HomeMy WebLinkAbout052126 - Association between cannabis use and insomnia symptoms among Veterans with chronic painALERT: BE CAUTIOUS This email originated outside the organization. Do not open attachments or click on links if you are not expecting them.
405 Veterans recruited nationally who were prescribed long-term opioid therapy for chronic pain and had a positive urine drug screen for THC
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Research //Required Reading//
Association between cannabis use and insomnia symptoms among Veterans with chronic pain <https://links-1.govdelivery.com/CL0/https:%2F%2Facademic.oup.com%2Fsleepadvances%2Farticle%2F7%2F2%2Fzpag026%2
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Jonathan E Elliott, Daniel Schriemer, Hannah Flegal, Natassja Pal, Meike Niederhausen, Travis I Lovejoy, Steven K Dobscha, Benjamin J Morasco
Sleep impairments (e.g., insomnia) and chronic pain commonly co-occur in Veterans contributing to reduced quality of life and other adverse neurologic sequela. The management of sleep
and chronic pain is complex, but frequently involves clinically directed long-term opioid therapy. However, as opioid prescribing practices evolve there is growing interest in cannabis
use for both pain and sleep management, and yet, little is known about potential associations between these factors.
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This study is a retrospective cross-sectional evaluation of 405 Veterans prescribed long-term opioid therapy who screened positive for cannabis use over the prior 3-6 months <https://links-1.govdeliv
ery.com/CL0/https:%2F%2Facademic.oup.com%2Fsleepadvances%2Farticle%2F7%2F2%2Fzpag026%2F8494266%3Futm_medium=email%26utm_source=govdelivery/2/0100019e4b80d28f-e9806e54-85b4-430e-be81-22590a4ae163-0000
00/DHGXsjL6VqnOR6LdYqNHmyHvYtwbnSmOq1UiqXD3cvc=452> (Carboxy-THC assayed from nail samples via liquid gas chromatography/mass spectroscopy). There was a strong association between insomnia
symptom severity with pain interference, anxiety, depression and PTSD symptomology; however, no group differences were found related to cannabis use (Carboxy-THC concentration). Whereas
prior studies consistently identified group differences in sleep impairment based on cannabis group status, in this study in which all patients endorse cannabis use, the severity of
cannabis use was not associated with insomnia symptoms.
Abstract
Study Objectives: Insomnia and chronic pain commonly co-occur, with Veterans more likely to experience both compared to the general population. As opioid prescribing practices change,
there is growing interest in the use of cannabis for pain management and insomnia yet little data evaluating these potential associations.
Methods: 405 Veterans recruited nationally who were prescribed long-term opioid therapy for chronic pain and had a positive urine drug screen for THC in the month prior were enrolled.
Participants were stratified into “none” (n = 118), “mild” (n = 140), and “moderate/severe” (n = 147) insomnia groups via the Insomnia Severity Index. THC consumption over the prior
~3-6 months was determined from nail samples, assayed for Carboxy-THC (pg/mg) via liquid gas chromatography/mass spectroscopy.
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Results: Bivariate analyses compared demographic and clinical factors based on insomnia severity classifications. Relative to patients without impaired sleep, those classified as having
mild insomnia had significantly worse pain interference, anxiety, depression, and PTSD symptom severity. These relationships were further amplified in the moderate/severe sleep impairment
group, which also reported significantly greater pain intensity. However, no group differences were found related to Carboxy-THC concentration, reflecting previous consumption characteristics.
Multivariable linear regression examined variables associated with insomnia severity; PTSD, depression, and pain interference were associated with insomnia, with no effect of cannabis
consumption.
Conclusions: These findings suggest that in a sample of Veterans prescribed long-term opioid therapy with past month cannabis use, THC consumption may not be associated with insomnia
symptoms. Future research should examine a possible threshold effect of cannabis dose on insomnia symptoms.
Help enhance Veteran care by forwarding this research article to your colleagues.
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