Study: Cannabis Improves Outcomes In Opioid-Dependent Subjects Undergoing Treatment

cannabis_pillsCannabis use is associated with improved outcomes in opioid-dependent subjects undergoing outpatient treatment, according to data published online ahead of print in the journal Drug and Alcohol Dependence.

Researchers at Columbia University assessed the use of cannabinoids versus placebo in opioid-dependent subjects undergoing in-patient detoxification and outpatient treatment with naltrexone, an opiate receptor antagonist. Investigators reported that the administration of oral THC (dronabinol) during the detoxification process lowered the severity of subjects’ withdrawal symptoms compared to placebo, but that these effects did not persist over the entire course of treatment. By contrast, patients who consumed herbal cannabis during the outpatient treatment phase were more readily able to sleep, were less anxious, and were more likely to complete their treatment as compared to those subjects who did not.

“One of the interesting study findings was the observed beneficial effect of marijuana smoking on treatment retention,” authors concluded. “Participants who smoked marijuana had less difficulty with sleep and anxiety and were more likely to remain in treatment as compared to those who were not using marijuana, regardless of whether they were taking dronabinol or placebo.”

The findings replicate those of two prior studies, one from 2001 and another from 2009, reporting greater treatment adherence among subjects who consumed cannabis intermittently during outpatient therapy.

Population data from states where medicinal cannabis is permitted report lower rates of opioid-abuse and mortality as compared to those states where the plant is prohibited. Clinical data and case reports also indicate that the adjunctive use of cannabis may wean patients from opiates while successfully managing their pain. Survey data of state qualified medical cannabis patients demonstrates that subjects with access to the plant often substitute it for opioids because they perceive it to possess fewer adverse side effects.

Overdose deaths involving opioids have increased dramatically in recent years. While fewer than 4,100 opiate-induced fatalities were reported for the year 1999, by 2010 this figure rose to over 16,600 according to an analysis by the US Centers for Disease Control.

An abstract of the study, “The effects of dronabinol during detoxification and the initiation of treatment with extended release naltrexone,” appears online here.

24 thoughts

  1. I wonder why tests are being performed with “smoked” marijuana instead of vaped. Is it because anti-marijuana types have said that “smoked” marijuana is not medicine?

    Personally, I believe it has medicinal properties used either way but also believe that vaporization is the superior method of usage.

  2. And again, another point that many of us have been arguing is validated by researchers.

    “Participants who smoked marijuana had less difficulty with sleep and anxiety and were more likely to remain in treatment as compared to those who were not using marijuana, regardless of whether they were taking dronabinol or placebo.”

  3. Is there nothing the Wonder Weed can’t do? If this is true then it’s even more important that the government stop spreading lies and misinformation and stop supporting/protecting the pharmaceutical’s distribution of opioid pain meds and addictive anti-anxiety meds. Why is this still criminalized when it’s becoming more and more evident that pot is not only not bad for you but good for you and for society as a whole.

    For 40 years,the government has spent billions of tax funds to deliberately suppress accurate information about marijuana, suppress research except to distribute false and biased information, ruin lives through unnecessary arrests and child removals, block effective medical treatment and instead has liberally supported pharmaceuticals distribution of addictive painkillers and anti-anxiety medications?

    When is NORML going to hold the government accountable through a lawsuit?

    When is NORML going to hold the government liable?

    [Editor’s Note: Been there, done that (NORML vs. DEA, 1972-1994). NORML (ACLU, DPA, etc…) are not going to be wasting time and resources litigating cannabis policy in the courts as almost all cannabis law reform in America is derived from legislation and initiatives as the courts, notably the federal courts, strongly defer to legislators’ will and intent when considering drug-policy related cases and challenges.

    Rather than rely on small non-profits to hold the government accountable via expensive and torturous legal cases, citizens voting for reform-minded policymakers are best bulwark for policy change.]

  4. I saw Gov. John Kasich interviewed by satirist Steven Colbert. His response to a question on marijuana conflated marijuana legalization with legalization of all drugs. Then he went on to talk about heroin and fentanyl.

    At one point Colbert interjected, ‘You do realize we’re not talking about fentanyl don’t you.’

    Judging from his blatant ignorance and willing self delusion, he is not competent to run the country.

    Cross him off the ‘might-vote-for-him’ list, NORML fans.

    [Editor’s note: Kasich is an old school drug warrior from his days in Congress in the late 80s/early 90s that unfortunately has not ‘evolved’ along with the changing views about cannabis in America.

    Watch him ill comport himself regarding Mr. Colbert’s line of questions here.]

  5. Mr Rosenberg – The real joke is the so-called leaders of our country; you know, the kind that put you into your current office! I could never have imagined, as a child, just how completely incompetent American leaders could possibly be.

    Our Govt and you Mr. Rosenberg are the joke but I’m not laughing…

    It’s incredibly depressing to think about what the ideals were when our country was founded and what our govt has turned it into. It’s just pathetic!

  6. @Fireweed

    Put this definition in front of reform-minded policy makers. It upholds the Necessary and Proper clause, deschedules cannabis, speaks to Big Cannabis, and could increase the chances of getting marijuana rescheduled.

    16. The term “marijuana” means all parts of the smoke produced by the combustion of the plant Cannabis sativa L. which is prohibited to be grown or sold by any publicly traded corporation or subsidiary company.

    This year is a good time to write them a letter.

  7. Need Congress more evidence to pass a House version of the VA bill FY2015 and provide marijuana to veterans and stop the suicides? Soldiers are begging the VA to get off of opiates while the VA overdoses them with opiate cocktails during in-patient treatment. Whether this is your first time visiting this blog or you just wrote your Congressman Click on the Take Action link above and let your Congressman know right now that we’re not putting up with this treason from the unconstitutional CSAct!

  8. Cannabis medications are prevalent globally with patients who wish to use natural medications and not consume the petrol-chemical based prescription medications killing and maiming millions world wide. Personal experience is overwhelming the prohibitionist propaganda with the truth.

  9. “Investigators reported that the administration of oral THC (dronabinol) during the detoxification process lowered the severity of subjects’ withdrawal symptoms compared to placebo, but that these effects did not persist over the entire course of treatment. By contrast, patients who consumed herbal cannabis during the outpatient treatment phase were more readily able to sleep, were less anxious, and were more likely to complete their treatment as compared to those subjects who did not”

    Not surprising at all,THC is just one cannabinoid among many others found in herbal cannabis along with all the terpenes that have a synergy with the cannabinoids and modulate them in all kinds of mysterious ways that only nature knows about,and man just discovering…

    Lets see a chemist create a sun ripened pear, from scratch in the laboratory that rivals the real deal in every way:cellulose,vitamins, minerals,antioxidants,flavonoids,that taste like the real thing too.

    Until then, real cannabis is the way to go, with terpenes intact.Cannabis is a Nutraceutical,that has been used for thousands of years,and has a broad range of applications.

    Not just to the highest bidder,in terms of Patent rights.

  10. It’s a good thing to see enlightened academia pursuing and publishing scientific data (read: truth, not agenda-driven rhetoric). One must hope the government’s stubborn ignorance will eventually fall like the house of cards it is.

  11. I wonder maybe the above cited and celebrated conquest of obesity proceeds from the cannabinoids and terpenes Entourageously vivifying– or revivifying if warranted– the IMAGINATION, so that an individual can in the magic minutes and/or Our Four Hour Tour hours after tokes invent or discover interesting new EXERCISES, or interesting new ways to mentally enjoy old conventional ones, as the case may be. But alas for $ugarmongers now $elling him-her an instant-gratification shortterm substitute, that might also mean an individual learns how to enjoy prolonged CHEWING of nutritious food rather than hurried medicine-like gulping of high-ounceage-canned and -bottled $ugarpotions. Longer chewed (or, if liquid, swished) foods are more completely saliva-medi(t)(c)ated, hence better readied for use in energy- and protein-creation.

    After tokes, nothing but water (swish real good,mmm) the first hour, maybe chew some fruit (the calcium, not just juice) the second, only very modest amount of well-chewed food thereafter thru fourth hour, the whole time best mainly reserved not for eating but for explorative-inventing activities, though you can chew just fine whilst walking or handworking.

    PS. During exercises or workprocesses, yes, do imagine, humn, sing, dance to tunes, rhythms, counts (how many seconds did it take you to tie that particular kind of shoe?) which helps develop mind-motion coordination. Walk muscularly like a cat rather than clop clop staccato like rich folks do in their stiff style shoe.

  12. I wish I could have made it to Texas NORML’s event tonight in Austin with Republican District 21 candidate John Murphy-TX and Democrat Tom Wakely who both support legal marijuana! This is coming from the same district currently run by R-Lamar Smith who has been nothing but in the way for any kind of cannabis reform, yet his seat is up for reelection this March.

    I wrote a letter to the candidates, copied below, with a reply from John Murphy:

    —- On Tue, 01 Dec 2015 21:50:01

    “Hi John,
    My name is Julian from District 21 in TX.
    I have two questions;
    Leading up to tomorrow’s forum with Texas NORML, would you support an amendment to the language in the marijuana plant extract law that passed through the state legislature to allow doctors to “recommend” instead of “prescribe” cannabis and to allow veterans to consume marijuana for any range of illness such as PTSD or seizures?
    Question two; will you support/ introduce any industrial hemp legislation in Texas for feed, fuel, cellulose plastics, medicine and building materials?
    Thank you,

    Best Regards,

    Name:: Julian”


    John Murphy for Congress
    Today at 12:29 PM

    Hi Julian,

    Thanks for taking the time to reach out, I appreciate it. I haven’t read the legislation you mentioned and would be hesitant to comment because of it. I am running for the U.S. House of Representatives and for the most part think the federal government should leave the states alone. I do think that the war on drugs has been and continues to be a total failure. I would like to see it ended posthaste and would vote as such if elected. If you have more questions let me know. Hope to see you tonight.

    Thanks again,

    The only comment I would add in light of current events, is that we finally return to spending more on drug treatment, education and violence prevention than we do on drug enforcement and interdiction.

  13. Well, this is certainly good news for Pennsylvania, which is experiencing a heroin epidemic beyond urban areas and out into the countryside.

    Apropos, Pennsylvania does not have a state budget, and the legislature and the governor should keep NOT having a budget until the spring or sometime until the situation is so dire that the public is willing to acquiesce in the legalization of both medical and adult recreational cannabis. Harrisburg needs money something bad for public education, and should look to how Colorado is using cannabis revenues to support their schools. Also, the Republicans want to privatize the state-run liquor store system, and they should look to Washington state, which switched privatized its liquor system and legalized cannabis, you know, to keep the state employees’ jobs, which, I guess, attrition as state employees retire will achieve the staff/salary reductions they were looking for in cutting the state budget and size of the state workforce.

    Democratic Governor Tom Wolf is supposed to be the most liberal governor in the country, so if the budget stalemate can keep running the economy into the ground, in short time the prohibitionists’ sway over the public will, I hope, give way to legalization.

    I mean, it must be funny as shit to be in the know about certain Republican state politicians’ use of cannabis in their younger years, their big secret, the skeleton in their closet, but empathizing with them not wanting to reveal it and taking basically the prohibitionist position against cannabis of their/my grandfather’s generation. Your not my grandfather’s politician. Times have changed. End the Reefer Madness!

    Orchestrate the budget stalemate so that Governor Tom Wolf will sign both medical and adult recreational marijuana into law in spring of 2016!

  14. I have been taking pain meds since 1996 for severe chronic back pain. I broke my back and had a surgery which left me in worse pain than before! I’ve smoked high quality cannabis and it really helps with my pain so much and I’m able to take LESS PAIN MEDS because of cannabis!! Now I can’t smoke any in fear of testing positive for THC from a urine test given to me from my Doctor who prescribed the pain meds!! I tested positive a few months ago after over 41 days of NOT SMOKING ANY cannabis!! The cannabis I was smoking was 26% and only took me a couple of hits to help my pain! I’m so scared to smoke any in between Doctors visits which is every 90 days. I’ve came home from my Doctors visit and taken only 2 hits of cannabis the first 2 days after the Dr visit and NOT SMOKED ANY MORE BUT STILL TESTED POSITIVE MY NEXT DR VISIT! Is there ANY THING I CAN DO SO I CAN USE CANNABIS? I live in NC so it’s not legal here yet, if it ever will be. Any thoughts or suggestions on what I can do if anything, THAT REALLY WORKS!!! My Dr told me it can stay in my system 90 to 120 days. If I drink that stuff that will clean out the toxins in my body won’t it also clean out the pain meds that he prescribed in which case he would think I was just selling them and I’m not!! Please HELP!!!

  15. Stubborn ignorance can be detrimental to development. Its like a banana peal placed before your path on purpose, just to see how far you may bounce?

  16. postscript

    Why not focus on Pennsylvania as a possibility of being among the first with a legislature legalizing adult recreational?

    Trudeau is legalizing in Canada.

    Pennsylvania borders on Ontario across from Lake Erie. Hello, Ottawa! National capital. Washington, DC is just south of Pennsylvania, and it has already legalized both medical and adult recreational. Regardless of the federal interference that has prevented the realization, the implementation, of adult recreational in DC.

    Pennsylvania does not of yet have legal medical marijuana. On a map of eastern states that legal medical marijuana, you have the / from DC up the I-95 corridor into New England. When Pennsylvania finally legalizes, you will have the \ of the X you mark on the map of the United States. Ohio was a no-go. It’s outside the line connecting Ottawa with DC.

    You can put a big X marking the North East and the Mid Atlantic down as pro-legalization.

  17. Jim Kenney is pro-legalization. Tom Wolf shouldn’t have a problem legalizing both medical and adult recreational simultaneously. The surrogates just have to get out there and spread the word and be the lightning rods before the Governor reveals why he is for it.

    Has any other state with a legislature legalized both medical and recreational cannabis at the same time? Any state legislature legalized adult recreational, yet?

    States that haven’t legalized by the time the feds legalize will be able to implement legalization of both at the same time, and will be looking at other states that have as models. Well, some state with a legislature has to be the first to legalize adult recreational. If you could get a state the size and location like PA to legalize before the feds legalize, or at least before the feds do something more to stay the hell out of the way such as legalize cannabis banking, you might be able to speed up the momentum for the feds to legalize all the sooner.

    Keep running the Pennsylvania state budget system into the ground until the ripple effects make the public landscape overripe for it.

    Nice business opportunities that are visible and pay taxes, make jobs. Hemp food labels and fees regarding state approval, etc. Pharmaceutical research into what in cannabis sativa makes for a more cerebral energetic high as opposed to a stony indica stuporific couch lock. These components in the sativa strains that account for the high-functioning cerebral effect, when isolated, perhaps in a cartridge if not effectively vaporized without the other vapors, could be a most effective solution depression or lack of energy, be it as a happy hour or more concentrated via prescription. Big Pharma in Pennsylvania can’t currently do any research on that for pill or nebulizer, inhaler, whatever.

  18. J.J. I am too on pain medicine and my doc wont let me smoke pot. But if you stop s moking 10 days before your next visit; and flush your system with baking soda and water everyday you should be clean. Just Google the baking soda method to see how much you need for your body weight. It has worked for me and my freinds every time. Good luck and keep on smoking!!!!! Freedom is Norml

  19. @Mexweed;
    Great post. I would respond that of course marijuana inspires the imagination to venture into different methods of excercise because, as you mention, various terpenes and cannabinoids are stimulating the exact same endorphins we feel when we get an excercise “high.” Its only natural our body would want to stretch and excercise after marijuana consumption, but I would recommend a sativa strain like trainwreck which is high in pinenes that keep us alert during a workout, laborous activity or a hike up the hills.
    Indica is great for relaxing after a good workout, but creates the “couch-lock” effect so many consumers complain or celebrate about… Depending on the time of day and activity.
    @JJ Kix
    You may wish to try the sativa strain I mentioned above and stay off the Indica. Your problem may be, possibly due to your medical condition, that you are retaining too much body fat where cannabinoids tend to be stored for later consumption. Go to any “tobacco” shop that sells pipes and hookas and you will find urine cleansers. Dont drink too much water just to evade a piss test: Even too much water is more toxic than marijuana, from which we cannot overdose.
    Keep up the volume on the association between marijuana and drug prohibition and the increase in heroin and needle sharing epidemic in the Philadelphia area. If older voters want to be scared into voting, lets let them know how AIDS is spreading from intravenous heroin use while naxalone and marijuana… The very remedies for this scurge… are being prevented from use.
    I used to think the Department of Health and Human Services patent 6630507 on cannabinoids as neuroprotectants while taking custody of children whose parents consume marijuana was the greatest hypocrisy of marijuana prohibition; But now I wonder if 15 years in Afghanistan and 45 years of drug war providing cheaper heroin while veterans are denied treatment for PTSD doesn’t win the Darwin award under the CSAct?

  20. The study to help with Opiod dependency is right on point. From a former opiod user for 6 years for back pain to a non-addict today. I used it for the very same thing and did not find myself addicted to cannabis. Also, it will save lives in the treatment for addiction of Herion, Cociane and Meth.

  21. In this study:
    1. placebo worked as well as dronabinol(synthetic cannabinoid) in helping patients stay in treatment
    Both kept only 35% of people in the detox phase of treatment
    2. If you need to do a post hoc analysis, your study is of poor quality

    [Paul Armentano responds: “Conclusion: Dronabinol reduced the severity of opiate withdrawal during acute detoxification but had no effect on rates of XR-naltrexone treatment induction and retention. Participants who elected to smoke marijuana during the trial were more likely to complete treatment regardless of treatment group assignment.”

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