Cross-sectional comparison of cannabis use in adults with neuropathic versus non-neuropathic pain

Carl Joshua P Laroya; Crystal Lederhos Smith; Ross J Bindler; Michael G McDonell; Jamie Lewis; Marian Wilson

doi:10.3389/fpain.2025.1677391

Cross-sectional comparison of cannabis use in adults with neuropathic versus non-neuropathic pain

Front Pain Res (Lausanne). 2025 Dec 18:6:1677391. doi: 10.3389/fpain.2025.1677391. eCollection 2025.

Authors

Carl Joshua P Laroya^{1

2}, Crystal Lederhos Smith², Ross J Bindler³, Michael G McDonell², Jamie Lewis^{2

4}, Marian Wilson³

Affiliations

¹ Northwest Spine and Pain Medicine, Spokane, WA, United States.
² Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States.
³ College of Nursing, Washington State University, Spokane, WA, United States.
⁴ Northwest Center for Regenerative Medicine, Northwest Spine and Pain Medicine, Spokane, WA, United States.

Abstract

Introduction: Cannabis has been decriminalized by many states and shows promise in treating both neuropathic and non-neuropathic pain through its interaction with the endocannabinoid system and anti-inflammatory effects. This study examines differences in cannabis use for adults whose most bothersome chronic pain condition is neuropathic vs. non-neuropathic.

Materials and methods: Survey data were collected from adults receiving care at a pain clinic. Participants completed demographic questions and standardized self-report measures (PROMIS Pain Intensity/Interference and the ID-Pain tool). Participants' most bothersome pain condition(s) were categorized as neuropathic or non-neuropathic pain based on ID-Pain scores. Linear regression models assessed differences in frequency and duration of cannabis product use between groups, adjusting for age and sex.

Results: A total of 113 individuals were recruited; following exclusions and missing data, 104 participants (61.5% female) were included in the final analysis. Of these, 36.5% reported neuropathic pain as their most bothersome, and 63.5% reported non-neuropathic pain. Those with neuropathic pain reported significantly more days per month of Tetrahydrocannabinol/Cannabidiol (THC/CBD) combination (b = 5.96, p = 0.02), Cannabidiol-only (CBD-only) (b = 8.82, p = 0.03), and Tetrahydrocannabinol-only (THC-only) products (b = 7.04, p = 0.02). They also used THC-only (b = 0.97, p < 0.05) and THC/CBD (b = 1.09, p < 0.01) products more frequently per day. Neuropathic pain was positively associated with pain intensity (b = 4.10, p < 0.001) and interference (b = 4.95, p < 0.001).

Discussion: Adults whose most bothersome pain condition(s) were neuropathic used cannabis, especially THC and THC/CBD combination products, more frequently than those whose most bothersome pain was non-neuropathic. Participants with neuropathic pain also reported higher levels of pain intensity and interference. Further longitudinal research is needed to confirm whether increased use of THC-rich cannabis provides symptom relief for adults with neuropathic pain.

Keywords: PROMIS; cannabidiol; cannabis; cannabis use patterns; chronic pain; neuropathic pain; pain management; tetrahydrocannabinol.

Grants and funding

S06 GM142130/GM/NIGMS NIH HHS/United States