Navigating chronic pain: aqualitative inquiry of experiences, impacts and treatments among medical cannabis patients in Pennsylvania

Abstract Background Most conditions that qualify for medical cannabis in Pennsylvania are marked by pain symptoms. However, little is known about how specific cannabis practices and other treatments interrelate and vary depending on types of pain. Methods Patients (42.6% male, n = 1,201) aged 18-78-year-old with a current certification for medical cannabis in Pennsylvania were surveyed between 2021 and 2025. Demographic data and the date of pain related diagnosis were extracted from the baseline quantitative survey. A subsample was administered semi-structured qualitative interviews between 2021 and 2022 while analysis was limited to patients who used cannabis to address pain symptoms ( n = 22). The qualitative interview guide included questions on pain experiences, diagnosis and treatments, including cannabis, prescribed and over-the-counter-medications, and other treatments. Thematic analysis was utilized for qualitative data. Results Navigating chronic pain among cannabis patients involved these four stages: (1) Pain experiences and impacts: many suffered from debilitating chronic pain for years and decades which interfered with daily functioning and sense of well-being; (2) Chronic pain treatment with pharmaceuticals: chronic use of pain medications was associated with various health complications leading to considering medical cannabis as a treatment option where healthcare providers were generally supportive of medical cannabis for chronic pain management; (3) Chronic pain management with medical cannabis: patients with pain developed a complex regimen of using cannabis forms with a specific terpene and minor cannabinoid content depending on type of pain (e.g., oral forms high in CBG and caryophyllene for stomachache, topicals for musculoskeletal pain), where THC concentrations were not paramount; (4) Alternative treatments: some patients resorted to alternative treatments as auxiliary modality to pharmaceuticals and medical cannabis. Conclusions Perceived pain relief with medical cannabis and/or in combination with other treatments varied according to cannabis forms, terpene and minor cannabinoid content and pain type. Our exploratory qualitative study demonstrates that effective chronic pain management may include multiple treatment modalities (e.g., pharmaceuticals, cannabis and aromatherapy) to ensure satisfactory quality of life in patients living with chronic pain.