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American Association for Hand Surgery

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Hand Surgery Patient Perspectives on Medical Cannabis: A Survey of over 680 Patients
Asif M Ilyas, MD, Orthopaedics, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA

INTRODUCTION: Acute, traumatic, and chronic musculoskeletal pain in the hand and upper extremity often requires pain management with opioids. Medical cannabis (MC) has potential as being an alternative to opioids for chronic pain conditions. In the United States, approximately 33 states have legalized cannabis for medical purposes. However, the efficacy of MC for various musculoskeletal complaints remains unclear, particularly for the hand and upper extremity. Moreover, patient awareness and knowledge for medical cannabis for such complaints is also poorly understood.

METHODS: A seventeen-question anonymous cross-sectional survey study with sub-questions was administered to an adult orthopaedic population during outpatient office appointments for hand and upper extremity complaints. Questions addressed significant topics such as current knowledge of legal status, safety, efficacy, cost, treatable conditions, and barriers to access. Sub-questions queried the use of MC as an alternative treatment modality to opioid prescription medications and types of conditions amendable to treatment.

RESULTS: The survey was completed by 680 individuals (57% female and 43% male) during routine office visits, with an average age of 52. Approximately 10% of individuals reported actively using MC for medical treatment. Overall, 53% believed that MC should be nationally legal for medical conditions. Of the individuals not currently using MC, 81% would consider using it for chronic pain. When considering the safety in using MC for musculoskeletal problems, 43% strongly agreed with MC use and 31 % expressed a moderate consideration. Only 10% would not consider using MC at all for any treatment. In comparing MC to prescription opioids for chronic pain, 49% strongly agreed and 25% agreed that MC was safer than opioids. Cost was perceived as a barrier to treatment, as 91% opined that cannabis should be covered by insurance. When priced at $100/month of treatment, 60% of individuals surveyed felt that this was too expensive.

CONCLUSION: This survey study revealed that currently 10% of surveyed individuals seeking hand and upper extremity complaints are already using MC for a medical diagnosis, while the majority felt that MC should be legalized nationally. However, the majority of those surveyed felt current MC costs and lack of insurance coverage is a barrier to use, and approximately 10% surveyed would not consider using MC for any medical diagnosis.

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