The Rate of Chronic Pain in the US & Adolescents And Cannabis Use

CF 283: The Rate of Chronic Pain in the US & Adolescents And Cannabis Use


Today we’re going to talk about The Rate of Chronic Pain in the US & Adolescents And Cannabis Use


But first, heres that sweet sweet bumper music


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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.


We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers.


I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together.


Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smart, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at


If you haven’t yet I have a few things you should do.

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
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You have found yourself smack dab in the middle of Episode #283


Now if you missed last week’s episode, we talked about new dietary ideas and how the doctor’s words matter. Make sure you don’t miss that info. Keep up with the class.


On the personal end of things…..

Summer is upon us and let’s talk about what happens in the Summer, you and your patients typically go places. When school is away, people tend to go out and play.


I’d be lying if I didn’t share that I have a little anxiety about it. Here’s why, if you listen regularly here, you know I’ve been a little slow this year and kind of hating life as a result. I’m very growth minded. Maybe life is just telling me to slow down, I don’t know. But, it’s looking like things are picking up. And what’s the quickest way to kill your momentum, yeah…..take days off. Of course.


With that being said, I have a trip to Boston in a couple of weeks. I’m only missing 2 days but it is what it is. My daughter was invited to a future medical professionals conference out there and you just have to go.


Then, we have an Alaskan cruise in late July early August. That’s a WEEK off and I’m so anxious about this.


Then in September, we have a front row seats for my wife’s favorite band on her birthday, it’s a Trane concert in Charleston, SC and the night before that, we’ll be at a Savannah Bananas game in Savannah, GA.


So here’s my thought process. In 10 years, I won’t remember the patients I saw in my clinic if I had stayed in town and not taken these trips. But I’ll always remember my daughter going to the conference in Boston. I’ll always remember the Alaskan cruise that we took. And I’ll always remember The Savannah/Charleston trip.


I guess my point is, we can experience only our clinic or we can experience life. Responsibly! You can’t abandon the responsibilities but life isn’t life if we’re not partaking in it. I’m all about my patients but I spent years and years so concerned about numbers that I lost sanity on some level. I’m still concerned about numbers.


Don’t get me wrong. I’m at 150 a week now instead of my usual 185-190 a week. That’s a solid hit folks but, I can hunker down and lose my mind about a practice that has shrunk a bit, or I can say it is what it is and I can keep on cooking but also stay busy living.


I’m going on my trips. My patients are going to go on their trips too. I’m going to freak out about being gone a little bit. It’s just going to happen. It’s going to be really slow when I get back and you know what? It’s going to be OK because my clinic has a reputation and the patients will continue to come.


So, if you’re where I’m at and you have some anxiety about taking trips with your family and enjoying your people, get your butt out fo the clinic and enjoy yourself. We only get one spin on the Earth. Let’s do it and let’s not worry about it.




Item #1


The first one today is called Nondisordered Cannabis Use Among US Adolescents” by Ryan S. Sultan et al and published in JAMA Network Open on May 3, 2023. Dayum. That’s hot.




Why They Did It


To describe the prevalence and demographics of nondisordered cannabis use and to compare associations of cannabis use with adverse psychosocial events among adolescents with no cannabis use, of nondisordered cannabis use, and cannabis use disorder.


How They Did It


This cross-sectional study used a nationally representative sample derived from the 2015 to 2019 National Survey on Drug Use and Health. Participants were adolescents aged 12 to 17 years, separated into 3 distinct groups: nonuse (no recent cannabis use), of nondisordered cannabis use (recent cannabis use below diagnostic threshold), and cannabis use disorder.


Analysis was conducted from January to May 2022.



What They Found


  • The 68 263 respondents) included in the analysis represented an estimated yearly mean of 25 million US adolescents during 2015 to 2019.
  • Among respondents, 1675 adolescents had cannabis use disorder, 6971 adolescents had of nondisordered cannabis use, and 59 617 adolescents reported nonuse.
  • Compared with nonusers, individuals with of nondisordered cannabis use had approximately 2 to 4 times greater odds of all adverse psychosocial events examined, including major depression, suicidal ideation, slower thoughts, difficulty concentrating, truancy, low grade point average, arrest, fighting, and aggression.
  • Prevalence of adverse psychosocial events was greatest for adolescents with cannabis use disorder, followed by of nondisordered cannabis use, then nonuse



Wrap It Up


In this cross-sectional study of US adolescents, past-year of nondisordered cannabis use was approximately 4 times as prevalent as past-year cannabis use disorder. A stepwise gradient association was observed for odds of adverse psychosocial events between adolescent of nondisordered cannabis use and cannabis use disorder. In the context of US normalization of cannabis use, prospective research into of nondisordered cannabis use is necessary.



Before getting to the next one,


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Item #2


Our last one this week is called, “Estimated Rates of Incident and Persistent Chronic Pain Among US Adults, 2019-2020” by Richard L. Nahin, MPH; Termeh Feinberg, MPH; Flavia P. Kapos, DDS, M; et al published in JAMA Network Open on May 16, 2023. Hot potato!



Why They Did It


To estimate rates of chronic pain and high-impact chronic pain (HICP) incidence and persistence in US adults across demographic groups.


How They Did It


  • This cohort study examined a nationally representative cohort with 1 year of follow-up.
  • Data from the 2019-2020 National Health Interview Survey (NHIS) Longitudinal Cohort were used to assess the incidence rates of chronic pain across demographic groups.


  • The cohort was created using random cluster probability sampling of noninstitutionalized civilian US adults 18 years or older in 2019.


  • Of the 19 081, the final analytic sample of 10 415 adults also participated in the 2020 NHIS. Data were analyzed from January 2022 to March 2023.


What They Found


  • Among 10 415 participants included in the analytic sample, 51.7% were female, 54.0% were aged 18 to 49 years, 72.6% were White, 84.5%were non-Hispanic or non-Latino, and 70.5% were not college graduates.


  • Among pain-free adults in 2019, incidence rates of chronic pain and high-impact chronic pain in 2020 were 52.4 and 12.0 cases per 1000 PY, respectively.


  • The rates of persistent chronic pain and persistent high-impact chronic pain in 2020 were 462.0 and 361.2 cases per 1000 PY, respectively.


Wrap It Up


In this cohort study, the incidence of chronic pain was high compared with other chronic diseases. These results emphasize the high disease burden of chronic pain in the US adult population and the need for early management of pain before it becomes chronic.



Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.


Let’s get to the message. Same as it is every week.




Remember the evidence-informed brochures and posters at



Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you cant beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.


When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.


It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient.


And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!


Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….


Thats Chiropractic!



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We cant wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.




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About the Author & Host

Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger



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