According to a study that involved hundreds patients, medical marijuana can help people with lower pain reduce their opioid usage as well as lower pain intensity and functional disabilities.
Researchers at Tel Aviv University in Israel, Rabin Medical Center, and Clalit Health Services tracked the pain, disability, and medication use of 1,000 patients with chronic back pain who had never used marijuana before. This was done for a 10-year period, each year, at a pain clinic specializing in orthopedic pain.
The opioid use measured by morphine equivalents “significantly” decreased 90 percent after a decade.
The researchers reported that the reduction in opioids was rapid during the first year, and then remained constant through the 10th year.
The pain intensity was also reduced by 84 per cent, while functional disability decreased by 30 per cent.
The study published by the European Spine Journal looked at the number of patients who met the pre-specified thresholds.
Patients who reduced their opioid usage met the goal of a minimum 50 percent reduction.
Participants achieved a reduction of pain intensity of 30% or more on an intensities scale. Sixty-two per cent of patients met the goal of a reduction of functional disability of at least 10 points on a scale.
The use of medical cannabis was associated with a reduction in opioid usage, pain intensity and functional disability after 10 years. This was accompanied by a reduction in polypharmacy and an acceptable tolerance.
The study participants also showed a “substantial decrease” in the use of other nonopioid drugs.
“Tramadol/tapentadol use decreased from 89.7% to 5.6% (−84.0% points), benzodiazepines from 78.8% to 5.3% (−73.5 pp), SSRIs from 77.7% to 5.8% (−71.9 pp), and gabapentinoids from 31.3% to 0.6% (−30.7 pp),” the study said. The study stated that these reductions were not protocol-mandated but rather clinically-driven, based on individual physician/patient decisions. “The pattern of polypharmacy decrease paralleled the opioid reduction and occurred primarily during the first two years.”
Researchers wrote that the reduction in medication use suggests “medical marijuana may be able to address multiple symptoms domains at once.”
The report stated that “Chronic Pain Patients frequently require Polypharmacy in order to manage their pain, anxiety, depression, sleep disturbance and insomnia, all of which carry the risk of adverse drug effects and interactions.”
Participants used cannabis products such as dried flower for vaporization, and cannabis oil for oral/sublingual use. The study continued, but some patients dropped off. Only 638 out of 1,000 enrolled completed the final follow-up.
Researchers cautioned against inferring causality from the observational study, as it was a single-arm study. Researchers also noted that reductions in outcome measures “substantially” exceeded those of previously published randomized-controlled trials. This suggested that “observational errors contributed to these results.”
They said that their study was the “longest-term follow-up for medical cannabis therapy in CLBP patients, and demonstrated sustained, clinically significant improvements beyond pre-specified [minimal clinically important difference] “Thresholds for opioid reduction, functional disability, and pain relief.”
“In this 10-year single-arm observational study, medical cannabis therapy was associated with reductions in opioid use (−89.8%), pain intensity (−84.2%), and functional disability (−30.4%), with high proportions of patients achieving pre-specified MCID thresholds,” the study concluded. “Substantial polypharmacy was reduced and tolerability was acceptable.”
This is far from the only study supporting the efficacy of marijuana in the treatment of pain—nor is it the first to suggest cannabis can serve as a substitute for conventional therapies such as opioids.
In a study that was published earlier this summer, it was found that the use of medical cannabis by people who suffer from chronic lower-back pain results in “large, sustained and statistically robust improvement.”
A study published in April revealed that people who use medical marijuana are less likely to take other medications like sleeping aids, opioids and antidepressants. The study, which involved more than 3,500 participants, also found that patients experienced fewer side effects when switching from prescription drugs to cannabis.
About one in three Americans who use CBD say they take it as an alternative or supplement to at least one medication—particularly painkillers—according to a federally funded study published in February.
Similarly, another recent federally funded study, published by the American Medical Association (AMA), added more evidence that marijuana can serve as an effective substitute for opioids in chronic pain treatment.
Other AMA-published research has found that legalizing marijuana for medical or recreational purposes is “significantly associated with reduced opioid use among patients diagnosed with cancer.”
A separate paper published last year similarly found that medical marijuana legalization is “associated with significant reductions in opioid prescribing.”
In August, meanwhile, Australian researchers published a study showing that marijuana can serve as an effective substitute for opioids in pain management treatment.
Another study published last year in the journal Drug and Alcohol Review found that, among drug users who experience chronic pain, daily cannabis use was linked to a higher likelihood of quitting the use of opioids—especially among men.
Other research also found that legalizing medical cannabis appeared to significantly reduce monetary payments from opioid manufacturers to doctors who specialize in pain, with authors finding “evidence that this decrease is due to medical marijuana becoming available as a substitute” for prescription painkillers.
Further research showed that the number of fatal opioid overdoses declined in jurisdictions which legalized marijuana for adults. That study found a “consistent negative relationship” between legalization and fatal overdoses, with more significant effects in states that legalized cannabis earlier in the opioid crisis. Authors estimated recreational marijuana legalization is “associated with a reduction of approximately 3.5 fatalities per 100,000 individuals.”
This report stated that “our findings suggest that broader access to recreational marijuana could help combat the opioid epidemic.” Previous research has shown that marijuana, primarily used for medical purposes, can reduce the number of opioid prescriptions. We also found it could reduce overdose deaths.
Another recently published report into prescription opioid use in Utah following the state’s legalization of medical marijuana found that the availability of legal cannabis both reduced opioid use by patients with chronic pain and helped drive down prescription overdose deaths statewide. The study concluded that cannabis has a significant role to play in the management of pain and reduction of opioid usage.
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