Canadian study shows significant reduction in opioid use associated with medical cannabis approvals

A recently published Canadian study found that approvals to use medicinal cannabis in patients with chronic pain correlate with reductions in opioid use in those prescribed it. A report on the study, “Opioid Use in Medical Cannabis Licensing for Adult Patients, 2013-2018: Alberta, Canada” was published earlier this month in BMC Public Health.

In their background statement for the abstract of the study, researchers from the University of Alberta and the University of Toronto wrote that the overprescription and widespread diversion of opioid drugs has led to an epidemic of abuse and abuse in both Canada and the United States Conditions. As a result, identifying appropriate medical alternatives to opioids and helping patients reduce their intake of strong pain relievers has become a critical area of ​​study.

“An increasing body of literature suggests that medical cannabis can relieve chronic pain, be a potential substitute for opioids, and act as contenders for reducing opioid use by patients,” the study authors wrote. “Recent studies, known as ‘opioid-sparing effects,’ have highlighted the analgesic properties of medicinal cannabis – and that its simultaneous use with cannabis may show a significant reduction in overall opioid dependency – and, consequently, improved quality of life.”

To conduct the research, researchers evaluated the association between the use of medicinal cannabis and the use of opioid pain relievers. Researchers analyzed medical cannabis use and opioid use among chronic opioid users, including more than 5,300 patients who were allowed to use medical cannabis and a group of control subjects who were not licensed to use medical cannabis. The researchers rated the change in the subjects’ weekly opioid use as measured by oral morphine equivalent (OME). The use of opioids by patients in the 26 weeks prior to and 52 weeks after approval of medical cannabis was studied.

Largest reduction in opioid use in high dose patients

Analysis of the data found that approval of medical cannabis had mixed results in short-term opioid use. Overall, however, subjects with medical cannabis approval reduced opioid drug use at a rate that was higher than comparable controls. The greatest reduction in use appeared to be in patients starting high doses of opioids.

At the prescribed high opioid doses (OME> 100), there was a significant reduction in opioid consumption compared to the corresponding controls. However, the subjects who were prescribed lower doses of opioids before they were approved for medical cannabis did not show a statistically significant reduction in their opioid intake compared to their respective controls.

“This short-term study found that approval of medical cannabis showed intermediate effects on opioid use that were dependent on initial opioid use,” the study’s authors wrote in their conclusion. “In patients with a high opioid dose (OME> 100) there appear to be larger observations of changes in OME. However, continued monitoring of patients using both opioids and medicinal cannabis is ensured by doctors to understand the long-term potential benefits and harms of ongoing use. “

The researchers found that the research is in line with other studies that have shown reductions in opioid use in relation to access to medical cannabis.

“Overall, our results could provide clinicians with ongoing evidence of the potential effects of medical cannabis in reducing opioid exposure in patients,” they wrote.

Earlier this year, a team of researchers from the University of Toronto reported that opioid prescriptions fell in Canada after recreational cannabis became legal in 2018.

“Our results support the hypothesis that easier access to cannabis for pain can reduce opioid use for both public and private drug plans,” the researchers wrote.