Medical Cannabis Use Declines Rapidly Among Older Adults with Chronic Pain, Study Finds
Table of Contents
A significant majority of patients prescribed medical cannabis for chronic musculoskeletal pain discontinue treatment within the first year, with age emerging as the most prominent factor influencing long-term use, according to research published August 7, 2025, in PLOS ONE. The findings raise questions about the sustained efficacy of cannabis as a long-term pain solution, particularly for older individuals.
More than half of patients—57.9%—stopped using medical cannabis within twelve months of receiving certification, a retrospective review of 78 patients in Pennsylvania revealed. This trend was particularly pronounced in the initial months of treatment, with nearly 45% ceasing use within the first three months.
Age, Not Pain, Dictates Continuation
Researchers at the Rothman Institute Foundation for Opioid Research & Education followed patients newly certified through Pennsylvania’s medical marijuana program over a two-year period to assess treatment continuation rates. The study revealed a striking correlation between age and discontinuation. Patients who stopped using cannabis were, on average, approximately seven years older than those who continued treatment—71.5 years compared to 64.5 years.
Notably, baseline physical and mental health, as measured by PROMIS Global Health scores, did not significantly differ between the two groups. This suggests that pre-existing health conditions were not a primary driver of the decision to discontinue cannabis therapy.
Pain Type Plays a Limited Role
Contrary to expectations, the location of a patient’s pain—whether in the lower back, neck, joints, or elsewhere—did not significantly influence their decision to stop treatment. While a slightly higher proportion of those who discontinued reported low back pain, the difference was not statistically significant.
“These results suggest that factors beyond the specific type of pain are at play,” explained a senior researcher involved in the study. “Dissatisfaction with treatment, unwanted side effects, or the pursuit of more definitive interventions like injections or surgery may be more influential.”
Concerns About Long-Term Efficacy
The high rate of discontinuation underscores the limitations of medical cannabis as a long-term pain management strategy for a substantial portion of patients. As one co-author, Dr. Asif M. Ilyas, emphasized, “Despite growing enthusiasm and widespread adoption, medical cannabis does not meet expectations for a significant subset of chronic pain patients.”
Lead author Dr. Mohammad Khak added that factors such as perceived benefit, daily functioning, the cost of treatment, and the consistency of product quality likely play a crucial role in determining whether patients remain on cannabis therapy.
Further Research Needed
The authors acknowledge limitations in their study, including a relatively small sample size drawn from a single institution. Crucially, detailed information regarding cannabis formulation, dosage, method of delivery, and patient-reported side effects or improvements was not consistently documented. This lack of granular data makes it difficult to pinpoint the precise reasons for discontinuation. A chart illustrating the breakdown of reasons for discontinuation would be highly valuable here.
The research team calls for larger, multi-center, prospective studies that collect more comprehensive data on these variables. Such studies are essential to identify which patients are most likely to benefit from medical cannabis and for how long. Until then, physicians and patients should approach long-term cannabis therapy with realistic expectations and a willingness to adjust treatment plans based on individual responses.
Reference: “Discontinuation rates and predictors of Medical Cannabis cessation for chronic musculoskeletal pain” by Mohammad Khak, Sina Ramtin, Juliet Chung, Asif M. Ilyas and Ari Greis, 7 August 2025, PLOS ONE. DOI: 10.1371/journal.pone.0329897.
