Medical cannabis users in Illinois opioid alternative program had similar psychological well-being as non-users

Average psychological well-being was 3.18 out of 5 (good) across the full sample. Cannabis users scored 3.21 and non-users 3.12, a non-significant difference (p=0.18). Regular cannabis use (3+ times per week) also showed no significant association with psychological well-being.

Survey sent from February-July 2019 to enrollees in Illinois' Opioid Alternative Pilot Program. Cannabis users (n=626) were compared with non-users (n=234) on psychological well-being (1-5 scale). Backward stepwise regression models were used, with sensitivity analysis for regular use.

As states create opioid alternative programs that include cannabis, understanding psychological impacts is essential. This null finding is reassuring: substituting cannabis for opioids in this program did not appear to worsen psychological well-being, though it did not clearly improve it either.

The lack of difference could mean several things: cannabis neither helped nor harmed psychological well-being, the effects balanced out, or the measurement was not sensitive enough to detect differences. Given that 67% of cannabis users reported having a disability, the comparable well-being scores could also indicate that cannabis was helping to equalize well-being despite greater health burdens.

Cross-sectional design cannot determine causation or change over time. Self-selection into cannabis use introduces bias. A single well-being measure (1-5 scale) may lack sensitivity. No baseline pre-program data available. Non-users in an opioid alternative program may have distinct characteristics.