People who inject drugs use cannabis for pain relief, emotional support, and as an opioid substitute

Among 387 people who inject drugs and use cannabis, the most common motivations were getting high, physical pain relief, emotional support, and reducing opioid use, with pain relief strongly linked to using cannabis as an opioid substitute.

Ceasar, Rachel Carmen et al.·Drug and alcohol dependence·2021·Preliminary EvidenceCross-Sectional
RTHC-03051Cross SectionalPreliminary Evidence2021RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Preliminary Evidence
Sample
N=387

What This Study Found

Cannabis use for physical pain relief was associated with higher odds of using cannabis as an opioid substitute. Cannabis for emotional problems was associated with depression diagnosis. Cannabis as an opioid substitute was linked to non-prescribed methadone use.

Key Numbers

387 people who inject drugs; most common motivations: getting high, pain relief, emotional problems, opioid reduction; pain relief associated with opioid substitution; depression associated with emotional use motivation

How They Did This

Analysis of 6-month follow-up data from 387 people who inject drugs and reported past-month cannabis use, recruited from Los Angeles and San Francisco (2016-2018). Multivariable logistic regression examined motivations.

Why This Research Matters

If people who inject drugs are already using cannabis as a self-directed harm reduction strategy, formalized programs could potentially leverage this behavior to reduce opioid use and overdose risk.

The Bigger Picture

These findings align with a growing body of evidence that cannabis may serve as a harm reduction tool in opioid-using populations, though the direction of causality is unclear.

What This Study Doesn't Tell Us

Cross-sectional design, self-reported motivations, specific to people who inject drugs in two California cities, cannot determine whether cannabis actually reduces opioid use or harm.

Questions This Raises

  • ?Would providing formal access to cannabis products reduce opioid use in this population?
  • ?Are cannabis-using people who inject drugs at lower risk for overdose?
  • ?What role should cannabis play in harm reduction programs?

Trust & Context

Key Stat:
Pain relief motivation strongly predicted using cannabis as an opioid substitute
Evidence Grade:
Cross-sectional survey of a specific high-risk population in two California cities
Study Age:
Published in 2021 using 2016-2018 data from Los Angeles and San Francisco.
Original Title:
Factors associated with health-related cannabis use intentions among a community sample of people who inject drugs in Los Angeles and San Francisco, CA 2016 to 2018.
Published In:
Drug and alcohol dependence, 219, 108421 (2021)
Database ID:
RTHC-03051

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

Are people who inject drugs using cannabis to reduce opioid use?

Yes. Among 387 cannabis-using people who inject drugs, reducing opioid use was a common motivation, and those who used cannabis for pain relief were most likely to also use it as an opioid substitute.

Could cannabis be part of harm reduction for opioid users?

The self-reported motivations suggest cannabis already functions as informal harm reduction in this population. However, clinical studies are needed to determine whether this actually reduces opioid use or improves outcomes.

Read More on RethinkTHC

Cite This Study

RTHC-03051·https://rethinkthc.com/research/RTHC-03051

APA

Ceasar, Rachel Carmen; Kral, Alex H; Simpson, Kelsey; Wenger, Lynn; Goldshear, Jesse L; Bluthenthal, Ricky N. (2021). Factors associated with health-related cannabis use intentions among a community sample of people who inject drugs in Los Angeles and San Francisco, CA 2016 to 2018.. Drug and alcohol dependence, 219, 108421. https://doi.org/10.1016/j.drugalcdep.2020.108421

MLA

Ceasar, Rachel Carmen, et al. "Factors associated with health-related cannabis use intentions among a community sample of people who inject drugs in Los Angeles and San Francisco, CA 2016 to 2018.." Drug and alcohol dependence, 2021. https://doi.org/10.1016/j.drugalcdep.2020.108421

RethinkTHC

RethinkTHC Research Database. "Factors associated with health-related cannabis use intentio..." RTHC-03051. Retrieved from https://rethinkthc.com/research/ceasar-2021-factors-associated-with-healthrelated

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.