Does this study sound like something you would be interested in participating in and will you have time to make this commitment?
* must provide value
Yes
No
During the first visit, we will determine if you are eligible for the study. If you are eligible, you will be randomly assigned to a group. There are two groups of people: ACTIVE and WAITLIST CONTROL. Do you understand the difference between the two groups?
* must provide value
Yes
No
If you are randomly assigned to the WAITLIST CONTROL GROUP, will you be willing abstain from marijuana for the duration of the six month study?
* must provide value
Yes
No
Medical marijuana and medical marijuana certificates will not be provided as part of this research study. You will be responsible for the costs any marijuana you choose to purchase at a dispensary. Typically, health insurance doesn't cover the cost of medical marijuana. It will be up to you to decide what kind of marijuana and how much you use. We are not recommending or advising you use marijuana as part of this research study and would ask you to make that decision with your current doctor or caregiver. Just so you know, we are not studying topical methods (like lotion or oil); if you are only interested in using topicals, you would not be eligible for this study.
Another important aspect of the study is that you will be asked to complete a short, daily survey to keep a record of pain levels, marijuana use, and opioid use every day. Do you own an android/iPhone or a computer with access to the Internet?
* must provide value
Yes
No
Are you willing to keep a daily log of your marijuana use, opioid use, and pain levels using a daily survey? We can set this up for you at your first visit, and send daily text reminders.
* must provide value
Yes
No
Your participation in this study is voluntary. Before starting any procedures, a member of the study staff will review a consent form with you. If you agree to participate, we will ask for your signature on the form. Your payment will depend on your attendance at study visits and whether you are able to record your substance use and other symptoms every day using the online survey. If you come to every study visit, and keep track of your substance use every day, you will earn up to $1,150. All payments will be made via check that will be mailed to you after each study visit. (All payments are contingent on your attendance).Now that you've learned more about the study, does this still sound like something you might be interested in?
* must provide value
Yes
No
Next we need you to answer some questions to see if this study is appropriate for you. Would you be willing to answer questions about your health and medical history to find out if you might qualify for the study? Some of the questions may make you feel uncomfortable. You can stop at any time.
* must provide value
Yes
No
First name:
* must provide value
Last name:
* must provide value
Phone number:
* must provide value
If you are found to be eligible for the study, how would you prefer to be contacted?
* must provide value
Phone
Email
Are you currently located in New England?
* must provide value
Yes
No
What state do you live in?
* must provide value
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Where do you primarily receive care?
* must provide value
Mass General Brigham
Cambridge Health Alliance
MaineHealth
None of the above
How did you hear about our study?
* must provide value
Physician referral
Patient Gateway - Mass General Brigham
MyChart - MaineHealth
MyChart - Cambridge Health Alliance
Mailed flyer
Craigslist ad
Reddit post
Facebook post
Email newsletter
Google ad
Twitter post
ResearchMatch
Other internet advertisement
Other
Which subreddit did you hear about the study from?
Which Facebook page did you find the post from?
* must provide value
Which email newsletter did you hear about the study from?
* must provide value
If other, where did you hear about this study?
* must provide value
How old are you?
* must provide value
Is English your first language?
* must provide value
Yes
No
1. Have you ever used marijuana?
* must provide value
Yes
No
2. Have you used marijuana in the last year?
* must provide value
Yes
No
2a. Have you used marijuana in the last 3 months?
* must provide value
Yes
No
2b. How frequently do you use marijuana?
* must provide value
Once every 3 months
Once every month
Once every week
Every other day
Every day
3. When was the last time you used marijuana?
* must provide value
Today M-D-Y If specific date is unknown, please write January 1st (01/01) and the year you last used it.
4. Do you currently use marijuana to self-treat medical conditions (i.e., pain, insomnia, anxiety, or depression)? If yes, please explain what you are using it to treat:
* must provide value
1. Do you currently take any prescribed opioids?
* must provide value
Yes
No
2. What type of medication?
* must provide value
Buprenorphine (Suboxone, Subutex)
Codeine
Fentanyl (Actiq, Duragesic, Fentora)
Hydrocodone (Zohydro, Hysingla)
Hydrocodone/acetaminophen (Vicodin, Norco, Lorcet, Lortab)
Hydromorphone (Dilaudid, Exalgo)
Methadone (Dolophine, Methadose)
Morphine (MS Contin, Kadian, Morphaband)
Oxycodone (OxyContin, Oxaydo)
Oxycodone/Acetaminophen (Percocet, Roxicet)
Tramadol (Ultram)
Oxymorphone (Opana)
Tapentadol (Nucynta)
Other
What is the total dose of buprenorphine you take every day (not including doses taken as needed)?
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of buprenorphine?
* must provide value
Today M-D-Y
What is the total dose of codeine you take every day (not including doses taken as needed)?
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of codeine?
* must provide value
Today M-D-Y
What is the total dose of fentanyl you take every day (not including doses taken as needed)?
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of fentanyl?
* must provide value
Today M-D-Y
What is the total dose of hydrocodone you take every day (not including doses taken as needed)?
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of hydrocodone?
* must provide value
Today M-D-Y
What is the total dose of hydrocodone/acetaminophen you take every day (not including doses taken as needed)?
Note: please only include the hydrocodone dose, not the acetaminophen dose. For example, if your daily dose is written as 10-325, only write 10.
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of hydrocodone/acetaminophen?
* must provide value
Today M-D-Y
What is the total dose of hydromorphone you take every day (not including doses taken as needed)?
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of hydromorphone?
* must provide value
Today M-D-Y
What is the total dose of methadone you take every day (not including doses taken as needed)?
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of methadone?
* must provide value
Today M-D-Y
What is the total dose of morphine you take every day (not including doses taken as needed)?
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of morphine?
* must provide value
Today M-D-Y
What is the total dose of oxycodone you take every day (not including doses taken as needed)?
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of oxycodone?
* must provide value
Today M-D-Y
What is the total dose of oxycodone/acetaminophen you take every day (not including doses taken as needed)?
Note: please only include the oxycodone dose, not the acetaminophen dose. For example, if your daily dose is written as 10-325, only write 10.
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of oxycodone/acetaminophen?
* must provide value
Today M-D-Y
What is the total dose of tramadol you take every day (not including doses taken as needed)?
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of tramadol?
* must provide value
Today M-D-Y
What is the total dose of oxymorphone you take every day (not including doses taken as needed)?
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of oxymorphone?
* must provide value
Today M-D-Y
What is the total dose of tapentadol you take every day (not including doses taken as needed)?
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of tapentadol?
* must provide value
Today M-D-Y
What other opioid medication do you take?
* must provide value
What is the total dose of of this medication you take every day (not including doses taken as needed)?
* must provide value
Units:
* must provide value
Milligrams (mg)
Micrograms (mcg)
Milliliters (mL)
Other
Other:
* must provide value
When did your physician last change your dosage of this medication?
* must provide value
Today M-D-Y
2a. If other, which opioid medication do you take?
3. What is the dose of this medication?
* must provide value
3a. How many times a day do you take this medication?
* must provide value
If you take this as needed, say 0.
3. When did your physician last change your dosage of opioids?
* must provide value
Today M-D-Y
4. If you take more than one opioid medications, please describe the dosage, frequency of use, and start date here of each additional medication.
1a. What opioid medications are you currently taking? What is the dose and frequency of each? When were you prescribed each medication?
3. Are you planning to change any of your opioid doses in the near future? This includes starting or stopping an opioid medication, or changing the dose of an opioid medication you currently take.
* must provide value
Yes
No
3a. Please explain the change in opioid dose that you are planning to make:
* must provide value
1. Do you currently use any illegal/recreational drugs, or take any prescription medication not as prescribed?
* must provide value
Yes
No
Answer no if you are only using alcohol and/or nicotine.
1a. Please write the recreational drugs(s) you use and answer the following questions for each:
* must provide value
1. Are you currently being treated for cancer?
* must provide value
Yes
No
2. Are you currently being treated for a heart attack?
* must provide value
Yes
No
3. Are you currently being treated for heart failure?
* must provide value
Yes
No
4. Do you have uncontrolled high blood pressure?
* must provide value
Yes
No
5. Are you currently being treated for a stroke?
* must provide value
Yes
No
6. Are you currently being treated for severe COPD (Chronic Obstructive Pulmonary Disease)?
* must provide value
Yes
No
7. Do you need oxygen support?
* must provide value
Yes
No
8. Do you currently have uncontrolled asthma?
* must provide value
Yes
No
9. Are you currently being treated for hypothyroidism or hyperthyroidism?
* must provide value
Yes
No
10. Are you currently being treated for sickle cell disease?
* must provide value
Yes
No
11. Do you have a history of schizophrenia or other psychotic disorder?
* must provide value
Yes
No
12. Do you have a history of bipolar I or bipolar II disorder?
* must provide value
Yes
No
13. Have you ever been diagnosed with a personality disorder, including borderline, antisocial, histrionic, or narcissistic personality disorder?
* must provide value
Yes
No
13. Have you ever been hospitalized overnight for a psychiatric reason?
* must provide value
Yes
No
13a. Please describe, including approximate dates and reason for hospitalization(s):
* must provide value
14. Have you ever been diagnosed with any cognitive disorder? E.g., delirium, dementia, amnesia?
* must provide value
Yes
No
1. Do you experience chronic, non-cancer pain?
* must provide value
Yes
No
2. Please describe your pain and when it first began:
* must provide value
3. Have you had any surgeries in the past month for pain management?
* must provide value
Yes
No
3a. Please describe the type of surgery, the date you had the surgery, and the number of days you spent in the hospital.
* must provide value
4. Do you have any surgeries or medical procedures planned for the next 6 months?
* must provide value
Yes
No
5. Rate your current pain on a scale from 0-10, where 0 is no pain at all and 10 is the worst pain you have ever experienced.
* must provide value
0 1 2 3 4 5 6 7 8 9 10
6. Over the past week, how severe was your pain on average, from 0-10?
* must provide value
0 1 2 3 4 5 6 7 8 9 10
1. What gender do you identify as?
* must provide value
Male
Female
Other
Are you or may you be pregnant?
* must provide value
Yes
No
Are you planning to become pregnant in the next 6 months?
* must provide value
Yes
No
Are you currently breastfeeding?
* must provide value
Yes
No
2. Will you be available for appointments during regular business hours (Monday-Friday, 9am-5pm)?
Yes
No
2a. Are there any times that you are regularly not available (e.g., Mondays, mornings, etc.)?
* must provide value
3. Do we have your permission to send you text messages for scheduling purposes if you are found eligible? Short Message Service (SMS) texting is not a secure method to communicate confidential information. We will only use this text service to send appointment reminders (i.e., the date, time, and address of your appointment). You can change your mind and opt out of this system at any time by informing study staff. Your preference to receive texts will apply to texts sent from this research group/study only.
Risks associated are: 1. Text messages are not secure and could result in unauthorized use of your information. 2. Text messages may be stored in backup server by telecommunications service providers, even if manually deleted from your device. 3. If you want to receive communications by unencrypted text despite these risks, Partners HealthCare will not be held responsible. 4. There is no guarantee that Partners will receive or be able to respond to text messages in a timely manner. Texting should not be used in urgent or emergency situations. 5. The consent we receive from you will only apply to messaging between you and your provider's office, department, or research study staff.
* must provide value
Yes
No
4. Do we have your permission to send you unencrypted emails, including the consent form, should we find you eligible?The Partners standard is to send email securely. This requires you to initially set up and activate an account with a password. You can then use the password to access secure emails sent to you from Partners HealthCare. If you prefer, we can send you "unencrypted" email that is not secure and could result in the unauthorized use or disclosure of your information. If you want to receive communications by unencrypted email despite these risks, Partners HealthCare will not be held responsible. Your preference to receive unencrypted email will apply to emails sent from this research group/study only.
* must provide value
Yes
No
5. Would you like to be contacted again for any other studies in future?
* must provide value
Yes
No
6. Would you like to discuss any of your responses to this survey over the phone?
* must provide value
Yes
No
That's it for our screen. Next, our study doctor will review your answers and determine if you qualify. If you do, you will hear back from us regarding scheduling within the next few weeks. If you do not hear back from us that means that, unfortunately, you did not qualify for this study.
