New research on the use of medical marijuana for pain finds that it was “comparatively more effective than prescription medications” for treating chronic pain after a three-month period, and that many patients reduced their use of opioid painkillers while using cannabis.
The study, conducted in part by a federal researcher at the National Cancer Institute (NCI) and funded by the state of Pennsylvania’s medical marijuana Academic Clinical Research Program, was published late last month in the journal Pain.
The report concludes that despite some methodological limitations, the analysis “was able to determine, using causal inference techniques, that use of medical marijuana for chronic pain under medical supervision is at least as effective and potentially more effective in relationship to patients with chronic pain treated by prescription medications (nonopioid or opioid).”
The study, by authors at the University of Pittsburgh, Harvard Medical School and NCI, compared patient-reported outcomes and electronic medical record data from 440 medical marijuana patients and 8,114 people who received conventional medications.
Notably, the demographics of the groups differed somewhat, with the medical marijuana group having a higher percentage of Black patients and patients with medical comorbidities and reported drug use as well as a lower rate of tobacco use. Conditions and pain levels also differed, with medical marijuana patients having a lower percentage of spinal pain diagnoses but a higher rate of fibromyalgia, neuropathic pain, headaches, arthritic conditions and other musculoskeletal pain.
Regardless of those differences, authors said their analysis allowed them “to make rigorous comparisons to a control group receiving prescription medications.”
“In sum, using a using a causal inference approach, we found that medical marijuana was comparatively more effective than prescription medication treatment for chronic pain, with the odds of responding being 2.6 times higher in the medical marijuana group, and having twice the predicted probability of a positive response,” their report says. “While we found that medical marijuana was comparatively more effective, we cannot extrapolate to conclude that medical marijuana is likely more effective in other populations, particularly because we compared 2 different (albeit similar) populations.”
“A more conservative interpretation of our results,” it continues, “is that medical marijuana is at least as effective as prescription medications for chronic pain.”
Specifically, among medical marijuana patients, 39 percent had a “meaningful treatment response after three months, compared to 35 percent of people on traditional medications. Authors noted that the “rates are in line with many randomized controlled trial (RCT) results of medicinal cannabis for pain.”
The positive response among medical cannabis patients was also “maintained at 6 months, speaking to its durability,” the report says.
Among the 157 medical marijuana patients who also had been prescribed opioids, authors observed a 39 percent reduction in prescribed morphine milligram equivalents (MMEs)—a standard measure of opioid dosage—over six months of treatment. “This is meaningful in that lower daily MMEs is associated with an improved safety profile,” they wrote, adding that the findings “seemingly contradict other studies finding no opioid sparing effect of marijuana.”
“While we cannot conclude that medicinal cannabis is opioid sparing,” the study continues, “our results do point to possible use as an adjunct in trying to wean opioids successfully.”
The research team acknowledged some limitations to the study, including that the types of cannabis products and dosage amounts—including THC and CBD levels, for example—were unknown, “which precludes the determination of any dose–response relationship to medical marijuana outcomes.” Authors were also unable to determine “potential differential therapeutic effects of various medications (such as opioids or nonopioids) vs medical cannabis,” they wrote.
“And finally, we were unable to track the potential harms of medical marijuana, such as development of cannabis use disorder, and such effects have been noted in systematic reviews,” the new paper says. It does not, however, mention the ability to track opioid use disorder among the control group.
The findings come amid separate reports indicating that marijuana is a promising treatment for pain.
A recent federally funded study, for example, shows that legalization of marijuana in U.S. states is associated with reduced prescriptions for opioid pain medications among commercially insured adults—indicating a possible substitution effect where patients are choosing to use cannabis instead of prescription drugs to treat pain.
“These results suggest that substitution of cannabis for traditional pain medications increases as the availability of recreational cannabis increases,” authors of that report wrote, noting that there “appears to be a small shift once recreational cannabis becomes legal, but we see stronger results once users can purchase cannabis at recreational dispensaries.”
“Reductions in opioid prescription fills stemming from recreational cannabis legalization may prevent exposure to opioids in patients with pain,” the paper, published in the journal Cannabis, continues, “and lead to decreases in the number of new opioid users, rates of opioid use disorder, and related harms.”
Other recent research also showed a decline in fatal opioid overdoses in jurisdictions where marijuana was legalized for adults. That study found a “consistent negative relationship” between legalization and fatal overdoses, with more significant effects in states that legalized cannabis earlier in the opioid crisis. Authors estimated that recreational marijuana legalization “is associated with a decrease of approximately 3.5 deaths per 100,000 individuals.”
“Our findings suggest that broadening recreational marijuana access could help address the opioid epidemic,” that report said. “Previous research largely indicates that marijuana (primarily for medical use) can reduce opioid prescriptions, and we find it may also successfully reduce overdose deaths.”
“Further, this effect increases with earlier implementation of [recreational marijuana legalization],” it added, “indicating this relationship is relatively consistent over time.”
Another recently published report into prescription opioid use in Utah following the state’s legalization of medical marijuana found that the availability of legal cannabis both reduced opioid use by patients with chronic pain and helped drive down prescription overdose deaths statewide. Overall, results of the study indicated that “cannabis has a substantial role to play in pain management and the reduction of opioid use,” it said.
Yet another study, published in 2023, linked medical marijuana use to lower pain levels and reduced dependence on opioids and other prescription medications. And another, published by the American Medical Association (AMA) last February, found that chronic pain patients who received medical marijuana for longer than a month saw significant reductions in prescribed opioids.
About one in three chronic pain patients reported using cannabis as a treatment option, according to a 2023 AMA-published report. Most of that group said they used cannabis as a substitute for other pain medications, including opioids.
Other research published that year found that letting people buy CBD legally significantly reduced opioid prescription rates, leading to 6.6 percent to 8.1 percent fewer opioid prescriptions.
A 2022 research paper that analyzed Medicaid data on prescription drugs, meanwhile, found that legalizing marijuana for adult use was associated with “significant reductions” in the use of prescription drugs for the treatment of multiple conditions.
A 2023 report linked state-level medical marijuana legalization to reduced opioid payouts to doctors—another datapoint suggesting that patients use cannabis as an alternative to prescription drugs when given legal access.
Researchers in another study, published last year, looked at opioid prescription and mortality rates in Oregon, finding that nearby access to retail marijuana moderately reduced opioid prescriptions, though they observed no corresponding drop in opioid-related deaths.
Other recent research also indicates that cannabis may be an effective substitute for opioids in terms of pain management.
A report published recently in the journal BMJ Open, for instance, compared medical marijuana and opioids for chronic non-cancer pain and found that cannabis “may be similarly effective and result in fewer discontinuations than opioids,” potentially offering comparable relief with a lower likelihood of adverse effects.
Separate research published found that more than half (57 percent) of patients with chronic musculoskeletal pain said cannabis was more effective than other analgesic medications, while 40 percent reported reducing their use of other painkillers since they began using marijuana.
In Minnesota, meanwhile, a new state government report on chronic pain patients enrolled in the state’s medical marijuana program said recently that participants “are finding a noticeable change in pain relief” within a few months of starting cannabis treatment.
The large-scale study of nearly 10,000 patients also shows that nearly a quarter who were taking other pain relievers reduced the use of those drugs after using medical marijuana.
New research on the use of medical marijuana for pain finds that it was “comparatively more effective than prescription medications” for treating chronic pain after a three-month period, and that many patients reduced their use of opioid painkillers while using cannabis. The study, conducted in part by a federal researcher at the National Cancer Institute Read More
