Does Cannabis Enhance the Analgesic Benefits of Opioids?

One in four Canadians aged 15 and older has chronic non-cancer pain for which opioid medications can provide adequate pain relief. However, due to the increased risk of serious side effects such as hyperalgesia, constipation, and the possibility of opioid dependence that could lead to overdose, chronic opioid use should be approached with caution. A recent study suggests that the combination of cannabis and opioids may benefit people suffering from chronic non-cancer pain, as cannabis may enhance the analgesic benefits of opioids and reduce daily opioid use and the risk of opioid-related complications.

As a result, cannabis is now being studied as a treatment for chronic pain and opiate addiction. While cannabis use may represent a potential preventive medicine to mitigate the impact of the current opioid-related death crisis, insufficient studies have been conducted to examine the long-term outcomes for patients associated with cannabis and opioid use at the same time. Because both drugs depress the central nervous system, using them together can increase the risk of respiratory depression, falls, and car accidents.

Codeine is the most commonly prescribed opioid in the world and is available over the counter in Canada. The opioid is prescribed at a low dose of 15 mg/dose formulation mixed with simple painkillers (nonsteroidal anti-inflammatory drugs). [NSAIDs] or paracetamol) after consulting a pharmacist. However, guidelines that typically recommend that users be screened for codeine addiction before administering low-dose codeine are rare. While codeine is typically used as a cough suppressant or analgesic, guidelines generally indicate that codeine has limited function in the management of chronic pain before initiating stronger opioids for acute pain conditions. Although codeine is a “weak opioid,” the potential for dependence and harm due to subsequent dose escalation and tolerance must be considered.

With the wave of cannabis legalization sweeping across Canada and the wide availability of OTC and prescription codeine, people may be using codeine and cannabis-containing products at the same time, putting them at greater risk. Since most people do not report their cannabis use to their doctor due to a self-perceived stigma, healthcare providers may ignore their patients’ concomitant OTC and/or prescription codeine and cannabis use. As a result, the latest study aims to assess the relationship between cannabis and codeine use.

result of the study

The population source for the study consists of a total of 16,349 respondents. After carefully eliminating 890 respondents with invalid responses, responses from 15,459 people were used to examine the variables. Overall, 21.86% (3,338) of respondents had used cannabis in the past year, while 78.4% (12,121) had not. Of those respondents who affirmed cannabis use, 62.2% (1,833) were males between the ages of 15 and 44. Codien use was also higher among respondents who reported cannabis use (14.0%) than those who did not report cannabis use (8.0%).

Most people who self-reported codeine use (98.3%) and who did not (97.4%) also reported smoking cannabis more than once. However, the self-reported frequency of weekly or more cannabis use was higher among those reporting codeine use (55.4%) than among those reporting no codeine use (36.0%). In addition, more people who reported using codeine also reported using cannabis for medical reasons (61.6%) than those who reported not using codeine (32.1%).

The study examined the association between cannabis and codeine use using data from an independent Canadian national survey. In 2017, 21.6% of Canadians reported using cannabis, with 36.2% using cannabis for medicinal purposes. According to multivariable logistic regression models, those who self-reported cannabis use were more likely to report codeine use. People who used cannabis for medical reasons were about three times more likely to report codeine use when the study was limited to cannabis users.

These results underscore the growing need for more research on the safety profile of concomitant use of cannabis and opioids. It also requires healthcare providers, particularly prescribers (i.e. nurses, physicians and practitioners) and pharmacists, to assess a patient’s cannabis use before prescribing codeine. Additionally, this study suggests that healthcare providers may have a role in monitoring patients’ cannabis use, as the long-term side effects of concomitant use of prescription drugs, particularly codeine, are undetermined. Recently, evidence has emerged supporting the use of cannabis to treat non-cancer chronic pain and opioid addiction, as studies show a decrease in opioid intake after cannabis use.

In addition to finding an association between cannabis and opioid use, the study shows that those who claim to have excellent general health are less likely to admit codeine use than those who claim to have poor health. These results are consistent with previous research showing that people who take opioids have poorer physical and mental health. Another interesting conclusion from the study is that male cannabis users are less likely to use codeine than females. These results are consistent with previous research showing differences in opioid prescription rates between men and women. Women are more likely to be prescribed opioids than men, which can be partially explained by the increasing prevalence of chronic pain problems in women such as fibromyalgia, inflammatory arthritis and migraines.

Conclusion

The current study shows that people who used cannabis in the last year had a 72% higher chance of using codeine-containing product(s). Looking only at people who used cannabis in the previous year, those who used cannabis for medicinal purposes were three times more likely to use codeine. They were also significantly more likely to use one or more codeine-containing products than those who used recreational cannabis. The vital link between cannabis and codeine underscores the importance of physicians monitoring patients for concomitant use of cannabis and codeine, as long-term side effects are still largely undefined. Interdisciplinary care can be beneficial for patients using cannabis for medicinal purposes. They should also be informed about the likelihood of increased central nervous system depression when using opioids and cannabis at the same time.

CANNABIS AND OPIOIDS, READ MORE…

MONTEL WILLIAMS HOW CANNABIS BROKE HIM OFF OPIOIDS!