Study: Users of Non-Prescription Opioids Frequently Turn to Cannabis to Reduce Drug Cravings

Vancouver, Canada: Those who consume unregulated opioids frequently report using cannabis to mitigate their drug cravings, according to data published in the International Journal of Drug Policy

Canadian investigators assessed cannabis use trends among a cohort of 205 consumers of non-prescription opioids. Many of the cohort were IV drug users and at-risk youth. 

Nearly half of the study’s participants (45 percent) acknowledged using cannabis to manage opioid cravings. Of those, 62 percent “reported self-assessed decreases in opioid use during periods of cannabis use.” Subjects suffering from chronic pain were most likely to engage in opioid substitution.

Authors concluded: “In the present study, we observed that cannabis use to manage opioid cravings was significantly associated with self-assessed decreases in opioid use during periods of cannabis use among a structurally marginalized population of PWUD [people who use unregulated opioids]. The sub-analysis indicated that this association was mainly driven by those living with moderate to severe pain. … This suggests that future studies of cannabis substitution for opioid use should measure and analyze the impact of pain, as not doing so may lead to equivocal findings when the effects of cannabis substitution may vary based on the prevalence of chronic pain.”

Although numerous studies indicate that patients typically decrease their use of prescription opioids after initiating cannabis therapy, data regarding the relationship between cannabis use and non-prescription opioids is less consistent. According to a 2020 review paper: “Growing pre-clinical and clinical evidence appears to support the use of cannabis … to combat OUD [opioid use disorder]. The evidence summarized in this article demonstrates the potential cannabis has to ease opioid withdrawal symptoms, reduce opioid consumption, ameliorate opioid cravings, prevent opioid relapse, improve OUD treatment retention, and reduce overdose deaths. … The compelling nature of these data and the relative safety profile of cannabis warrant further exploration of cannabis as an adjunct or alternative treatment for OUD.”

Full text of the study, “Cannabis use to manage opioid cravings among people who use unregulated opioids during a drug toxicity crisis,” appears in the International Journal of Drug Policy. Additional information is available from the NORML Fact Sheet, ‘Relationship Between Marijuana and Opioids.’