgesic effects and decreased the use of opioids3,4. However, other studies have found that cannabinoids are not effective in managing pain, are associated with negative outcomes, and are correlated with an increase in opioid use in arthroplasty patients5,6. Despite the conflicting evidence in the literature, cannabinoid use likely plays a significant role in patient care. However, it is difficult for healthcare workers to understand that role due to lack of data. The purpose of this study is to 1) document self-reported cannabinoid use among patients with knee and hip OA, and 2) investigate for clinico-demographic factors associated with cannabinoid use in knee and hip OA patients. One hundred and fifty-one patients were recruited. Due to missing data, 3 patients were excluded resulting in 148 participants (59 male, 89 female), including 94 knee OA patients and 54 hip OA patients. Data on age, sex, height, weight, socioeconomic status, tobacco use, alcohol use, and cannabinoid use were collected. The overall cannabinoid usage rate was 16%, with 15% using cannabinoids regularly. More specifically, regular cannabinoid use in patients having at least 7 drinks of alcohol a week was over 37%. In patients 55 years old and above, over 15% tried cannabinoids while 14% use them regularly. Younger age (mean difference of 5.8 years between groups; p=0.016), more pack years (mean difference of 8.4 pack years between groups; p=0.005), over 5 years of tobacco use (odds ratio [OR], 4.2 [95% confidence interval [CI], 1.6–10.9]; p=0.004), over 10 years of tobacco use (OR, 4.1 [95% CI, 1.5–10.8]; p=0.007), over 4 cigarettes consumed per day (OR, 3.1 [95% CI, 1.2–8.1]; p=0.024), and 7 or more alcoholic drinks per week (OR 1≥ : 7≤ dr/wk, 3.6 [95% CI, 1.2–12.2], OR 2-6 : 7≤ dr/wk, 4.8 [95% CI, 1.1–20.5]; p=0.045) were significantly associated with self-report cannabinoid use. Following the legalization of cannabinoids, the overall cannabinoid usage rate of over 16% in knee and hip OA patients resembles that of other US states with recently legalized cannabinoid use. Compared to the general population, older patients have significantly higher cannabinoid usage, suggesting that a large portion of these patients might be exploring cannabinoids as a means to manage their symptoms. These findings emphasize that a considerable proportion of end-stage OA patients use cannabinoids thereby creating the need for healthcare professionals to better understand the implications of its use, the patient outcomes, and the guidelines for cannabinoid use. Further studies are needed to explore the long-term effects of cannabinoid use in managing OA symptoms.

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