Cannabis co-use with opioids linked to worse mental health but not worse pain in Black adults | Research

The takeaway

Among Black adults with chronic musculoskeletal pain who use opioids, those who also used cannabis had higher anxiety, depression, opioid dependence, and risky substance use, but not worse pain outcomes.

Black adults managing chronic pain, pain medicine providers, addiction researchers

Worse mental health but no pain benefit

What the researchers found

Compared to opioid use alone, cannabis-opioid co-use was associated with elevated anxiety and depression symptoms, greater opioid dependence, and riskier use of other substances, but was not associated with differences in pain intensity or interference.

Why it matters

Black individuals with chronic pain face worse pain outcomes and opioid-related disparities. Some may add cannabis hoping to reduce opioid needs, but this study found co-use was associated with more substance-related problems without additional pain relief.

The numbers in context

401 Black adults (51.62% female, mean age 35.9). Co-use associated with elevated anxiety, depression, opioid dependence, and risky substance use. No difference in pain outcomes.

How the study worked

Cross-sectional study of 401 Black adults with chronic musculoskeletal pain who use opioids. Online measures assessed pain intensity/interference, emotional distress, opioid dependence, and risky substance use.

What this study cannot tell us

Cross-sectional design cannot establish causation. Online sample may not be representative. Self-reported measures. Cannot determine whether people with worse mental health are drawn to co-use or whether co-use worsens mental health.

How to read the evidence

Cross-sectional survey with adequate sample size but cannot establish causal direction between co-use and mental health outcomes.

When this study was published

2024 cross-sectional study of Black adults with chronic pain

The bigger picture

The lack of pain benefit challenges the popular narrative that cannabis can help reduce opioid use for pain. Among this population, co-use appears to add complexity without reducing pain, though the cross-sectional design cannot determine whether cannabis co-use is a cause or consequence of worse mental health.

Questions still open

Would supervised cannabis-opioid substitution programs produce different outcomes? Do these findings apply across racial groups or are they specific to Black adults with chronic pain?

Common questions

Does adding cannabis to opioids help with pain?

In this study, no. Black adults who co-used cannabis and opioids did not report less pain than those using opioids alone, but did have more mental health symptoms and substance use problems.

Why focus on Black adults specifically?

Black individuals with chronic pain experience worse pain outcomes and face disparities in opioid access and treatment. Understanding co-use patterns in this population can inform more equitable and effective pain management.

Read the original research

Cannabis Co-Use Among Black Individuals with Chronic Pain Who Use Opioids: Associations with Other Substance Use and Pain Related Outcomes.

Journal of health care for the poor and underserved, 35(2), 564-582

View on PubMed ↗

Citation

Bakhshaie, Jafar; Doorley, James D; Choukas, Nathaniel R; Fishbein, Nathan S; Grunberg, Victoria A; Vranceanu, Ana-Maria. (2024). Cannabis Co-Use Among Black Individuals with Chronic Pain Who Use Opioids: Associations with Other Substance Use and Pain Related Outcomes.. Journal of health care for the poor and underserved, 35(2), 564-582.