What We Know About Opioids Vs. Medical Cannabis for Pain Management
Prescription opioids are important therapeutic agents in the treatment of pain. However, repeated, and long-term use of opioids can lead to opioid tolerance, wherein the same dose of the opioid leads to a reduced analgesic effect.1 In addition, the over-prescription of opioids, in combination with escalating rates of illegal sharing and their high potential for abuse and addiction has led to a public health crisis.2 In Canada, there were 6,214 opioid toxicity deaths reported the previous year, of which 96% were accidental.3
Research into medical cannabis’ impact on pain management has generated great interest in the possibility that cannabis could be authorized as a replacement for opioids or could be used in combination with them. Up to 80% of individuals have reported either substituting or replacing prescribed pharmaceuticals for medical cannabis, with 72% replacing opioids.4
What Role Does CBD Play in Pain Management?
Research indicates a potential role for CBD in pain management. For example, one study found that more than 70% of participants with fibromyalgia substituted their pain medications with CBD, with 70-94% of these participants stopping or reducing their use of other pain medications.5 Those who substituted CBD products for other pain medications reported improvements in overall health and pain compared to those who did not.6 These results certainly speak for themselves.
Can cannabis limit the risk of opioid overdose?
Several studies have been conducted to answer this very question. Here’s what was found:
- The odds of daily illicit opioid use were almost 50% lower if an individual was using daily cannabis versus no cannabis.7
- CBD was effective in decreasing cue-induced drug craving and anxiety in abstinent heroin users.8
- Regions with medical cannabis laws have reported lower average opioid overdose mortality rates and prescribing rates compared to states without medical cannabis laws. 9,10
- Recreational cannabis laws reduced opioid-related emergency department visit rates by approximately 7.6% across six months.11
In ConclusionAt Aurora, we always want our patients to be well-informed and know the facts. We hope this information has helped you learn more about how medical cannabis can have a potential impact on decreasing the abuse of opioids.
1. Dumas EO, Pollack GM. Opioid Tolerance Development: A Pharmacokinetic/Pharmacodynamic Perspective. The AAPS Journal 2008. 10:4. 2008;10(4):537-551. doi:10.1208/S12248-008-9056-1
2. Lisa B, Jessica H. Evidence synthesis - The opioid crisis in Canada: a national perspective. Health Promotion and Chronic Disease Prevention in Canada : Research, Policy and Practice. 2018;38(6):224. doi:10.24095/HPCDP.38.6.02
3. Government of Canada. Opioid- and Stimulant-related Harms in Canada - Public Health Infobase | Public Health Agency of Canada.Published 2021. Accessed July 21, 2021. https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/
4. Boehnke KF, Scott JR, Litinas E, Sisley S, Williams DA, Clauw DJ. Pills to pot: observational analyses of cannabis substitution among medical cannabis users with chronic pain. The Journal of Pain. 2019;20(7):830-841. doi:10.1016/j.jpain.2019.01.010
5. Boehnke KF, Gagnier JJ, Matallana L, Williams DA. Substituting Cannabidiol for Opioids and Pain Medications Among Individuals With Fibromyalgia: A Large Online Survey. Journal of Pain. Published online 2021. doi:10.1016/j.jpain.2021.04.011
6. Boehnke KF, Gagnier JJ, Matallana L, Williams DA. Substituting Cannabidiol for Opioids and Pain Medications Among Individuals With Fibromyalgia: A Large Online Survey. Journal of Pain. Published online 2021. doi:10.1016/j.jpain.2021.04.011
7. Lake S, Walsh Z, Kerr T, et al. Frequency of cannabis and illicit opioid use among people who use drugs and report chronic pain: A longitudinal analysis. PLoS medicine. 2019;16(11):e1002967. doi:10.1371/journal.pmed.1002967
8. Hurd YL, Spriggs S, Alishayev J, et al. Cannabidiol for the reduction of cue-induced craving and anxiety in drug-abstinent individuals with heroin use disorder: A double-blind randomized placebo-controlled trial. American Journal of Psychiatry. 2019;176(11):911-922. doi:10.1176/appi.ajp.2019.18101191
9 - Bachhuber MA, Saloner B, Cunningham CO, Barry CL. Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010. JAMA Internal Medicine. 2014;174(10):1668-1673. doi:10.1001/JAMAINTERNMED.2014.4005
10 - Wen H, Hockenberry JM. Association of medical and adult-use marijuana laws with opioid prescribing for medicaid enrollees. JAMA Internal Medicine. 2018;178(5):673-679. doi:10.1001/jamainternmed.2018.1007
11. Drake C, Wen J, Hinde J, Wen H. Recreational cannabis laws and opioid-related emergency department visit rates. Health Economics. Published online 2021. doi:10.1002/HEC.4377