A new study suggests that fibromyalgia (FM) patients that use marijuana for medicinal relief from symptomatic widespread pain, fatigue, and insomnia suffer from poorer mental health.

Researchers at McGill University Health Center (MUHC; Montreal, Canada) documented self-reported cannabinoid use in 457 FM patients. FM diagnosis was validated, and associations and trends of self-medicating with medical marijuana or Cannabis, prescription cannabinoids, or both, were investigated. Patient pain levels were measured using the visual analog scale (VAS), functional ability was assessed with the Fibromyalgia Impact Questionnaire (FIQ), and a psychologist evaluated all FM participants for prior or current psychiatric conditions according to the Diagnostics and Statistical Manual of Mental Disorder (DSM-IV).

After FM diagnosis was confirmed in 302 participants, the other 155 patients were assigned another primary diagnosis (non-FM group), as controls. The researchers determined that 13% of all 457 participants used cannabinoids, with 80% using herbal Cannabis or marijuana; one third of all males used cannabinoids. Analysis found that 24% of cannabinoid users used prescription cannabinoids such as nabilone and dronabinol, and 3% were both herbal Cannabis and prescription cannabinoid users. Those smoking marijuana consumed up to 6 grams, with 72% reporting use of one gram or less per day.

The researchers determined that herbal Cannabis use was associated with unstable mental illness, opioid drug-seeking behavior, and male gender at 36%, 17%, and 26%, respectively compared to 23 %, 4%, and 7% for nonusers. A 77% unemployment rate was identified in herbal marijuana users, which the researchers believe may be due to ineffective pain control to improve functionality or a more serious functional disability. The study was published in the June 2012 issue of Arthritis Care & Research.

“While self-medicating with cannabinoids may provide some pain relief to FM patients, we caution against general use of illicit drugs until health and psychosocial issues risks are confirmed,” said lead author Prof. Mary-Ann Fitzcharles, MD. “Physicians should be alert to potential negative mental health issues in FM patients using illicit drugs for medical purposes. Some herbal Cannabis users may be dishonestly using a FM diagnosis to justify self-medicating with illegal drugs.”

Fibromyalgia is a common syndrome of chronic widespread soft-tissue pain accompanied by weakness, fatigue, and sleep disturbances; the cause is unknown, but FM is often seen as a rheumatic condition causing joint and soft tissue pain.

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