Daily cannabis use linked to higher rates of illicit opioid cessation among people with chronic pain
Article Written by Adam Isaac Miller
Read time: 2-3 mins
New research has found that daily cannabis use is associated with significantly higher rates of unregulated opioid cessation among people who use drugs (PWUD) living with chronic pain, potentially offering a harm reduction strategy amidst the ongoing opioid crisis.
The study, published in Drug and Alcohol Review, analysed data from three prospective cohort studies in Vancouver, Canada, examining the relationship between cannabis use frequency and cessation of unregulated opioid use.
"This research provides important evidence on the potential benefits of cannabis use among people who use drugs, particularly in the context of the devastating opioid overdose crisis," explained Chenai Kitchen, the study's lead author.
Researchers investigated data from 1242 people who reported both chronic pain and use of unregulated opioids over eight years from June 2014 to May 2022. During the study period, 764 participants experienced a cessation event from unregulated opioid use.
Key findings from the study revealed:
Daily cannabis use was positively associated with opioid cessation, with an adjusted hazard ratio of 1.40 (95% confidence interval 1.08-1.81)
The cessation rate was 28.5 per 100 person-years across the entire study population
Sex-specific differences were observed, with daily cannabis use significantly associated with increased rates of opioid cessation, specifically among males.
"Participants reporting daily cannabis use exhibited higher rates of cessation compared to less frequent users or non-users," noted Dr. Hudson Reddon, one of the study's co-authors. "This suggests cannabis may play a role in supporting people to reduce or stop their use of unregulated opioids, which could have significant harm reduction implications."
The research comes at a critical time as health authorities continue to grapple with high rates of opioid-related overdoses and deaths, particularly from unregulated sources contaminated with potent synthetic opioids like fentanyl.
Sex-specific findings
One of the study's notable discoveries was the sex-specific difference in cannabis's effect on opioid cessation. For male participants, daily cannabis use was significantly associated with increased rates of opioid cessation, with an adjusted hazard ratio of 1.50 (95% confidence interval 1.09-2.08).
"The observed sex-specific differences in cannabis use and opioid cessation suggest potential variations in cannabis use behaviours and effects between males and females," explained Dr. M.-J. Milloy, Canopy Growth professor of cannabis science at the University of British Columbia and study co-author. "Understanding these differences could help tailor harm reduction approaches more effectively."
Implications for harm reduction
This study adds to growing evidence that cannabis might serve as a harm reduction tool in addressing the opioid crisis. For people living with chronic pain who use unregulated opioids, cannabis could potentially provide an alternative approach to pain management.
"These findings underscore the importance of accessible, regulated cannabis for people who might benefit from its use," said Dr. Kanna Hayashi, St. Paul's Hospital Chair in Substance Use Research and study co-author. "However, we need to recognise that cannabis is not a panacea, and comprehensive approaches to harm reduction and addiction treatment remain essential."
The researchers noted several limitations to their study, including its observational nature, which prevents establishing a causal relationship between cannabis use and opioid cessation. They also acknowledged the need for further research to understand the mechanisms behind the observed associations.
"Our findings add to the growing evidence supporting the potential benefits of cannabis use among people who use drugs, underlining the need for further research," Kitchen concluded. "Understanding how cannabis might help people reduce harmful drug use could inform more effective public health responses to the opioid crisis."
This research was supported in part by the National Institutes of Health and Michael Smith Health Research BC, highlighting the growing interest in exploring cannabis's potential role in addressing substance use disorders.
Adam has spent a decade working with unregistered medicines, specialising in Cannabinoid Therapeutics, where he has supported the development, implementation and market entry of multiple cannabinoid product portfolios across Australia, New Zealand, Germany and Brazil. Before working in the medical cannabis field, Adam spent nearly ten years building various B2B businesses in education, investment, and medicinal cannabis, progressing through roles in business development, strategy, product development, and project management. As one of the early experts in Australia's emerging cannabis industry, he has consulted for private and listed cannabis producers and ancillary businesses since 2015. Adam founded and served on the board of The Medical Cannabis Council, Australia's first not-for-profit industry body. A graduate of the Royal Melbourne Institute of Technology with a Bachelor of Entrepreneurship, he is a frequent public speaker and publishes a widely read industry newsletter. His expertise has been featured in major news outlets, including the Sydney Morning Herald, The Australian Financial Review, Nine News, Startup Smart, SBS, SkyNews, MJBizDaily and other prominent publications.
Disclaimer: This information is shared with a global readership for educational purposes only and does not constitute medical or business advice. All patient-related information has been de-identified OR fictional to protect privacy. Nothing in this article is intended to promote the use or supply of medical cannabis to members of the public.
