Can cannabis help with arthritis?

An interdisciplinary team of researchers at the University of Alberta will develop a cannabis use decision tool for the estimated 20 per cent of Canadians who live with arthritis, thanks to a $300,000 award from Alberta Innovates.

People with arthritis are more likely than others to use cannabis for pain, mood and sleep disorders, but few studies have examined whether the products are effective in treating the disease, according to one of the principal investigators, Cheryl Sadowski, professor in the Faculty of Pharmacy and Pharmaceutical Sciences.

“We don’t have the evidence to say this product is a good choice or not a good one based on your symptoms,” said Sadowski, who has noticed many of her patients have started using cannabis on their own since it was legalized in Canada in 2018. Medicinal cannabis has been allowed since 2001.

“Both patients and health professionals need tools to make decisions about what is the safest, most appropriate and most affordable use,” said Sadowski, who provides care at the geriatric outpatient clinic at Edmonton’s Misericordia Community Hospital.

“We see a lot of cannabis use in patients who have so many questions,” said co-principal investigator Elaine Yacyshyn, professor in the Faculty of Medicine & Dentistry and rheumatologist at the University of Alberta Hospital, pointing out that a major concern is that patients stop taking prescribed and proven medicines in favour of cannabis, despite the lack of evidence.

“The tool has to be patient-centric and focused on their needs, so that pharmacists and physicians and their patients can have an open discussion and make an educated decision about use,” said Yacyshyn.

The project team also includes patients, a physiotherapist, nurses, epidemiologists, students and a health economist. They will investigate how widespread cannabis use is among arthritis patients in Alberta, develop the tool using the best evidence available, and then validate it with patients and health-care professionals. Other partners include the Arthritis Society, Alberta Health Services, the Institute of Health Economics and Strainprint, a Canadian medical cannabis data company that collects consumer information.

Both Yacyshyn and Sadowski encourage people with arthritis to talk openly about the potential risks and benefits of cannabis use with their health-care team.

“Cannabis use is now part of your regular medication history,” Sadowski said. “We used to have to put it under the category of illicit use along with cocaine and excessive alcohol. Now it’s just part of a list—are you taking aspirin, are you using a laxative, are you using cannabis? Be transparent about exactly what you’re taking, why you’re taking it and how much.”

The two-year project is one of three U of A investigations funded by an Alberta Innovates initiative to address urgent clinical or policy knowledge gaps related to the efficacy and safety of cannabis in a real-world setting.

Bo Cao, assistant professor of psychiatry in the Faculty of Medicine & Dentistry, is leading a project entitled, “Predicting the risk of opioid misuses in patients using cannabis-based medicine and opioids,” which received $299,717 in funding.

Suzette Brémault-Phillips, associate professor of occupational therapy in the Faculty of Rehabilitation Medicine, is heading up a project entitled, “Understanding Medical Value and Risks for Veterans: Medicinal and Recreational Cannabis Use,” which received $300,000 in funding.