Medical marijuana

New findings offer evidence that medical cannabis could be helpful in tapering patients off long-term opioid treatment for chronic pain, investigators say. 

The study was conducted in New York state, where medical cannabis became legal in 2014. Investigators examined health data for more than 8,000 adults from 2017 to 2019. Prescription opioid dosages were tracked over the 12 months prior to receipt of medical cannabis and up to eight months later. 

Cannabis tied to tapering 

The results showed significant opioid dose reductions among patients receiving medical cannabis for more than 30 days, said study lead Trang Nguyen, MD, of the New York State Department of Health. 

“Patients’ daily opioid dosages were reduced by 47% to 51% of the baseline dosages after eight months,” she reported. In contrast, those who received medical cannabis for 30 days or less reduced their initial opioid dosages by only 4% to 14%.

Notably, the largest reductions in opioid dosages were among patients who had higher baseline dosages of prescription opioids when they started receiving medical cannabis, Trang and colleagues wrote.  

Seniors and opioids

Many patients, particularly older adults, have limited options for chronic pain treatment. Nonsteroidal anti-inflammatory drugs, for example, are often contraindicated for these patients, they noted. 

But reliance on long-term opioid prescriptions can come with complications. 

“Changes in attitudes and policies toward opioid prescribing over the past decade have left some patients dependent on long-term high dosage prescriptions but fewer providers willing to write these prescriptions,” said Danielle Greene, PhD, of the City University of New York. Abrupt disruption of high-dose prescriptions may raise the risk of opioid-related morbidity and mortality, she said.

The investigation was partly inspired by anecdotal evidence from patients and healthcare providers, who said that medical cannabis reduced the amount of opioids patients take to manage pain, the researchers said. 

“These findings … contribute robust evidence for clinicians regarding the potential clinical benefits of medical cannabis in reducing the opioid burden for long-term opioid therapy patients,” Trang added. This also may reduce the risk for use of illicit substances and overdose. 

The study was published in JAMA Network Open.

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