Cannabis Significantly Reduces the Use of Prescription Opioids and Improves Quality of Life in Authorized Patients: Results of a Large Prospective Study

Abstract

Objectives This article presents findings from a large prospective examination of Canadian medical cannabis patients, with a focus on the impacts of cannabis on prescription opioid use and quality of life over a 6-month period. Methods The Tilray Observational Patient Study took place at 21 medical clinics throughout Canada. This analysis includes 1,145 patients who had at least one postbaseline visit, with follow-up at 1, 3, and 6 months. Instruments included a comprehensive cannabis use inventory, the World Health Organization Quality of Life Short Form (WHOQOL-BREF), and a detailed prescription drug questionnaire. Results Participants were 57.6% female, with a median age of 52 years. Baseline opioid use was reported by 28% of participants, dropping to 11% at 6 months. Daily opioid use went from 152 mg morphine milligram equivalent (MME) at baseline to 32.2 mg MME at 6 months, a 78% reduction in mean opioid dosage. Similar reductions were also seen in the other four primary prescription drug classes identified by participants, and statistically significant improvements were reported in all four domains of the WHOQOL-BREF. Conclusions This study provides an individual-level perspective of cannabis substitution for opioids and other prescription drugs, as well as associated improvement in quality of life over 6 months. The high rate of cannabis use for chronic pain and the subsequent reductions in opioid use suggest that cannabis may play a harm reduction role in the opioid overdose crisis, potentially improving the quality of life of patients and overall public health.

Cannabis‐based medicines and medical cannabis for patients with neuropathic pain and other pain disorders: Nationwide register‐based pharmacoepidemiologic comparison with propensity score matched controls

“…As such, our study does not support the notion that CBM/MC will reduce the use of opioids among pain patients. Some studies have found similar results to us in this respect, whereas other studies do observe a reduction in the use of opioids among users of CBM/MC (Boehnke et al, 2016;Caputi & Humphreys, 2018;Lucas et al, 2020;Nielsen, Sabioni, et al, 2017). It is also noteworthy that the rates of opioid use were relatively high, probably indicating that MC/CBM was not used as a first line of treatment.…”

Possible opioid‐saving effect of cannabis‐based medicine using individual‐based data from the Norwegian Prescription Database

“…In the present study, there was no general opioid‐saving effect of Sativex® in all those who tried the drug. Our findings could thus be interpreted as contrary to other researchers looking into cannabis‐based medicine 22–25,32,48,49 . However, looking more closely at different patterns of Sativex® use after the initial prescription, we found that those filling only one or two prescriptions in the follow‐up year (occasional users) increased their opioids use substantially, whereas there was a decrease in those filling three or more prescriptions (frequent users).…”

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

“…Recreational and medicinal cannabinoid use is expanding, including various applications to chronic pain management, and may be replacing chronic opioid and other substance use in some patients [144][145][146]. Providers should actively engage patients in shared decision-making and education regarding the perioperative implications of chronic cannabinoid use (discussed comprehensively elsewhere [147,148]), including how postoperative pain is affected.…”