{"doi":"10.1001/jamanetworkopen.2025.12870","title":"Prevalence Rates, Perceptions of Risk, and Motivations for Nonmedical Cannabis Use in Pediatric Pain","abstract":"Importance: Characterizing cannabis use (CU) rates in pediatric pain is critical as adolescence is a period of increased substance use and risk for negative outcomes. Youths with chronic pain may engage in CU to cope with symptoms. Objective: To examine CU rates, risk perceptions, and motivations for use among treatment-seeking youths with diagnosed pain disorders. Design, Setting, and Participants: Cross-sectional survey study conducted from September 2021 to May 2024 at a pain treatment clinic at a pediatric hospital in the Northeast United States. Participants were 251 adolescents receiving treatment for diagnosed pain conditions. Of 312 approached, 40 did not complete the survey; 17 were excluded. Exposures: Validated self-report measures assessing demographics, pain, and substance use. Main Outcomes and Measures: CU rates, motivations for use, and perceived risks. Results: Of 245 adolescents providing complete data (mean [SD] age 16.9 [1.4] years; 168 [68.6%] female; 1 [0.4%] American Indian, 3 [1.2%] Asian, 3 [1.2%] Black, 19 [7.8%] Hispanic or Latino, and 201 [82.1%] White), 62 (25.3%) endorsed lifetime CU, with a mean (SD) age at first use of 15.3 (1.9) years. Among those endorsing CU, past-year prevalence was 90.2% (56 of 62 participants) and past-month prevalence was 64.5% (40 of 62 participants). The CU group was older (mean difference, 0.9 years; 95% CI, 0.5 to 1.2 years; P < .001), included fewer female participants (difference, -14.0%; 95% CI, -32.6% to -2.9%; P = .03), and reported greater pain interference scores (mean difference, 2.7; 95% CI, 0.8-4.6; P = .01) and depressive symptoms scores (mean difference, 6.2; 95% CI, 2.8-9.5; P < .001) compared with the no CU group. The no CU group perceived cannabis as riskier (odds ratio, 2.37; 95% CI, 1.28-4.39; P = .01). Among youths endorsing CU, 48 of 62 (77.4%) endorsed instrumental use (IU) to alleviate psychological or physical symptoms (primarily pain, sleep, and anxiety), representing an overall IU prevalence of 19.6% (48 of 245 participants). Youths reporting IU were younger (mean difference, -0.7 years; 95% CI, -1.3 to -0.1 years; P = .04) and reported greater functional disability scores (mean difference, -8.4; 95% CI, 2.1 to 12.6; P = .01) compared with the no IU group. Conclusions and Relevance: In this cross-sectional study, approximately 25% of treatment-seeking youths with chronic pain reported CU, with more than 75% using cannabis instrumentally to treat symptoms despite limited evidence supporting cannabis for pain, sleep, or anxiety. Given CU rates in this population, education about the risks of self-medication and the development of alternative coping strategies are needed.","journal":"JAMA Network Open","year":2025,"id":532450,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9358,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1413611,"name":"Christine Greco","orcid":"0000-0002-9318-1159","position":1,"is_corresponding":false},{"id":784768,"name":"Bridget A. Nestor","orcid":"0000-0002-7792-3773","position":2,"is_corresponding":false},{"id":1135170,"name":"Camila Koike","orcid":"0000-0002-6728-0428","position":3,"is_corresponding":false},{"id":1023499,"name":"Nicole Tacugue","orcid":null,"position":4,"is_corresponding":false},{"id":1103181,"name":"Andreas M. Baumer","orcid":"0009-0009-1048-8066","position":5,"is_corresponding":false},{"id":809377,"name":"Elissa R. Weitzman","orcid":"0000-0003-1299-0008","position":6,"is_corresponding":false},{"id":502769,"name":"Joe Kossowsky","orcid":"0000-0002-6272-6259","position":0,"is_corresponding":true}],"reference_count":60,"raw_metadata":null,"created_at":"2026-07-19T02:51:23.237536Z","pmid":"40440015","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}