Cannabis associated with long-term reduction in opioid use – study

Medicinal cannabis was associated with a reduction in daily use of prescription opioids among chronic pain patients.

A new study suggests that medical cannabis products were associated with substantial long-term decreases in the daily use of prescription opioids among patients living with chronic pain.

With opioid-related deaths reaching their highest ever levels in 2021, the US Center for Disease Control and Prevention (CDC) published new guidelines intended to reduce prescribing. Similar has been seen in the UK, with NICE no longer recommending the prescribing of opioids for long-term chronic pain. 

However, without effective alternatives, patients may be at risk of experiencing a mental health crisis and/or turning to the illicit market. 

Numerous other studies have indicated that cannabis can reduce the reliance on opioids, with a recent paper revealing that one in three people with chronic pain in the US are now using cannabis to manage their symptoms. 

Researchers from the State University of New York at Albany and the New York State Department of Health, assessed the impact of medical cannabis on opioid use patterns in over 8,000 chronic pain patients receiving long-term opioid therapy.

The participants were split into two groups and studied for eight months after beginning cannabis treatment, with one group stopping the treatment after 30 days and the second continuing to take it.

The data, published in the Journal of the American Medical Association (JAMA) Network Open, reports that patients’ daily morphine milligram intake (MME) decreased following cannabis therapy and that this decline grew more significantly over time.

According to the paper, ‘significantly greater reductions’ in opioid dosage were observed among the group which was exposed to medical cannabis for a longer period of time. Larger reductions were observed for patients receiving higher opioid dosages at the beginning of the study. 

Following the eight month study period, patients receiving cannabis treatment for more than 30 days saw a daily MME reduction of 47% to just over half (51%) of what their baseline dosages had been. Adults receiving cannabis for less time reduced their baseline dosages by just 4% to 14%.

The authors concluded: “In this cohort study of patients receiving LOT [long-term opioid therapy], receiving MC [medical cannabis] for a longer duration was associated with reductions in opioid dosages.

“These findings contribute robust evidence for clinicians regarding the potential benefits of MC in reducing the opioid burden for patients receiving LOT and possibly reduc[ing] their risk for overdose.”

They added: “Further research is needed to confirm the causal effect of MC and conduct benefit-risk assessment of MC as opioid alternative or companion treatments to address management of chronic pain and the opioid crisis.”

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