Background
Chronic pain is prevalent in older adults, affecting >50% of the 65+ population. Many with chronic pain use opioids to manage their symptoms, despite incomplete symptom relief, negative side effects, and high risk of misuse. A growing number of studies provide compelling evidence that medical cannabis (MC) and cannabinoids may be efficacious for chronic pain. Accordingly, many older adults have initiated MC treatment. Interestingly, several studies report associations between cannabis legalization, the use of MC and reductions in problematic opioid use. The goal of this study was to directly assess the impact of 3-6 months of MC use on opioid use and clinical ratings of pain in older adults.

Methods
As part of a larger longitudinal, observational study assessing the impact of MC use, older adults aged 45-75 with chronic pain who use opioids (n=52) were recruited into three groups: 1) patients planning to initiate MC use after baseline (MC-naïve; n=20); 2) patients already using MC at baseline (already-using; n=15); and 3) patients continuing treatment-as-usual without MC (TAU, n=17). Visits occurred at baseline and follow-ups were completed after 3 and 6 months. At each visit, patients reported all medication use, with opioid use standardized using a morphine equivalent dose (MED), and also completed clinical ratings of pain (Visual Analog Scale [VAS], Pain Distress Scale [PDS], Pain Disability Index [PDI]). Statistical analyses were conducted using one-tailed paired t-tests to examine within-group differences.