Medicinal Cannabis and Opioid Dependency – Is There a Benefit?
Written by Heema Joshi BMS'22
Published on November 18, 2020
The implementation of medicinal cannabis in the field of health has by no means been an easy transition. It had to endure a fair amount of trials and tribulations, yet continues to face obstacles in proving itself to be an innovative and legitimate treatment to the public today. The expansion of treatments exposed the field for a new niche of care, and the discoveries found from the experimentation of medicinal marijuana have had astounding success. Medicinal cannabis, specifically the component of tetrahydrocannabinol (THC), has substantial evidence for improving chronic pain in adults who have exhausted all other treatment options. In addition, patients who had a previous history with opiates showed reduced usage when undergoing medicinal cannabis treatment.
Persistent-chronic pain is one of the foundational health conditions that has shown good results in the utilization of medicinal cannabis. Due to opiates being commonly prescribed to persistent pain (PP) patients, adding an alternate treatment method can lead to a reduction of future opiate-related issues. Patients who use opiate medications tend to build an opiate dependency and tolerance. This can increase their chances of an Opioid Use Disorder (OUD) and also puts them at risk for an overdose. In addition to providing an analgesic effect, medicinal cannabis has been linked to reducing opiate medication side effects such as anxiety, nausea, inflammation, and sleep disturbance. Another group that may benefit from medicinal cannabis are those who are looking for alternative methods to combat their OUD.
Evidence is developing which supports the notion that incorporating cannabis into the treatment of OUD patients decreases their withdrawal symptoms and urges. It may improve OUD treatment success rates as well as decrease the chance of a relapse and overdose. This begs the question: Do patients perceive the benefits of medicinal cannabis differently, based on their condition? What role does cannabis have on patients who have been prescribed opioids for pain versus those who utilize it to combat their opioid addiction?
A study conducted by the College of Nursing at Washington State University attempted to find if individuals with a history of opiate use or chronic pain differ in their motivations for utilizing marijuana. The research consisted of a cross-sectional survey with an emphasis to see if the cannabis treatment showed any improvements in their pain management. This study was based on a parent experiment that sampled 243 participants, with 139 participants representing the OUD group and 104 in the PP group. The mean age for the PP group was significantly older than the mean age of the OUD group (51.26yrs vs 38.64yrs, respectively), with all participants being over the age of 18.
In addition, 53.9% of the overall testing population, which includes both groups, were female. In terms of the demographic characteristics, the majority of the participants self-identified as Caucasian/White (81%); however, their socioeconomic status and age were variable. The OUD group were younger in age and had a lower education level in comparison to the PP group.
The results showed that among all participants, both groups were likely to utilize cannabis treatment for health-related reasons such as pain (which includes withdrawal), sleep, and anxiety. Other research findings found that the quality of life was improved through the reduction of side effects. Although the results correlated with all participants, the two groups faced different challenges with their pain. For example, the persistent-pain patients were searching for a way to better manage their pain with an effective analgesic treatment, whereas the OUD group focused on either reducing their opiate use or helping them with withdrawal symptoms. Despite having significant differences in age and education, medicinal cannabis was viewed to improve pain in both the OUD and PP groups.
There appears to be a benefit in individuals who have used medicinal cannabis to have better success at managing their OUD. The addition of medicinal cannabis may provide patients with what they have been devoid of for far too long: a safer solution to their burdening pain. Patients seem to believe that cannabis can help in relieving their pain and reducing their need for opiates.
Regardless of the evidence supporting cannabis' medicinal use, multiple studies have refuted its benefits. In my following blog, we will counter this argument by focusing on the contradicting side of medicinal cannabis for OUD.