Study Finds No Association Between Cannabis Use and Non-Medical Opioid Misuse

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Study Finds No Association Between Cannabis Use and Non-Medical Opioid Misuse

Study Finds No Association Between Cannabis Use and Non-Medical Opioid Misuse

A new study suggests that there is no association between cannabis use and non-medical opioid misuse in individuals undergoing medication-assisted treatment for opioid use disorder. The results neither confirm that cannabis leads to opioid use nor validate its effectiveness in reducing opioid use.

The popularity of cannabis is partly due to its widespread legalization, leading people to believe that it can effectively treat drug addiction, especially opioid addiction, given its perceived lower risks compared to “harder” drugs.

The conflicting nature of research findings adds to the debate, with some claiming that cannabis can alleviate opioid withdrawal symptoms, while others argue it may serve as a “gateway drug” promoting opioid use. With 60 million people worldwide struggling with opioid addiction and over 100,000 deaths annually due to opioid overdose, the question of whether cannabis can aid in opioid cessation is both pertinent and urgent.

Researchers from the University of São Paulo, Cleveland Clinic Medical Center, and Yale School of Medicine conducted a systematic review and meta-analysis to provide a clearer answer on whether cannabis helps or hinders those seeking to quit opioids.

Gabriel Costa, the lead author and co-corresponding author, emphasized, “Clarifying the interaction between cannabis and opioids is crucial if healthcare professionals are to offer evidence-based addiction treatment, prevent overdose deaths, and save lives.”

The study involved an analysis of 10 longitudinal studies, encompassing 8,367 participants undergoing opioid agonist therapy—buprenorphine (21.3%), methadone (76.3%), or naltrexone (2.4%)—for opioid use disorder, with 38% being female. Over an average follow-up period of approximately 10 months, non-medical opioid behaviors were monitored, including using non-prescription opioids, taking more opioids than prescribed, or using opioids without a prescription.

Researchers compared the frequency of opioid use between those using cannabis (typically obtained from non-regulated sources) and those not using cannabis. They found no significant association between cannabis use and the non-medical use of opioids among individuals undergoing medication-assisted treatment for opioid use disorder.

Costa stated, “Overall, we found no apparent association between cannabis and non-medical opioid use in patients undergoing medication-assisted treatment for opioid use disorder. These findings neither confirm concerns that cannabis increases non-medical opioid use among individuals seeking treatment for opioid use disorder nor endorse the efficacy of cannabis in reducing non-medical opioid use.”

The study’s findings carry significant implications, particularly for the operation of opioid treatment programs.

Joao De Aquino, co-corresponding author, remarked, “Our findings challenge the ineffective practice of prohibiting cannabis as a condition for providing life-saving medications for opioid use disorder. The data suggest that healthcare systems should adopt personalized treatment approaches based on each patient’s specific circumstances. This includes assessing cannabis use disorders, addressing pain management needs, and treating concurrent mental illnesses such as depression and anxiety.”

The study also questions the increasingly popular opposing view that cannabis can effectively help people quit opioids.

Research on whether cannabis and its components, such as cannabinoids, can alleviate symptoms of opioid use disorder is limited. Further research is needed to thoroughly evaluate its safety and effectiveness. Until then, researchers recommend adhering to existing approved treatment methods.

De Aquino added, “With the growing availability of high-potency synthetic opioids like fentanyl, it is crucial that individuals with opioid use disorder have access to FDA-approved treatments. It is well-established that medications like methadone, buprenorphine, and extended-release naltrexone can save lives and form the cornerstone of opioid use disorder treatment.”

The researchers acknowledge limitations in their study, including inconsistent reporting of opioid and cannabis use, methodological variations, and a general lack of dedicated research on the relationship between cannabis and subsequent non-medical opioid use.

They concluded, “Our review provides clinical and methodological insights for future research to adopt more rigorous and standardized methods to fully elucidate this relationship, especially as attitudes toward cannabis continue to evolve during the escalating opioid crisis.”

The study is published in the “Journal of Substance Abuse and Alcoholism.”

Study Finds No Association Between Cannabis Use and Non-Medical Opioid Misuse