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

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.

Bakhshaie, Jafar et al.·Journal of health care for the poor and underserved·2024·Moderate EvidenceCross-Sectional
RTHC-05105Cross SectionalModerate Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
Not reported

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
Worse mental health but no pain benefit
Evidence Grade:
Cross-sectional survey with adequate sample size but cannot establish causal direction between co-use and mental health outcomes.
Study Age:
2024 cross-sectional study of Black adults with chronic pain
Original Title:
Cannabis Co-Use Among Black Individuals with Chronic Pain Who Use Opioids: Associations with Other Substance Use and Pain Related Outcomes.
Published In:
Journal of health care for the poor and underserved, 35(2), 564-582 (2024)
Database ID:
RTHC-05105

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked 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 More on RethinkTHC

Cite This Study

RTHC-05105·https://rethinkthc.com/research/RTHC-05105

APA

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.

MLA

Bakhshaie, Jafar, et al. "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, 2024.

RethinkTHC

RethinkTHC Research Database. "Cannabis Co-Use Among Black Individuals with Chronic Pain Wh..." RTHC-05105. Retrieved from https://rethinkthc.com/research/bakhshaie-2024-cannabis-couse-among-black

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.