Daily Cannabis Can Cut Illicit Opioid Use For Those With Chronic Pain

For people in chronic pain who are tempted to use illicit opioids, a new study reveals that cannabis can act as an effective and much less dangerous alternative to help manage pain.

The findings, published in the journal PLOS Medicine, show that participants in pain who used cannabis every day had nearly 50 percent reduced odds of using illicit opioids every day compared to cannabis non-users.

“These findings, in combination with past research, again demonstrate that people are using cannabis to help manage many different conditions, including pain. And in some cases, they’re using cannabis in place of opioids,” said senior author Dr. M-J Milloy, a research scientist at the BC Centre on Substance Use (BCCSU) and the Canopy Growth professor of cannabis science at the University of British Columbia (UBC).

“In the midst of an ongoing public health emergency caused by opioid overdose deaths, the results suggest that increasing access to cannabis for therapeutic purposes could help curb overdose risk associated with illicit opioid use.”

For the study, the researchers interviewed more than 1,100 Vancouver residents at high risk of opioid overdose who also reported substance use and major or chronic pain.

The researchers found that daily cannabis use was associated with significantly lower odds of daily illicit opioid use, suggesting people are replacing opioids with cannabis to manage their pain.

In fact, people who used cannabis every day had nearly 50 percent lower odds of using illicit opioids every day compared to cannabis non-users, whereas people who reported occasional use of cannabis were neither more nor less likely than non-users to use illicit opioids on a daily basis.

Researchers further found that there may be an intentional therapeutic element associated with at least daily cannabis use. For instance, daily users were significantly more likely than occasional users to report a number of therapeutic uses of cannabis, including addressing pain, stress, nausea, mental health, and symptoms of HIV or side effects of HIV antiretroviral therapy, or improving sleep.

The findings suggest that some people who use drugs and who are experiencing pain might be using cannabis as an ad-hoc, self-directed strategy to reduce the frequency of opioid use.

“These findings point to a need to design formal clinical evaluations of cannabis-based strategies for pain management, opioid use disorder treatment supports, and wider harm reduction initiatives,” said Stephanie Lake, a PhD candidate at UBC’s school of population and public health, and the lead author of the study.

Milloy is currently planning controlled trials to evaluate whether cannabis could help people with opioid use disorder stay on their treatment and serve as a substitute to opioid use.

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