Cannabis use did not worsen opioid treatment outcomes in patients on buprenorphine
Among 100 men on long-term buprenorphine maintenance, those who used cannabis (35%) had comparable opioid cravings, withdrawal symptoms, employment, and quality of life to non-users, despite being on lower buprenorphine doses.
Quick Facts
What This Study Found
Researchers studied 100 randomly selected men who had been stable on buprenorphine maintenance for opioid use disorder for an average of 96 months. Compliance with buprenorphine was excellent across the group, with patients taking their medication on approximately 87 of every 90 days.
Thirty-five percent were currently using cannabis, and 77% had used it at some point in their lives. Current cannabis users were on significantly lower buprenorphine doses (7.9 mg vs 8.9 mg per day), yet showed no significant differences in opioid use, cravings, or withdrawal symptoms compared to non-users.
Employment rates, daily earnings, and quality of life scores across all domains were comparable between cannabis users and non-users. The findings suggest that concurrent cannabis use does not negatively impact the effectiveness of buprenorphine maintenance treatment for opioid use disorder.
Key Numbers
100 male patients studied. Average buprenorphine treatment duration: 96 months. Compliance: 86.92 days out of 90. 35% currently using cannabis. 77% lifetime cannabis use. Cannabis users on lower buprenorphine doses: 7.9 mg vs 8.9 mg (p = 0.04). No significant differences in opioid use, cravings, withdrawals, employment, or quality of life.
How They Did This
This was a cross-sectional study of 100 randomly selected adult male patients attending a community drug treatment clinic who had been stabilized on buprenorphine for more than 3 months. Measures included the WHO-ASSIST substance involvement screening tool and WHO Quality of Life-Brief assessment. Cannabis users and non-users were compared on buprenorphine dose, opioid outcomes, employment, and quality of life.
Why This Research Matters
Whether cannabis use undermines opioid treatment is a practical clinical question with real consequences. Some treatment programs prohibit cannabis use, potentially excluding patients who could benefit from opioid treatment. This study provides evidence that cannabis use may not warrant exclusion from buprenorphine treatment, especially given the lower buprenorphine doses among cannabis users.
The Bigger Picture
This study contributes to an ongoing debate about whether cannabis should be tolerated or prohibited during opioid agonist treatment. While some studies report cannabis use as a risk factor for poor treatment outcomes, this and other research suggests the relationship may be more nuanced, with cannabis potentially not interfering with, or possibly even supporting, opioid recovery.
What This Study Doesn't Tell Us
The sample was exclusively male, limiting generalizability to women. The cross-sectional design cannot determine causation. Patients were long-term stable patients (average 96 months), who may differ from those early in treatment. Cannabis use was self-reported. The study was conducted at a single community clinic in India, and findings may not generalize to other treatment settings.
Questions This Raises
- ?Could cannabis use actually support opioid recovery in some patients, as suggested by the lower buprenorphine doses among cannabis users?
- ?Would these findings hold in the early stages of buprenorphine treatment?
- ?Should opioid treatment programs reconsider policies that exclude cannabis users?
Trust & Context
- Key Stat:
- Cannabis users on lower buprenorphine doses (7.9 vs 8.9 mg) with equivalent outcomes
- Evidence Grade:
- This is a moderate-sized cross-sectional study with appropriate measures, but the observational design limits causal conclusions.
- Study Age:
- Published in 2018. The debate about cannabis use during opioid treatment continues with mixed findings.
- Original Title:
- Does Cannabis Use Influence Opioid Outcomes and Quality of Life Among Buprenorphine Maintained Patients? A Cross-sectional, Comparative Study.
- Published In:
- Journal of addiction medicine, 12(4), 315-320 (2018)
- Authors:
- Bagra, Igam, Krishnan, Vijay, Rao, Ravindra(2), Agrawal, Alok
- Database ID:
- RTHC-01581
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Does cannabis interfere with buprenorphine treatment?
This study found no evidence of interference. Cannabis users on buprenorphine had similar opioid cravings, withdrawal symptoms, employment, and quality of life compared to non-users. They were actually on slightly lower buprenorphine doses.
Should treatment programs test for cannabis?
This study raises questions about policies that penalize or exclude cannabis use during opioid treatment. If cannabis use does not worsen outcomes, mandatory testing and consequences may deter patients from seeking or continuing treatment.
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Cite This Study
https://rethinkthc.com/research/RTHC-01581APA
Bagra, Igam; Krishnan, Vijay; Rao, Ravindra; Agrawal, Alok. (2018). Does Cannabis Use Influence Opioid Outcomes and Quality of Life Among Buprenorphine Maintained Patients? A Cross-sectional, Comparative Study.. Journal of addiction medicine, 12(4), 315-320. https://doi.org/10.1097/ADM.0000000000000406
MLA
Bagra, Igam, et al. "Does Cannabis Use Influence Opioid Outcomes and Quality of Life Among Buprenorphine Maintained Patients? A Cross-sectional, Comparative Study.." Journal of addiction medicine, 2018. https://doi.org/10.1097/ADM.0000000000000406
RethinkTHC
RethinkTHC Research Database. "Does Cannabis Use Influence Opioid Outcomes and Quality of L..." RTHC-01581. Retrieved from https://rethinkthc.com/research/bagra-2018-does-cannabis-use-influence
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.