Medical Cannabis Patients Cut Opioid Use From 40mg to Under 3mg Daily Over One Year | Research

The takeaway

Chronic pain patients co-prescribed medical cannabis reduced their median daily opioid dose from 40mg to 2.7mg over 12 months, but nearly half dropped out of the cannabis treatment.

Pain medicine clinicians; medical cannabis prescribers; patients and researchers exploring opioid reduction strategies.

Median opioid dose dropped from 40 mg/day to 2.7 mg/day in cannabis group

What the researchers found

Among 102 chronic pain patients co-prescribed cannabinoids alongside opioids, median opioid consumption dropped from 40 mg/day to 2.7 mg/day at one year, significantly lower than the 42.3 mg/day maintained by 53 opioid-only controls. However, 46 of 102 cannabis patients dropped out compared to only 1 of 53 controls.

Why it matters

The opioid reduction was dramatic, but the 45% dropout rate reveals that medical cannabis as an opioid-sparing strategy only works for a subset of patients. Both the promise and the limitation are important for realistic expectations.

The numbers in context

Baseline: median 40 mg/day opioids in both groups. At 12 months: cases 2.7 mg/day vs controls 42.3 mg/day (p<0.05). Cannabis dose: median 15mg THC + 15mg CBD daily. Dropout: 46/102 cannabis group vs 1/53 control group. Disability and insomnia also decreased in cases.

How the study worked

Prospective observational study at two Australian pain clinics. One cohort (n=102) received opioids plus medical cannabis (titrated to median 15mg THC/15mg CBD daily); the other (n=53) received opioids only. Assessed at 12 months with intention-to-treat analysis.

What this study cannot tell us

Observational, not randomized. High dropout rate in cannabis group (45%) creates selection bias among completers. Non-blinded. Small sample size. Single clinic setting in Australia. Reasons for dropout not fully detailed.

How to read the evidence

Prospective cohort with control group, but not randomized and high dropout rate limits conclusions.

When this study was published

2025 study

The bigger picture

The opioid crisis has driven interest in cannabis as an opioid-sparing tool. This real-world data shows it can work dramatically for some patients, but the high dropout rate tempers enthusiasm and highlights the need to identify who will benefit.

Questions still open

Why did nearly half of cannabis patients drop out? What predicts who will successfully use cannabis to reduce opioids? Would lower starting cannabis doses improve retention?

Common questions

Why did so many patients drop out of the cannabis group?

The study notes that cannabinoid treatment was "tolerated by only a subgroup of patients." Specific dropout reasons weren't fully detailed, but likely included side effects and insufficient symptom relief.

What type of cannabis was used?

An oil formulation starting at 2.5 mg/day, titrated up to a median of 15mg THC plus 15mg CBD daily.

Read the original research

Opioid reduction in patients with chronic non-cancer pain undergoing treatment with medicinal cannabis.

Pain management, 15(10), 703-711

View on PubMed ↗Publisher’s paper ↗

Citation

Finch, Philip M; Price, Leanne M; Price, Toby J F; Kent, Michael J; Drummond, Peter D. (2025). Opioid reduction in patients with chronic non-cancer pain undergoing treatment with medicinal cannabis.. Pain management, 15(10), 703-711. https://doi.org/10.1080/17581869.2025.2544511