Associations Between Medical Cannabis and Prescription Opioid Use

by | Apr 29, 2021 | 2017, Alternative Therapies, CBD

Written by Joyce Smith, BS. Researchers, using informal surveys of patients enrolled in the medical cannabis program, discovered that a significant proportion of chronic pain patients reported having replaced their opioid prescriptions with cannabis for treating their chronic pain.

Today opioid-related drug overdoses are the leading cause of preventable deaths in the United States, killing approximately 100 Americans every day.1 Conventional pharmaceutical medications for treating opioid addiction, such as methadone and buprenorphine-tapering, can be similarly dangerous due to substantial risks of lethal drug interactions and overdose.1-3 Whole, natural Cannabis sativa and extracts made from the plant may serve as an alternative to opioid-base medications for treating chronic pain.

Cannabis has been investigated as a potential treatment for a wide range of medical conditions from post-traumatic stress disorder 4 to cancer,5,6 and showing the most consistent support for the treatment of chronic pain, epilepsy, and spasticity.7 In the United States, states have enacted Medical Cannabis Programs (MCPs) in part for people with chronic, debilitating pain who cannot be adequately or safely treated with conventional pharmaceutical medications. New Mexico, hardest hit by the opioid epidemic, currently has close to 50,000 enrolled members.

Researchers hypothesized that legal access to cannabis may reduce the use of multiple classes of dangerous prescription medications in certain patient populations. Using a historical cohort research design, they examined the association between enrollment in the New Mexico Medical Cannabis Program (MCP) and opioid prescription use. They observed 37 habitual opioid using, chronic pain patients (mean age = 54 years; 54% male; 86% chronic back pain) who chose to enroll in the MCP between 2010 and 2015, and compared them to 29 opioid users with similar health conditions (mean age = 60 years; 69% male; 100% chronic back pain) who chose not to enroll in the MCP.

Researchers used opioid records from the Prescription Monitoring Program over a 21 month period (first three months prior to enrollment for the MCP patients) to measure cessation and reduction of opioid use (cessation defined as “the absence of opioid prescriptions activity during the last three months of observation” and reduction as “ the decrease calculated in average daily intravenous morphine dosages”). The MCP patient-reported benefits and side effects of using cannabis one year after enrollment were also collected.

MCP enrollment was associated with 17.27 higher odds of discontinuing opioid prescriptions (p=0.012) and 5.12 higher odds of reducing daily prescription opioid dosages (p=0.007). Participants reported improvements in pain reduction, quality of life, social life, activity levels, and concentration as well as few side effects from using cannabis one year after enrollment in the MCP (p< 0.001 for all improvements).

The results from this preliminary study provide clinically and statistically significant evidence for an association between MCP enrollment and opioid prescription cessation and reduction and improved quality of life, and warrant “the necessity of more extensive research into the possible uses of cannabis as a substitute for opioid painkillers, especially in the form of placebo-based, randomized controlled trials and larger sample observational studies”

Source: Vigil JM, Stith SS, Adams IM, Reeve AP (2017) Associations between medical cannabis and prescription opioid use in chronic pain patients: A preliminary cohort study. PLoS ONE 12(11): e0187795. https://doi.org/10.1371/journal. pone.0187795

Copyright: © 2017 Vigil et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

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Posted January 2, 2019.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

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