Cannabis prescribed for pain linked with risk of heart disorders: Study

Barcelona: According to research, cannabis which is used to treat chronic pain is connected with an increased risk of heart rhythm abnormalities. The findings of the study were published in the European society of cardiology. Study author Dr. Nina Nouhravesh of Gentofte University Hospital, Denmark said: "Chronic pain is a rising problem. According to Danish health authorities, 29 percent of Danish adults over 16 years of age reported chronic pain in 2017, up from 19 percent in 2000. Medical cannabis was approved in January 2018 on a trial basis in Denmark, meaning that physicians can prescribe it for chronic pain if all other measures, including opioids, have proven insufficient. Safety data are sparse, hence this study investigated the cardiovascular side effects of medical cannabis, and arrhythmias in particular, since heart rhythm disorders have previously been found in users of recreational cannabis."

Medical cannabis comes in various formulations depending on tetrahydrocannabinol (THC) and cannabidiol (CBD) levels. Dronabinol (high THC), cannabinoid (more THC than CBD), and cannabidiol (high CBD) can be prescribed in Denmark. The drug can be inhaled, eaten, or sprayed in the mouth.

The researchers identified a total of 1.6 million patients diagnosed with chronic pain in Denmark between 2018 and 2021. Of those, 4,931 patients (0.31 per cent) claimed at least one prescription of cannabis (dronabinol 29 percent, cannabinoids 46 percent, cannabidiol 25 percent).

Each user was matched by age, sex and pain diagnosis to five non-users with chronic pain who acted as controls. Users and controls were followed for 180 days and their risks of new cardiovascular conditions were compared.The median age of participants was 60 years and 63 percent were women. The study reports, for the first time, the chronic pain conditions of medical cannabis users in Denmark. Some 17.8 percent had cancer, 17.1 percent arthritis, 14.9 percent back pain, 9.8 percent neurological diseases, 4.4 percent headaches, 3.0 percent complicated fractures, and 33.1percent other diagnoses (mostly unspecified chronic pain).

The absolute risk of new-onset arrhythmia was 0.86 percent in medical cannabis users compared with 0.49 percent in non-users, for a relative risk of 1.74.

The risks of the new-onset acute coronary syndrome and heart failure did not differ between the two groups. The results were similar for each chronic pain condition and each type of medical cannabis.Dr. Nouhravesh said: "Our study found that medical cannabis users had a 74 per cent higher risk of heart rhythm disorders compared with non-users; however, the absolute risk difference was modest.

It should be noted that a higher proportion of those in the cannabis group were taking other pain medications, namely non-steroidal anti-inflammatory drugs (NSAIDs), opioids and anti-epileptics, and we cannot rule out that this might explain the greater likelihood of arrhythmias."

She concluded: "Since medical cannabis is a relatively new drug for a large market of patients with chronic pain, it is important to investigate and report serious side effects. This study indicates that there may be a previously unreported risk of arrhythmias following medical cannabis use. Even though the absolute risk difference is small, both patients and physicians should have as much information as possible when weighing up the pros and cons of any treatment."