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Cannabis vs. Opioids in Treating Chronic Pain

Throughout history — for at least two millennia — cannabis has been known as a plant with therapeutic properties. One of the most common conditions patients use cannabis for is chronic pain. In many states, more than 80% (and as high as 90%+) of patients indicate “severe pain” as the primary or secondary condition they’re using cannabis to treat.

There’s also quite a bit evidence suggesting patients are using cannabis to replace opioids to treat their chronic pain — a phenomenon known as the “substitution effect.”  This much is clear: we are experiencing the worst opioid epidemic crisis in history. Shouldn’t cannabis be a bigger part of the national conversation on how to combat the opioid crisis?

Anecdotally, few people would argue opioids are better than cannabis. But, of course, anecdotes aren’t the same as studies. So what does the research say about cannabis compared to opioids?

Predictably, on numerous measures, cannabis comes out on top.

Here’s what we know…

The “Substitution Effect”: Patients Are Replacing Opioids With Cannabis

The “substitution effect” refers to the conscious choice by individuals to replace (or reduce) the use of one substance (legal or illicit) for a substance they consider safer, less addictive, or more effective.

A number of studies have documented the “substitution effect” among clinical cannabis patient populations.

One Canadian study of dispensary patients found 67.8% of patients use cannabis as a substitute for prescription drugs like opioids and benzodiazepines.

States With Robust Medical Marijuana Programs Experience Fewer Opioid-Related Deaths and Treatment Admissions

Over the last couple of years, researchers have published several studies comparing medical marijuana states with states that don’t have legal medical marijuana programs. Recent research includes a study by the prestigious RAND Corporation and another multi-institutional study led by researchers at the Perelman School of Medicine at the University of Pennsylvania.

Both studies had similar findings. Key findings include:

  • 25% Decline in Opioid-Related Deaths: In the years following the implementation of medical marijuana programs, states where dispensaries are permitted to operate openly and legally, experienced an average decline of more than 25% in opioid-related deaths. In the first year following implementation, the average drop was approximately 20%, after five years, the average drop was 33.7%.
  • Opioid-Related Treatment Admissions Drop by 20%: States with legal medical marijuana programs have 20% fewer drug-treatment admissions related to opioids.

Medical Marijuana Is Associated With Several Health Benefits Compared to Opioids

The University of Michigan Schools of Public Health and Medicine conducted a study in which they found that patients using clinical cannabis to experience several benefits, including:

  • Patients Reduced Opioids: On average, patients with chronic pain who incorporated cannabis into their treatment regimen lowered their use of opioids by 64%.
  • Patients Experienced Fewer Side Effects: Most patients found cannabis caused fewer side effects from cannabis and were able to use fewer medications.
  • Patients Reported Their Quality of Life Improved: Patients reported, on average, a 45% improvement in their quality of life.

Ongoing research consistently finds numerous benefits associated with the use of cannabis over opioids. And, it’s hard to ignore the data on the magnitude of our opioid epidemic. Data reported by the Centers for Disease Control and Prevention (CDC) are staggering! Consider the following:

  • More than 15,000 people die each year from prescription opioids. That’s more than 40 people per day!
  • As many as 1 in 4 people prescribed opioids to treat long-term noncancer pain struggles with addiction.
  • On any given day, more than 1,000 people are admitted to an ER for misusing prescription opioids.
  • Prescription opioid-related overdose deaths have quadrupled since 1999.

From 1999 to 2015, more than 183,000 people have died from a prescription opioid-related overdose in the U.S. During that same period, there wasn’t a single reported overdose death related to cannabis. If we’re serious about solving the opioid epidemic, clinical cannabis should be a part of the discussion on finding solutions to the current crisis. Of course, there’s no magic solution to the opioid epidemic, but the evidence is pretty clear: compared to opioids, cannabis is safer and potentially more effective to treat chronic pain.

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