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Li ZI, Chalem I, Berzolla E, Vasavada KD, DeClouette B, Kaplan KM, Alaia MJ. Perceptions and Opinions on Cannabidiol in the Orthopaedic Sports Medicine Community. Orthop J Sports Med 2023; 11:23259671231191766. [PMID: 37745814 PMCID: PMC10517622 DOI: 10.1177/23259671231191766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 05/03/2023] [Indexed: 09/26/2023] Open
Abstract
Background Cannabidiol (CBD) is a known pain modulator that is garnering increased attention in the orthopaedic world. There may be a considerable knowledge gap among orthopaedic sports medicine providers and their perception of its therapeutic value. Purpose To (1) examine the knowledge and beliefs of sports medicine orthopaedic providers with respect to CBD, (2) deliver an educational component, and (3) elucidate potential barriers to its widespread application. Study Design Cross-sectional study. Methods A 3-component, 25-question online survey was distributed to members of the American Orthopaedic Society for Sports Medicine and the Arthroscopy Association of North America between July and October 2022. The first 20 questions assessed baseline knowledge and opinions regarding CBD, followed by an educational component, and then 5 questions assessing whether the respondents' opinions had changed after learning more about CBD. Responses were compared according to age, practice setting, and state's cannabinoid legalization status using the chi-square test, and changes in opinions from before to after the educational component were compared using the paired t test. Results There were 101 survey responses, for a response rate of approximately 1%. Most respondents believed that there is a role for CBD in postoperative pain management (76%), acute pain and inflammation after an injury (62%), and chronic pain (94%). Most respondents admitted that they were not knowledgeable about the mechanism of action (89%) or their state's laws (66%) concerning CBD. A minority (25%) believed that CBD has psychoactive properties. While most respondents (76%) did not believe that they would be stigmatized if they were to suggest CBD to a patient, only 48% had ever suggested CBD. Notably, 94% of respondents had encountered patients who reported trying CBD to treat pain. After reading the fact sheet, 51% of respondents stated that their opinion on CBD had changed, and 63% felt inclined to investigate the topic further. Conclusion Most survey respondents believed that CBD has a role in postoperative and chronic pain management. Although there was a relative familiarity with CBD, there was a knowledge gap, suggesting that increased attention, education, and research are necessary.
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Affiliation(s)
- Zachary I. Li
- Department of Orthopedic Surgery, New York University Langone Health, New York, New York, USA
| | - Isabel Chalem
- Department of Orthopedic Surgery, New York University Langone Health, New York, New York, USA
| | - Emily Berzolla
- Department of Orthopedic Surgery, New York University Langone Health, New York, New York, USA
| | - Kinjal D. Vasavada
- Department of Orthopedic Surgery, New York University Langone Health, New York, New York, USA
| | - Brittany DeClouette
- Department of Orthopedic Surgery, New York University Langone Health, New York, New York, USA
| | - Kevin M. Kaplan
- Jacksonville Orthopaedic Institute, Jacksonville, Florida, USA
| | - Michael J. Alaia
- Department of Orthopedic Surgery, New York University Langone Health, New York, New York, USA
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Yang A, Townsend CB, Ilyas AM. Medical Cannabis in Hand Surgery: A Review of the Current Evidence. J Hand Surg Am 2023; 48:292-300. [PMID: 36609049 DOI: 10.1016/j.jhsa.2022.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 08/21/2022] [Accepted: 11/09/2022] [Indexed: 01/06/2023]
Abstract
Acute and chronic pain management remains an ongoing challenge for hand surgeons. This has been compounded by the ongoing opioid epidemic in the United States. With the increasing legalization of medical and recreational cannabis throughout the United States and other countries, previous societal stigmas about this substance keep evolving, and recognition of medical cannabis as an opioid-sparing pain management alternative is growing. A review of the current literature demonstrates a strong interest from patients regarding the use of medical cannabis for pain control. Current evidence demonstrates its efficacy and safety for chronic musculoskeletal and neuropathic pain. However, definitive conclusions regarding the efficacy of cannabis for pain control in hand and upper extremity conditions require continued investigation. The purpose of this article is to provide a general review of the mechanism of medical cannabis and a scoping review of the current evidence for its efficacy, safety, and potential applicability in hand and upper extremity conditions.
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Affiliation(s)
- Andrew Yang
- Rothman Institute at Thomas Jefferson University, Philadelphia, PA
| | - Clay B Townsend
- Rothman Institute at Thomas Jefferson University, Philadelphia, PA
| | - Asif M Ilyas
- Rothman Institute at Thomas Jefferson University, Philadelphia, PA; Rothman Orthopaedic Institute Foundation for Opioid Research & Education, Philadelphia, PA.
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Chin G, Etiz BAF, Nelson AM, Lim PK, Scolaro JA. Cannabinoids for Pain Modulation in Orthopedic Surgery. Orthopedics 2022; 45:e295-e302. [PMID: 35858162 DOI: 10.3928/01477447-20220706-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Cannabinoid compounds are being increasingly used as an analgesic adjuvant in the orthopedic population, but little data exist to either support or oppose this practice pattern. A review of all contemporary (2000-2020) studies on the use of cannabinoids in orthopedics is presented. Physicians and patients are optimistic that cannabinoids can decrease pain scores and perhaps opioid use; however, their application in orthopedics is not well characterized. In addition to the social stigma regarding the use of cannabis, there is limited high-quality evidence of the efficacy of cannabinoids in treating orthopedic-related pain. As cannabis becomes more accessible, well-designed trials are needed to better understand cannabinoids and guide orthopedic practice. [Orthopedics. 2022;45(6):e295-e302.].
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Chin G, Etiz BAF, Nelson AM, Lim PK, Scolaro JA. Knowledge and Opinion on Cannabinoids Among Orthopaedic Traumatologists. J Am Acad Orthop Surg Glob Res Rev 2021; 5:01979360-202104000-00006. [PMID: 33872227 PMCID: PMC8057750 DOI: 10.5435/jaaosglobal-d-21-00047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/22/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Cannabinoids are an increasingly popular therapy among orthopaedic patients for musculoskeletal conditions. A paucity of evidence to support their use in orthopaedics exists, likely because of the incongruence of federal and state legalization and the stigma surrounding cannabis. The purpose of this study is to elucidate sentiments and knowledge base of the orthopaedic trauma community with regard to cannabinoid-containing compounds. METHODS A 21-question online survey was distributed to the members of the Orthopaedic Trauma Association with a response window of 3 months. RESULTS We evaluated 251 responses. Most (88%) of the respondents did not believe that they were knowledgeable about the mechanism of action of cannabis/cannabidiol (CBD) but did feel that cannabis or CBD products play a role in managing postoperative pain (73%). Most respondents did not believe that they would be stigmatized if they suggested CBD (83%) or cannabis (67%) to patients. Despite this, fewer respondents have suggested CBD (38%) or cannabis (29%) to their patients. CONCLUSIONS Sentiment toward cannabinoids among orthopaedic traumatologists is remarkably favorable; however, in-depth understanding is admittedly poor and routine use is uncommon. More clinical research for cannabinoids is needed to help orthopaedic traumatologists provide guidance for patients seeking advice for this recently popular therapeutic.
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Affiliation(s)
- Garwin Chin
- From the Department of Orthopaedic Surgery, University of California, Irvine, CA (Dr. Chin, Dr. Lim, and Dr. Scolaro), Orange, CA; the University of California, Irvine School of Medicine, Irvine, CA (Mr. Etiz); and the Department of Anesthesiology and Perioperative Care, Division of Pain Medicine, University of California (Dr. Nelson), Irvine, Orange, CA
| | - Brent A. F. Etiz
- From the Department of Orthopaedic Surgery, University of California, Irvine, CA (Dr. Chin, Dr. Lim, and Dr. Scolaro), Orange, CA; the University of California, Irvine School of Medicine, Irvine, CA (Mr. Etiz); and the Department of Anesthesiology and Perioperative Care, Division of Pain Medicine, University of California (Dr. Nelson), Irvine, Orange, CA
| | - Ariana M. Nelson
- From the Department of Orthopaedic Surgery, University of California, Irvine, CA (Dr. Chin, Dr. Lim, and Dr. Scolaro), Orange, CA; the University of California, Irvine School of Medicine, Irvine, CA (Mr. Etiz); and the Department of Anesthesiology and Perioperative Care, Division of Pain Medicine, University of California (Dr. Nelson), Irvine, Orange, CA
| | - Philip K. Lim
- From the Department of Orthopaedic Surgery, University of California, Irvine, CA (Dr. Chin, Dr. Lim, and Dr. Scolaro), Orange, CA; the University of California, Irvine School of Medicine, Irvine, CA (Mr. Etiz); and the Department of Anesthesiology and Perioperative Care, Division of Pain Medicine, University of California (Dr. Nelson), Irvine, Orange, CA
| | - John A. Scolaro
- From the Department of Orthopaedic Surgery, University of California, Irvine, CA (Dr. Chin, Dr. Lim, and Dr. Scolaro), Orange, CA; the University of California, Irvine School of Medicine, Irvine, CA (Mr. Etiz); and the Department of Anesthesiology and Perioperative Care, Division of Pain Medicine, University of California (Dr. Nelson), Irvine, Orange, CA
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