Cannabis substitution reduces opioid use in patients with chronic pain

14th July 2021
The results of a new study support previous evidence that cannabis may be an effective substitute for millions of patients using opioids while suffering from chronic pain.

The researchers from the University of Michigan Medical School concluded that individuals using cannabis for chronic pain management reported reductions in the use of opioids and other pain medications.

Over 1000 people (n=1321) participated in the study, with 53% (n=691) substituting cannabis for opioids and 22% (n=287) for benzodiazepines. More than 65% of substitutors reported the discontinued use of these medications due to better symptom management and fewer side effects.

Cannabis as an Opioid Alternative 

The authors claim that the poor performance of many pain medications, including high numbers needed to treat (NNT) and challenging side-effect profiles, have many patients looking for alternatives with greater analgesic efficacy as well as fewer side effects and risk of addiction.

The researchers also note that the ongoing opioid crisis has, in some cases, made it more difficult for patients to obtain opioid prescriptions. This, paired with the increasing social acceptance of cannabis as a safe, alternative medication may be driving people toward opioid alternatives.

Although the data collected through this study is observational and retrospective, the pattern emerging from these and numerous similar studies make it clear that some individuals derive benefit from cannabis-based medicines – “enough so that they discontinue traditional pain medications.”

Dr Kevin Boehnke, PhD of the University of Michigan Medical School, added: “Recent studies provide intriguing hints of how clinicians might help patients effectively substitute cannabis for opioids.”

“Clinicians can embody the practice of evidence-based medicine by synergizing the best available scientific evidence with compassionate clinical expertise that accounts for the preferences and rights of patients with whom they are making clinical decisions.”

At the end of the study, the authors gave tips to those GPs and clinicians who may be able to prescribe cannabis for their patients.

Despite the lack of strong clinical trials that give explicit dosing guidance, clinicians can still provide sound clinical oversight by:

  • Developing treatment plans that take into account patient expectations/goals (eg, substitution) and that include symptom tracking;
  • Employing harm-reduction strategies (eg, avoid smoking, “start low, go slow”); and
  • Ensuring patients know the limits of both the evidence and the regulatory system in place—especially for CBD products, which often are inaccurately labelled and do not undergo stringent safety testing.

If you’re interested in the full report, you can read it by clicking on this link.

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