How Pain Drives Cannabis Consumption Patterns

Individuals with pain may engage in pain self-management by using cannabis, increasing the risk of cannabis-related consequences. Past research has demonstrated that the presence of next-day responsibilities significantly reduced cannabis demand in regular cannabis users. This study determined the association of pain with cannabis demand, and whether pain would attenuate the effect of next-day responsibilities. This was a secondary analysis of data from a crowdsourced study of cannabis demand among regular cannabis users (N = 172, 41% women). Participants completed 2 conditions of a marijuana purchase task in counterbalanced order. In one, participants imagined they had a job interview the following morning. In the other, no interview was present. Pain was assessed using the Brief Pain Inventory. Mixed GLM analyses examined the effects of task condition (responsibility vs no responsibility) and pain intensity (a continuous measure) on demand indices, including Omax, Pmax, Intensity, Elasticity, and Breakpoint. Greater pain intensity was associated with greater Omax, Pmax, Intensity, Breakpoint, and Elasticity. Next-day responsibilities were associated with significant reductions in Breakpoint, Intensity, and Elasticity. Next-day responsibilities interacted significantly with sex and pain intensity on elasticity such that for women, pain was associated with lower elasticity in the next-day responsibilities. Consistent with models suggesting pain is a potent antecedent for substance use and highlighting the importance of effective and accessible pain management, individuals reporting greater pain exhibited both greater amplitude (as reflected by Intensity) and persistence (reflected by Omax, Pmax, and Breakpoint) of cannabis demand.