Cannabis could help reduce opioid use in patients with chronic pain

According to recent research, cannabis could help significantly reduce opioid use among patients with chronic pain and could play a key role in pain management as more providers seek less addictive therapies. However, the study authors said larger studies are needed to confirm the results and better understand the long-term effects of cannabis use. The data was presented at a meeting of the Utah Medical Cannabis Policy Advisory Board.¹

Cannabis could help reduce opioid use in patients with chronic pain / Irina_Evva – stock.adobe.com

Although opioid-related deaths in the United States fell in 2023 for the first time since 2018, they are still significantly high.² Previous research has found that medical cannabis use can reduce opioid prescription rates and uptake. In a study published in JAMA network openedfound Nguyen et al. found that patients receiving long-term opioid treatment and receiving medical cannabis for a long period of time had a reduction in opioid doses.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 relieves chronic pain in cancer patients after surgery

“The opioid crisis remains a major public health problem, affecting countless individuals and communities across the United States,” the authors of the Utah study wrote. “In Utah, the impact of this crisis has been profound, leading to an increase in overdose deaths and widespread addiction to prescription opioids. Since the legalization of medical cannabis in 2018, the U.S. has seen a noticeable decrease in deaths related to prescription opioids.” State. This shift suggests that the introduction of cannabis as a therapeutic alternative may have contributed to a decline in opioid use among patients seeking pain relief.”

Researchers at database management company Management Science Associates conducted a study to examine the connection between cannabis use and opioid prescriptions. Data for the study was collected from the company’s databases and patients were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes. Guidelines from the International Association for the Study of Pain (IASP) were used to classify the types of pain.

The study cohort included 186 patients between the ages of 23 and 89 years with chronic pain who used cannabis. Over 98% of patients were from Utah, with the remainder coming 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 postoperative pain. traumatic and postoperative pain.

The study found that 84.4% of patients experienced a decrease in morphine milligram equivalents (MME) per month after taking cannabis, for an overall reduction of 53.1%. Reductions in opioid prescriptions were most commonly observed in patients using cannabis products at a ratio of 1:0, followed by 1:1 and 0:1. Most patients with reduced opioid prescriptions during cannabis use experienced chronic musculoskeletal pain, and many patients also reported more than one type of pain. However, patients with chronic headaches and orofacial pain showed an increase in opioid use after starting cannabis.

“As the medical community continues to seek safer options for pain management, cannabis may become a key component of treatment strategies, particularly for patients with chronic pain,” the authors concluded. “These results support the hypothesis that cannabis can significantly reduce opioid consumption in patients with chronic pain. This is critically important as it represents a potential way to combat opioid addiction and offers a less addictive alternative to treating chronic pain with fewer side effects.”

READ MORE: Non-opioid pain therapy

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References

1. Impact of cannabis on opioid prescriptions for chronic pain: Findings from recent research in Utah. Report. Employees in management sciences. November 19, 2024. Accessed December 2, 2024. www.utah.gov/pmn/files/1194859.pdf

2. U.S. overdose deaths decline in 2023 for the first time since 2018. Press 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 in patients receiving medical cannabis for chronic pain, New York State, 2017-2019. JAMA Network 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 the frequency of non-medical prescription opioid use among US adults. Int J Ment Health Addiction (2023). https://doi.org/10.1007/s11469-023-01191-y