Cannabis could help significantly reduce opioid use in patients with chronic pain and could play a key role in pain management as more providers look for less addictive therapies, according to recent research. However, the study’s authors said that larger studies are needed to confirm the findings and better understand the long-term effects of cannabis use. The data was presented at a Utah Medical Cannabis Policy Advisory Board meeting.1
Cannabis Could Help Reduce Opioid Use in Patients with Chronic Pain / Irina_Evva – stock.adobe.com
Although deaths involving opioids decreased in 2023 in the United States for the first time since 2018, they still remain significantly high.2 Previous research has found that medical cannabis use may decrease opioid prescription rates and intake. In a study published in JAMA Network Open, Nguyen et al found that patients receiving long-term opioid treatment who received a longer duration of medical cannabis had a reduction in opioid dosages.3 Other research has also found that states with medical cannabis laws had lower rates of non-medical prescription opioid use.4
READ MORE: Ketamine Improved Chronic Pain for Patients with Cancer Following Surgery
“The opioid crisis remains a significant public health concern, affecting countless individuals and communities across the United States,” authors of the Utah study wrote. “In Utah, the impact of this crisis has been profound, leading to a surge in overdose deaths and widespread dependence on prescription opioids.Since the legalization of medical cannabis in 2018, there has been a noticeable decrease in deaths related to prescription opioids in the state. This shift suggests that the introduction of cannabis as a therapeutic alternative may have contributed to a reduction in opioid use among patients seeking pain relief.”
Investigators from database management company Management Science Associates conducted a study to examine the association between cannabis use and the prescription of opioids. Data for the study was gathered from the company’s databases and patients were identified by using the International Classification of Diseases, Tenth Revision (ICD-10) codes. Guidelines from the International Association for the Study of Pain (IASP) were used to classify pain types.
The study cohort included 186 patients between the ages of 23 and 89 years with chronic pain who used cannabis. Over 98% of the patients were from Utah, with the rest being from either Oregon or New Mexico. Of the patients, 57% were diagnosed with chronic musculoskeletal pain, 19% with chronic visceral pain, 13% with chronic headache and orofacial pain, 4% with chronic primary pain, 3% with chronic neuropathic pain, and 2% with chronic post-traumatic and postsurgical pain.
The study found that 84.4% of the patients had a decrease in Morphine Milligram Equivalents (MME) per month after starting cannabis, with an overall reduction of 53.1%. A reduction in opioid prescriptions was seen most in patients using cannabis products with a ratio of 1:0, followed by 1:1 and 0:1. Most patients with reduced opioid prescriptions during cannabis use had chronic musculoskeletal pain and many patients also reported more than 1 type of pain. However, patients with chronic headache and orofacial pain showed an increase in opioid use after starting cannabis.
“As the medical community continues to seek safer pain management options, cannabis may become a key component of treatment strategies, particularly for chronic pain patients,” the authors concluded. “These findings support the hypothesis that cannabis can significantly reduce opioid use among chronic pain patients. This is crucial as it provides a potential pathway to tackle opioid dependency, offering a less addictive alternative for chronic pain management with fewer side effects.”
READ MORE: Nonopioid Pain Management
Are you ready to elevate your pharmacy practice? Sign up today for our free Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips, straight to your inbox.
References
1. Impact of Cannabis on Opioid Prescriptions in Chronic Pain:Insights from Recent Research in Utah. Report. Management Science Associates. November 19, 2024. Accessed December 2, 2024. www.utah.gov/pmn/files/1194859.pdf
2. U.S. Overdose Deaths Decrease in 2023, First Time Since 2018. News Release. CDC. May 15, 2024. Accessed December 2, 2024. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.htm
3. Nguyen T, Li Y, Greene D, Stancliff S, Quackenbush N. Changes in Prescribed Opioid Dosages Among Patients Receiving Medical Cannabis for Chronic Pain, New York State, 2017-2019. JAMA Netw Open. 2023;6(1):e2254573. doi:10.1001/jamanetworkopen.2022.54573
4. Samples H, Levy NS, Bruzelius E, et al. Association Between Legal Access to Medical Cannabis and Frequency of Non-Medical Prescription Opioid Use Among U.S. Adults. Int J Ment Health Addiction (2023). https://doi.org/10.1007/s11469-023-01191-y
Most patients with reduced opioid prescriptions during cannabis use had chronic musculoskeletal pain. Read More
