Medical Cannabis Patients Reported 64% Less Opioid Use After Starting Cannabis
Medical Cannabis Use Is Associated With Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain.
Bottom Line
A survey of 244 medical cannabis patients with chronic pain found that cannabis use was associated with a 64% decrease in opioid use, fewer medication side effects, and a 45% improvement in quality of life.
Why It Matters
In the context of the opioid crisis, any intervention that helps chronic pain patients reduce opioid use while maintaining or improving quality of life is significant. This study provides patient-level data supporting what population-level studies (linking medical cannabis laws to reduced opioid overdoses) have suggested.
The Backstory
In 2016, Kevin Boehnke walked into a medical cannabis dispensary in Michigan and did something that pharmaceutical companies weren't doing: he asked patients what happened when they started using cannabis alongside their other medications.
The answer was straightforward. They stopped taking so many of them.
The Survey
Boehnke, working with pain researcher Daniel Clauw at the University of Michigan, conducted a cross-sectional retrospective survey of 244 medical cannabis patients with chronic pain who patronized a Michigan dispensary between November 2013 and February 2015. The questionnaire collected demographic information, changes in opioid use, quality of life, medication classes used, and side effects — all before and after initiating cannabis use.
The design was simple. The findings were not subtle.
Nearly two-thirds of patients who had been using opioids reported reducing their opioid use after starting cannabis. They also reported fewer side effects from their remaining medications and a meaningful improvement in quality of life.
What This Study Can and Can't Tell You
This study cannot prove that cannabis caused patients to reduce their opioid use. It can only show that patients report doing so. The distinction matters enormously. People who seek out medical cannabis and patronize dispensaries are already motivated to use cannabis and may have negative feelings about their other medications. They may overestimate cannabis benefits and underestimate its role in their medication decisions.
But the study captured something the clinical trial literature was entirely missing: what patients actually do when they have access to cannabis alongside their prescription medications. Randomized trials can tell you whether cannabinoids beat placebo for pain on a rating scale. Only surveys like this one can tell you whether patients, in their own lives, are choosing cannabis over opioids — and reporting that the trade feels like an improvement.
The Opioid Context
This study landed in the middle of America's opioid crisis. In 2016, opioid overdoses were killing more than 100 Americans per day. The search for anything that might reduce opioid consumption was desperate and urgent. Boehnke's finding — that patients with access to medical cannabis voluntarily reduced their opioid use by 64% — was exactly the kind of signal that policymakers, physicians, and families were looking for.
The finding didn't prove that cannabis is a solution to the opioid crisis. But it suggested that cannabis access might be one piece of a harm reduction strategy — not by being a superior painkiller, but by being a good-enough alternative with a vastly safer side effect profile. Nobody has ever fatally overdosed on cannabis. The same cannot be said for the medications patients were replacing.
The pattern Boehnke documented has since been replicated. Corroon et al. (2017) found that 46% of cannabis users reported substituting cannabis for prescription drugs, with opioids the most commonly replaced category. Bradford & Bradford (2016) found that states with medical cannabis laws showed significant reductions in Medicare opioid prescribing. The individual-level and population-level data pointed in the same direction.
The Substitution Pattern
The substitution pattern raises a practical question for anyone considering this approach: is cannabis a viable harm reduction tool for people on opioids? The evidence, while observational, consistently suggests yes — for some patients, in some circumstances, with appropriate medical guidance. The key is that it should be a discussion with a physician, not a solo decision. Abrupt opioid discontinuation is dangerous, and not all pain responds equally to cannabinoids.
Key Takeaways
Medical Cannabis Use Is Associated With Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain
Boehnke KF, Litinas E, Clauw DJ () · The Journal of Pain
Frequently Asked Questions
Cite this study
Boehnke, Kevin F; Litinas, Evangelos; Clauw, Daniel J. (2016). Medical Cannabis Use Is Associated With Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain.. The journal of pain, 17(6), 739-44. https://doi.org/10.1016/j.jpain.2016.03.002