Pain Is Not a Predictor of Cannabis Use in People With Psychotic Disorders

Objective: People with a psychotic disorder are more likely to experience pain and interference from pain in their daily lives. There is also a high prevalence of cannabis use among people with psychotic disorders, which is known to be effective in pain management. This study investigates whether pain is a predictor of cannabis use in people with psychosis. Since sedating antipsychotics may also suppress pain, this is included as a covariate. Methods: This sample included 108 Dutch people with a psychotic disorder, participating in the VAT observational cohort study. Cross-sectional regression analyses were performed with cannabis use (yes/no and units per week) as outcomes, and pain and the degree of interference from pain (RAND-36-SF items 7 and 8) as predictors. Covariates included were age, sex, severity of psychosis, and use of sedating antipsychotics. Results: In this sample, 59% experienced some degree of pain and 18.5% used cannabis. Pain and interference from pain were not significant predictors of cannabis use, nor of the amount of cannabis use. However, the use of antipsychotics with low sedating effects was associated with a greater amount of cannabis use in our participants (p = .028). Conclusions: We found no direct link between pain experience and cannabis use in people with psychotic disorders. It is possible that cannabis effectively suppresses the pain, and participants using cannabis therefore did not report experiencing pain. Furthermore, our finding that participants who were prescribed antipsychotic drugs with low sedating effects use more cannabis warrants further investigation. It is possible that people with psychotic disorders who experience numbness and sedation from their antipsychotics, may be less inclined to attempt to reach these effects using cannabis, which could potentially influence the choice of prescribed antipsychotics in the treatment of psychotic disorders in the future.