As opioids continue to drive overdose deaths, a new study suggests that making medical cannabis available and affordable can help patients reduce their use of the prescription painkillers.
“Although cannabis has historically been characterized as a potential ‘gateway drug,’ it may also serve as a harm-reduction tool for some patients seeking to reduce reliance on higher-risk opioid medications,” the researchers from University of Pennsylvania’s Perelman School of Medicine found.
The study, a prospective observational trial conducted at the Hospital of the University of Pennsylvania, followed 29 adults over five months. All had been living with chronic pain for years—a median of 11 years—and all were already taking opioid medications but had struggled to taper them despite other treatments.
The investigation is unique for its focus on cost as a factor in medical marijuana access, with the researchers describing their work as “the first prospective observational study evaluating medical cannabis as an alternative to opioids in a setting where cost was removed as a major barrier.”
Participants were recruited from a university-based outpatient chronic pain clinic and then underwent monthly pain assessments using the Numeric Pain Rating Scale (NRS). Researchers measured daily opioid use, measured in morphine milligram equivalents (MMEs).
“Seven patients (24%) were able to completely discontinue opioid therapy by the end of the study, five of whom achieved this by the second month. Pain levels also decreased over time,” the authors wrote.
Notably, there was “a statistically significant reduction in mean pain scores that was sustained over the five-month study period,” the paper, published in the Cureus Journal of Medical Science, says.
“There was also a reduction in mean opioid consumption of approximately 32 MMEs per day, which was similarly sustained throughout the follow-up. In addition, seven patients were able to discontinue opioid therapy completely during the study.”
“Mean daily opioid consumption decreased from a baseline of 46.8 MMEs/day to 16.2 MMEs/day at one month and remained low throughout the five-month follow-up period,” the researchers observed.
What sets the new study apart was not only the introduction of medical cannabis, but the deliberate removal of cost as an obstacle. Participants have “consistently identified cost as a major barrier to initiating medical cannabis” prior to enrollment in the study, the paper says.
Highlighting the novelty of the study, they added their hypothesis that “improving access to medical cannabis will enable a subset of patients, particularly those for whom cost is a major barrier, to reduce or discontinue opioid use while maintaining adequate pain control.”
“These results suggest that medical cannabis may be a useful adjunct therapy for reducing opioid use, relieving chronic pain, and improving health-related quality of life,” they concluded.
“The findings of this study add to the growing body of literature supporting the safety profile and potential therapeutic role of cannabis.”
The study’s authors are careful in their conclusions, warning of limitations and the need for further research. “The sample size was small and derived from a single clinical site, and there was no control group.” And because “patients self-titrated medical cannabis products, resulting in variability in dosing and frequency of use,” the findings are not standardized.
But the authors concluded that “when used under appropriate medical supervision, medical cannabis may represent an effective adjunctive strategy for reducing opioid use among patients receiving long-term opioid therapy.”
This research comes on the heels of a recent study showing that using medical marijuana appears to help people reduce the use of other medications, including opioids, sleeping aids and antidepressants. They also experience far fewer negative side effects after switching to cannabis from prescription drugs, the study involving more than 3,500 patients found.
It also comes after President Donald Trump said marijuana can “make people feel much better” and serve as a “substitute for addictive and potentially lethal opioid painkillers.”
Last month, the Trump administration announced it is moving ahead with the federal reclassification of marijuana by moving medical cannabis from Schedule I to Schedule III of the Controlled Substances Act.
