Large study shows cannabis does not help treat opioid addiction, despite widespread belief
A large new study published this week in JAMA Network Open has found that cannabis has no clear effect on opioid addiction treatment. The findings contradict a common belief that marijuana can help treat and prevent opioid addiction.
The study analyzed data from the ongoing Population Assessment of Tobacco and Health (PATH) study, which is following over 49,000 American adults long-term. Out of these, over 8,000 reported non-medical opioid use.
Researchers found no significant differences in non-medical opioid use between people who used cannabis and those who did not. They concluded that cannabis likely does not improve opioid addiction treatment outcomes.
“Cannabis use was neither associated with an increased risk of continuing nonmedical opioid use among people with OUD overall nor with an altered probability of opioid discontinuation specifically,” the authors wrote.
This conflicts with the belief held by many patients and even doctors that cannabis can curb opioid cravings and withdrawal symptoms. Several previous small studies had suggested cannabis may have benefits.
“There was so much interest in the potential protective benefits of cannabis that it was important to conduct a statistically powered study,” said lead author Deborah Hasin. “The results indicate no protective benefit of cannabis use.”
Reactions from experts and advocates
Patient advocates have expressed disappointment at the findings. The US Pain Foundation, an organization supporting chronic pain patients, said many rely on cannabis when opioids are ineffective or have intolerable side effects.
“This news is disheartening for pain patients who have found life-changing relief from medical cannabis,” said CEO Nicole Hemmenway. She urged doctors not to discourage cannabis use, as pain patients have few alternative options.
Other experts say the study should dampen some of the hype around cannabis addiction treatment. “This rigorous study should temper some of the exuberant claims about cannabis curing the opioid epidemic,” said Keith Humphries, PhD, a professor of psychiatry at Stanford University.
“Cannabis is an extremely valuable medicine for many patients, but the evidence does not suggest it will rescue people from opioid addiction,” Humphreys said.
However, patient advocates say the study also highlights the need for more research. Paul Armentano of cannabis advocacy group NORML said there is “tremendous variability” in cannabis formulations, dosages and routes of administration.
“We need to objectively assess the potential therapeutic utility of these various cannabis options if we are to truly evaluate marijuana’s role in combating this drug epidemic,” Armentano said.
New findings on cannabis and pain management
While the study found cannabis ineffective for opioid addiction treatment, new research shows it remains very effective for chronic pain relief.
A separate large clinical study published this month provides strong evidence that cannabis provides similar pain relief benefits as opioids. Researchers found medical marijuana users had 64% lower odds of opioid use compared to non-users.
The study analyzed over 7,000 patients with chronic pain in Minnesota’s medical cannabis program. It found medical cannabis just as effective at treating pain as opioids, but with far fewer side effects.
“Notable improvements in pain severity, pain interference, fatigue, mood and quality of life measures were observed,” researchers wrote. Over 75% of patients reported medical cannabis provided some pain relief.
These findings confirm what many pain patients already report about the pain-relieving properties of cannabis. A recent patient survey by NORML and the American Chronic Pain Association found over 90% of respondents said cannabis was more effective for their pain than other medications.
“For many pain patients, medical cannabis is the only treatment that provides significant pain relief and allows them to reduce their opioid intake,” said NORML deputy director Paul Armentano.
What comes next?
The conflicting findings highlight the complex, unsettled science around cannabis. While it shows little promise for opioid addiction treatment, cannabis remains an extremely valuable alternative for pain management.
Experts say more high quality research is urgently needed. Currently the federal government continues to classify cannabis as a Schedule 1 illegal drug, greatly hindering research. Rescheduling cannabis would allow far more studies on its medical benefits and risks.
In the meantime, doctors are unlikely to discourage cannabis use outright based on this one study. “Doctors should not tell patients to stop using cannabis based on this observational data,” said Stanford addiction expert Keith Humphreys. “More research is still needed.”
Patient advocates say the focus should remain on providing alternative pain treatments beyond just opioids and cannabis. “This study cannot be taken in isolation,” said Nicole Hemmenway of the US Pain Foundation. “We need a range of options so patients can find an individualized treatment plan.”
While the hype around cannabis addiction treatment may be premature, cannabis remains an effective option for pain management. With opioid misuse at epidemic levels, experts say all alternatives must be explored.
“We have an ethical obligation to offer patients alternatives to opioids,” said Humphreys. “Cannabis likely has a role to play in pain management even if it does not treat addiction.”
Table 1: Summary of Key Study Findings
Study | Key Finding |
---|---|
JAMA study on cannabis for opioid addiction | Cannabis found ineffective for improving opioid addiction treatment outcomes |
Minnesota medical cannabis study | Cannabis found as effective as opioids for chronic pain relief |
NORML patient survey | Over 90% of patients said cannabis more effective than other medications for pain |
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