Cannabis use in the management of endometriosis-related pain during the COVID19 pandemic

The survey study reveals cannabis consumption is increasingly used for pain management during the pandemic by endometriosis patients

Key Points

Highlight

• Self pain management methods such as cannabis consumption for endometriosis patients have become popular because routine healthcare access was impossible during the COVID19 pandemic.

Importance

• During the pandemic, endometriosis patients were affected by the lack of access to healthcare, delayed surgeries, and lack of access to prescriptions for their symptom relief.
• Cannabis consumption as a self pain management option in endometriosis patients increased during the pandemic.

What is done here

• This is a cross-sectional survey study performed on patients with endometriosis aging from 18 to 65 years.
• It aimed to investigate the cannabis use patterns, access to cannabis, and the patients' quality of life during the pandemic.

Key results

• There were a total of 1634 patients participated in the survey.
• The most reported symptoms were fatigue, dysmenorrhea, and chronic pelvic pain.
• Cannabis was reported to be used in the last 12 weeks by half of the participants.
• Those using cannabis legally were more likely to tell their healthcare professionals about the usage.
• Cannabis consumption was seen to be increased during the pandemic, with inhaler forms being preferred less. 
• The health-related quality of life of the cannabis users was significantly higher than that of non-users, according to the EHP-30 questionnaire.  

Strengths & Limitations

• Strengths of the study included the large sample size, international dissemination of the survey, and the anonymous nature.
• Limitations were not being able to gather proof of diagnosis, a non-response selection bias, and a recall bias.

Lay Summary

Pain management in endometriosis has been challenging owing to many reasons. Since the pathways that cause pain in endometriosis have not been elucidated extensively, the medical and surgical management of pain remains to be symptomatic. Alternative pain management methods have also been investigated to provide a better quality of life. With the decrease in health care access due to the COVID-19 pandemic, self-management of pain control has been a part of those suffering from endometriosis pain. Cannabis consumption has been one of the self-management methods that endometriosis patients have been using to control their symptoms.

Armour et al. from Australia, New Zealand, and Canada have applied an online cross-sectional survey to endometriosis patients worldwide and aimed to investigate the cannabis use patterns, access to cannabis, and patient's quality of life during the early periods of the COVID19 pandemic. The survey results were published in the January 2022 issue of the journal Cannabis and Cannabinoid Research.

There were a total of 1634 endometriosis patients that took the survey, with a median age of 30.7 years. The most reported symptoms were fatigue, dysmenorrhea, and chronic pelvic pain. Half of the patients reported using cannabis for symptom relief in the last 12 weeks. About 35% of these people said they were using cannabis illegally. The legality of access and using cannabis were found to be associated. The people who were using cannabis with legal access were more likely to tell their healthcare professionals about the usage. The majority of the cannabis users preferred inhaled forms before the pandemic, whereas many users started using edible or oil forms after the pandemic began, primarily due to concerns for their respiratory health. More than half of the people reported that their cannabis consumption increased during the pandemic. The most common reasons for cannabis consumption during the pandemic were increased stress and anxiety, lack of access to routine healthcare, and delayed surgery. The health-related quality of life of the cannabis users was significantly higher than that of non-users, according to the EHP-30 questionnaire.  

The authors then discussed the legal barriers to cannabis consumption for pain relief, its consequences in countries where the usage is still illegal, and the cost-effectiveness of using cannabis in pain management. It was concluded that cannabis consumption might become important in endometriosis management, particularly when there are restrictions on standard medical care.

Research Source: https://pubmed.ncbi.nlm.nih.gov/35089093/