Severe pain linked to more cannabis, cigarette use in Ehlers-Danlos patients
Study: Further research needed to understand pain/substance use relationship
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People with Ehlers-Danlos syndrome (EDS) or generalized hypermobility spectrum disorder (HSD) who experience more severe pain tend to use more cannabis and cigarettes, according to a study by researchers in Canada.
The study, “Associations Between Pain and Substance Use Among Individuals Diagnosed with Ehlers-Danlos Syndromes or Generalized Hypermobility Spectrum Disorder,” was published as a brief report in the International Journal of Behavioral Medicine.
Nearly half of participants used cannabis
EDS and generalized HSD are conditions of the connective tissue that share many symptoms. They both cause hypermobile joints, or joints that bend beyond the normal range of motion, and patients often experience long-lasting pain.
Pain can lead to situations of substance use “as a form of self-medication,” the researchers wrote. However, not many studies have focused on EDS and generalized HSD. In this study, the researchers looked at how patients with these conditions experience pain and whether they use substances such as alcohol, cannabis, tobacco, or prescription opioids.
The researchers reviewed the medical charts from 533 patients at the GoodHope EDS Clinic in Toronto, Canada. Most patients were women (88.9%), with an average age of 33.7 years. Most had generalized HSD (76.9%), while the others had either hypermobile EDS (15.2%) or other types of EDS (7.9%).
More than half of the patients (up to 56.9%) reported moderate to severe pain — scoring above four points on a scale from 0 to 10 — that affected their daily lives.
Longitudinal [over a period of time] studies are needed to determine if pain is a motivator for cannabis/cigarette use and/or if persistent use exacerbates pain in this population.
Alcohol use was common (58.5%). While patients consumed a median of one drink per week, a smaller proportion (11.8%) had seven or more. Nearly half (48.2%) currently used cannabis, and about two-thirds (68.6%) did it four or more times per week. Fewer patients were smoking cigarettes (14.3%) or were prescribed opioids (17.6%).
More severe or disruptive pain was linked to more frequent or heavier use of cannabis, opioids, and cigarettes. The opposite was observed for alcohol, with more severe or disruptive pain being tied to less alcohol drinking.
No differences regarding substance use behaviors were observed between the EDS and generalized HSD groups.
People with EDS or generalized HSD “experience high rates of pain,” the researchers wrote. “Results from the current study suggest they also engage in alcohol, cannabis, and some cigarette use. Longitudinal [over a period of time] studies are needed to determine if pain is a motivator for cannabis/cigarette use and/or if persistent use exacerbates pain in this population,” they concluded.
