Multi-site feasibility of a cannabis coaching intervention for chronic low back pain

The National Center for Complementary and Integrative Health awarded Regents of the University of Michigan $574,978 on August 7, 2026, under the Research and Training in Complementary and Integrative Health program (CFDA 93.213) to conduct a multi-site feasibility study of CAN-COACH, a cannabis coaching intervention for chronic low back pain.

CAN-COACH uses motivational interviewing to coach individuals on the use of commercially available cannabis products for pain management, focusing on cannabinoid content, routes of administration, and dosing. The feasibility study evaluates three primary objectives: recruitment and retention across two sites, fidelity of intervention implementation, and safety monitoring processes. The study targets enrollment of more than 75 percent of eligible individuals and retention above 70 percent at six-month follow-up at two sites—University of Michigan in Ann Arbor and University of California Irvine—to inform a planned multi-site effectiveness trial.

The award builds on preliminary single-site feasibility work among veterans with chronic pain that demonstrated high satisfaction and clinically and statistically significant improvements in pain interference and severity.

Performance occurs in Ann Arbor, Michigan, with the project period running through July 31, 2029.

Abstract

Cannabis-based therapies for managing chronic low back pain (CLBP) are hampered by limited literature and barriers to research, leading to uncertainty among healthcare providers regarding clinical guidance despite increasing use among patients. To address this, we have developed can-coach, an innovative intervention that empowers individuals to use commercially available cannabis products for pain management through a coaching approach based on motivational interviewing and known effects of cannabis products (i.e., cannabinoid content, routes of administration, and dosing). Before advancing to a large-scale effectiveness trial, IT is essential to conduct this multi-site feasibility study to evaluate key operational factors that could impact broader implementation. Our preliminary work provides a strong foundation for this study. Our initial single-site feasibility study of can-coach among veterans with chronic pain demonstrated high satisfaction as well as clinically and statistically significant improvements in pain interference and severity, suggesting that can-coach holds promise as an effective intervention. In the current proposal, we build on these initial findings to develop a multi-site feasibility study for CLBP at two sites in michigan and california. Our feasibility study sets the groundwork for a successful multi-site effectiveness trial by focusing on three primary objectives: recruitment and retention, fidelity of intervention implementation, and safety monitoring processes. 1) recruitment and retention: we aim to assess the feasibility of engaging and retaining a sufficient and demographically distinct participant pool across our two sites (university of michigan, university of california irvine). We have established benchmarks to enroll more than 75% of eligible individuals and maintain retention rates above 70% at the six-month follow-up. 2) fidelity and adaptability: this objective involves evaluating the consistency and adaptability of can-coach to confirm that intervention components are delivered as intended while also meeting individual participant needs. Our goal is to achieve over 85% protocol adherence and greater than 90% participant satisfaction, establishing can-coach's integrity and readiness for a larger trial. 3) safety monitoring framework: developing a robust framework for monitoring participant safety and cannabis use patterns is vital for identifying potential safety concerns and ensuring comprehensive, reliable data collection through both digital and in-person channels. We aim to capture complete cannabis use data for over 70% of participants and effectively manage any emergent safety risks. This feasibility study is critical for identifying and resolving potential challenges of protocol implementation and will allow US to refine our approach and establish a solid foundation for a multi-site effectiveness trial. If effective, the broader application of can-coach could provide an empirically tested framework for clinicians to integrate cannabis-based therapies into chronic pain management.