Study points to benefits of cannabis for reducing opioid use and symptoms of withdrawal

A new study highlights how cannabis can be a helpful tool for reducing opioid use and providing ‘rapid relief’ from symptoms of withdrawal.

The study, which received funding from the National Institute of Drug Abuse (NIDA), comes following a surge in overdose mortality rates over the last decade and a growing interest in the role cannabis can play in tackling the opioid crisis.

While the evidence is mixed, several studies have reported its use as a substitute for prescription drugs and for managing symptoms of withdrawal. However, the authors note, there is still a gap in the literature when it comes to qualitative data which centres around the experiences of those who use opioids and people who inject drugs (PWID).

‘Rapid and ongoing relief’ 

Between July 2021 and April 2022, the researchers conducted 30 one-on-one interviews with PWID at two community sites near a syringe service programme and a methadone clinic in Los Angeles.

The average age of participants was 40-years-old, with 70% of the sample identifying as male. The majority reported having a high school education or greater, an income less than $2100 in the past 30 days and being homeless or unstably housed in the past three months.

Participants said that the use of cannabis assisted in reducing their opioid use in a number of ways. This included ‘maintaining opioid cessation and/or adhering to opioid use disorder treatment by managing cessation-specific symptoms’; managing symptoms of opioid withdrawal; and decreasing opioid use due to ‘low barrier accessibility of cannabis’.

Some participants used cannabis to manage specific symptoms, such as cravings and anxiety after stopping opioid use, describing how cannabis helped them ‘get over the hump’ and taper down their use of methadone. 

Others described episodic use of cannabis to provide ‘rapid and ongoing relief’ from opioid withdrawal symptoms, including physical pain, with some finding it prolonged the time between injection frequency.

‘Important insights’ may help guide future interventions 

The research was a part of a longitudinal, prospective cohort study examining whether changes in the frequency of cannabis use are associated with changes in frequency of opioid use and opioid-related health outcomes among opioid-using PWID in California and Colorado.

The researchers used ‘constructivist grounded theory methods’ for identifying and comparing emerging themes and then constructing a ‘conceptual explanation of how PWID co-used cannabis and opioids’. 

While the study has a number of limitations, including the fact that it was conducted in California where cannabis is medically and recreationally legal —and therefore may not be generalisable to other jurisdictions—the authors believe the research provides ‘important insights to guide interventions in opioid use’.

They conclude: “These findings support the extant literature on cannabis and opioid co-use for pattern changes among vulnerable populations. Nonetheless, carefully controlled studies that examine these connections between cannabis use, intentions, and utilization patterns are needed to establish the value of cannabis to opioid-using PWID. 

“Our data provide an initial exploration for future studies examining these connections among PWID experiencing inequities such as housing insecurity and material deprivation. The majority of the literature on this topic is quantitative, and we believe that our qualitative findings from this community-recruited sample provide a much needed perspective on cannabis-opioid co-use from PWID.”