Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study

Campbell, Gabrielle; Hall, Wayne; Peacock, Amy; Lintzeris, Nicholas; Bruno, Raimondo; Larance, Briony; Nielsen, Suzanne; Cohen, Milton; Chan, Gary; Mattick, Richard P.; Blyth, Fiona; Shanahan, Marian; Dobbins, Timothy; Farrell, Michael; Degenhardt, Louisa

doi:10.1016/s2468-2667(18)30110-5

Cited by 190 publications

(150 citation statements)

References 39 publications

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“…Recent individual‐level studies addressed some limitations in Olfson et al . by examining prescription opioid and medical cannabis use among chronic pain patients . Substitution patterns from prescription opioids to medical cannabis were common in this population.…”

Section: Introductionmentioning

confidence: 99%

Medical and non‐medical cannabis use and risk of prescription opioid use disorder: Findings from propensity score matching

Liang

Wallace

Shi

2019

Drug and Alcohol Review

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Introduction and Aims Previous research suggested that cannabis use was associated with increased risks of prescription opioid misuse and use disorder. This study examined whether these associations differed by cannabis use purpose. Design and Methods This is a secondary analysis of cross‐sectional surveys with propensity score matching. Medical cannabis users (N = 1295), cannabis dual users with both medical and non‐medical purposes (N = 707) and non‐medical cannabis users (N = 18 666) were compared with cannabis non‐users (N = 57 196) in the pooled 2013–2016 US nationally representative National Survey on Drug Use and Health. Propensity score models were applied to match cannabis non‐users to cannabis users with different purposes with respect to potential confounders in individual socioeconomic characteristics, other substance use disorders and health conditions. In a matched sample, logistic regressions were used to assess associations. Results Propensity score matching considerably improved the balance of the potential confounders between cannabis non‐users and users. In a matched sample, non‐medical cannabis use was associated with increased risks of prescription opioid misuse (OR = 3.15, 95%CI: 2.89–3.44) and use disorder (OR = 2.52, 95%CI: 2.06–3.10). Cannabis dual use and medical cannabis use were associated with increased risks of prescription opioid misuse (OR = 2.55, 95%CI: 1.78–3.65; OR = 2.15, 95%CI: 1.58–2.91, respectively), but they were not associated with prescription opioid use disorder. Discussion and Conclusions Medical and non‐medical cannabis use both were both associated with increased risks of prescription opioid misuse. Medical cannabis use, however, was not associated with prescription opioid use disorder, and non‐medical cannabis was. There appeared to be differential associations between cannabis use and prescription opioid use disorder by cannabis use purpose.

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Section: Introductionmentioning

confidence: 99%

Medical and non‐medical cannabis use and risk of prescription opioid use disorder: Findings from propensity score matching

Liang

Wallace

Shi

2019

Drug and Alcohol Review

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“…Although there are several studies supporting the promise of cannabis on reducing pain and opioid use, one recent observational study did not find any effect of cannabis on pain and opioid use. 51 In addition, other prominent researchers have raised questions as to whether physicians should recommend replacing opioids with cannabis. 35…”

Section: Cannabinoids and Opioidsmentioning

confidence: 99%

Cannabinoids, Pain, and Opioid Use Reduction: The Importance of Distilling and Disseminating Existing Data

Hutchison

Hagerty

Galinkin

et al. 2019

Cannabis and Cannabinoid Research

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The high prevalence of chronic pain conditions combined with an over-reliance on opioid prescriptions has resulted in an opioid epidemic and a desperate need for solutions. There is some debate about whether cannabis might play a role in addressing chronic pain conditions as well as the opioid epidemic. Recent surveys suggest that a large number of people are using cannabis as a treatment for pain and to reduce use of opioids, and cannabis-derived products demonstrate at least modest efficacy in the treatment of pain in randomized controlled trials. In addition, surveillance studies from countries that have approved the use of Sativex, which is a cannabis-based product, have demonstrated that a combination of D9-tetrahydrocannabinol and cannabidiol has low potential for harm, is well tolerated, and is helpful to patients. Given the number of people in the United States who are already using cannabis to manage pain and opioid use in state-regulated markets, it is imperative to conduct additional research in these areas, and to disseminate information on how to minimize harm and maximize any benefits of using cannabinoids to mitigate pain and reduce opioid use. The purpose of this article is to call attention to the fact that cannabis is being used in the management of chronic pain. Thus, this article also provides a set of guidelines on how to approach using cannabis to treat pain.

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“…"No evidence" emerged that cannabis influenced opioid use. 15 The limitations of the evidence base might account for the mixed results. For example, most studies evaluated by Whiting and colleagues assessed nausea and vomiting caused by chemotherapy, chronic pain or spasticity.…”

Section: Even More Mixed Evidencementioning

confidence: 99%

Are patients taking pot luck with cannabis?

Greener¹

2018

Prescriber

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Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study

Abstract: National Health and Medical Research Council and the Australian Government.

Cited by 190 publications

References 39 publications

Medical and non‐medical cannabis use and risk of prescription opioid use disorder: Findings from propensity score matching

Medical and non‐medical cannabis use and risk of prescription opioid use disorder: Findings from propensity score matching

Cannabinoids, Pain, and Opioid Use Reduction: The Importance of Distilling and Disseminating Existing Data

Are patients taking pot luck with cannabis?

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