Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients

Lucas, Philippe; Walsh, Zach

doi:10.1016/j.drugpo.2017.01.011

Cited by 226 publications

(224 citation statements)

References 22 publications

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“…For example, in 2013 and 2016, Lucas et al17,18 found that 68% of 259 and 87% of 410 physician-authorized medical cannabis users in Canada reported substituting cannabis for alcohol and illicit or prescription drugs, respectively. In 2017, Lucas and Walsh19 found that 63% of 271 such subjects reported substituting cannabis for prescription drugs such as opioids (30%), benzodiazepines (16%) and antidepressants (12%), representing the same top three categories as data presented here. These findings also agree with our previous data showing that medical cannabis users report using cannabis most frequently to manage pain, anxiety and depression 6.…”

Section: Discussionsupporting

confidence: 65%

Cannabis as a substitute for prescription drugs – a cross-sectional study

Corroon¹,

Mischley²,

Sexton

2017

JPR

178

127

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BackgroundThe use of medical cannabis is increasing, most commonly for pain, anxiety and depression. Emerging data suggest that use and abuse of prescription drugs may be decreasing in states where medical cannabis is legal. The aim of this study was to survey cannabis users to determine whether they had intentionally substituted cannabis for prescription drugs.MethodsA total of 2,774 individuals were a self-selected convenience sample who reported having used cannabis at least once in the previous 90 days. Subjects were surveyed via an online anonymous questionnaire on cannabis substitution effects. Participants were recruited through social media and cannabis dispensaries in Washington State.ResultsA total of 1,248 (46%) respondents reported using cannabis as a substitute for prescription drugs. The most common classes of drugs substituted were narcotics/opioids (35.8%), anxiolytics/benzodiazepines (13.6%) and antidepressants (12.7%). A total of 2,473 substitutions were reported or approximately two drug substitutions per affirmative respondent. The odds of reporting substituting were 4.59 (95% confidence interval [CI], 3.87–5.43) greater among medical cannabis users compared with non-medical users and 1.66 (95% CI, 1.27–2.16) greater among those reporting use for managing the comorbidities of pain, anxiety and depression. A slightly higher percentage of those who reported substituting resided in states where medical cannabis was legal at the time of the survey (47% vs. 45%, p=0.58), but this difference was not statistically significant.DiscussionThese patient-reported outcomes support prior research that individuals are using cannabis as a substitute for prescription drugs, particularly, narcotics/opioids, and independent of whether they identify themselves as medical or non-medical users. This is especially true if they suffer from pain, anxiety and depression. Additionally, this study suggests that state laws allowing access to, and use of, medical cannabis may not be influencing individual decision-making in this area.

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Section: Discussionsupporting

confidence: 65%

Cannabis as a substitute for prescription drugs – a cross-sectional study

Corroon¹,

Mischley²,

Sexton

2017

JPR

178

127

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“…30,31 Interestingly, some studies have found that jurisdictions where cannabis is available for therapeutic purposes tend to see a decrease in prescription opioid/pain medication use, 32,33 suggesting that some people with chronic pain may be using therapeutic cannabis as a substitute for prescription opioids. 34,35 This study also indicated that among those who reported CUTP, 15.2% reported that they had medical approval to use cannabis therapeutically. Such medical approval, however, does not necessarily mean that cannabis was obtained through Health Canada's regulatory system, 6 as proof of medical authorization is required to access that system.…”

Section: Discussionmentioning

confidence: 73%

Therapeutic use of cannabis: Prevalence and characteristics among adults in Ontario, Canada

Hamilton

Brands

Ialomiteanu

et al. 2017

Can J Public Health

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OBJECTIVE: To investigate the prevalence of therapeutic cannabis use within a general population sample of adults and to describe various characteristics associated with use.METHODS: Data were derived from the 2013 and 2014 CAMH Monitor Survey of adults in Ontario, Canada. This repeated cross-sectional survey employed a regionally stratified design and utilized computer-assisted telephone interviewing. Analyses were based on 401 respondents who reported using cannabis. RESULTS:The data indicated that 28.8% of those who used cannabis in the past year self-reported using cannabis for therapeutic purposes. Of therapeutic users, 15.2% reported having medical approval to use cannabis for therapeutic purposes. Cannabis use for therapeutic purposes was associated with more frequent use of cannabis, a moderate to high risk of problematic cannabis use, and a greater likelihood of using prescription opioids for medical purposes. There was little difference in cannabis use for therapeutic purposes according to sex, age, and marital status after adjusting for opioid use and problematic cannabis use. CONCLUSION:Findings suggest some potential negative consequences of cannabis use for therapeutic purposes; however, further research is needed to better understand the range and patterns of use and their corresponding vulnerabilities.KEY WORDS: Medical cannabis use; medical marijuana use; prescription opioids; problematic cannabis use La traduction du résumé se trouve à la fin de l'article.

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“…AIAN individuals and communities may view oral and long-acting injectable naltrexone somewhat more favorably because it has neither the opiate-related effects nor can it be diverted. An alternative or adjunct that may be in line with Indigenous traditional treatment is medicinal cannabis, which recently is being explored as a MAT (47, 48). Similarly, peyote, used in NAC, has been described as an ethnopharmacologic agent that may have benefit in treating alcohol and OUDs (49), but with limited research.…”

Section: Discussionmentioning

confidence: 99%

Future directions for medication assisted treatment for opioid use disorder with American Indian/Alaska Natives

Venner

Donovan

Campbell

et al. 2018

Addictive Behaviors

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The U.S. is experiencing an alarming opioid epidemic, and although American Indians and Alaska Natives (AI/AN) are especially hard hit, there is a paucity of opioid-related treatment research with these communities. AI/ANs are second only to Whites in the U.S. for overdose mortality. Thus, the National Institute on Drug Abuse convened a meeting of key stakeholders to elicit feedback on the acceptability and uptake of medication assisted treatment (MAT) for opioid use disorders (OUDs) among AI/ANs. Five themes from this one-day meeting emerged: (1) the mismatch between Western secular and reductionistic medicine and the AI/AN holistic healing tradition; (2) the need to integrate MAT into AI/AN traditional healing; (3) the conflict between standardized MAT delivery and the traditional AI/AN desire for healing to include being medicine free; (4) systemic barriers; and (5) the need to improve research with AI/ANs using culturally relevant methods. Discussion is organized around key implementation strategies informed by these themes and necessary for the successful adoption of MAT in AI/AN communities: (1) type of medication; (2) educational interventions; (3) coordination of care; and (4) adjunctive psychosocial counseling. Using a community-based participatory research approach is consistent with a “two eyed seeing” approach that integrates Western and Indigenous worldviews. Such an approach is needed to develop impactful research in collaboration with AI/AN communities to address OUD health disparities.

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Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients

Cited by 226 publications

References 22 publications

Cannabis as a substitute for prescription drugs – a cross-sectional study

Cannabis as a substitute for prescription drugs – a cross-sectional study

Therapeutic use of cannabis: Prevalence and characteristics among adults in Ontario, Canada

Future directions for medication assisted treatment for opioid use disorder with American Indian/Alaska Natives

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Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients

Cited by 226 publications

References 22 publications

Cannabis as a substitute for prescription drugs &ndash; a cross-sectional study

Cannabis as a substitute for prescription drugs &ndash; a cross-sectional study

Therapeutic use of cannabis: Prevalence and characteristics among adults in Ontario, Canada

Future directions for medication assisted treatment for opioid use disorder with American Indian/Alaska Natives

Contact Info

Product

Resources

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Cannabis as a substitute for prescription drugs – a cross-sectional study

Cannabis as a substitute for prescription drugs – a cross-sectional study