People who inject drugs in Los Angeles reported using cannabis to help reduce their opioid use

Three themes emerged for how cannabis co-use facilitated reduced opioid use: (1) maintaining opioid cessation and treatment adherence by managing cessation-specific symptoms, (2) managing episodic opioid withdrawal symptoms, and (3) decreasing opioid use because cannabis was more easily accessible than opioids. Participants described cannabis as helping them "get over the hump" of opioid cravings and withdrawal.

Semi-structured qualitative interviews with 30 people who inject drugs at two community sites in Los Angeles (near a syringe service program and methadone clinic), July 2021 to April 2022. Constructivist grounded theory analysis.

With the fentanyl crisis driving unprecedented overdose deaths, understanding how people who inject drugs already use cannabis as a self-directed harm reduction strategy can inform formal intervention design and peer support programs.

These findings suggest cannabis could complement medication-assisted treatment for opioid use disorder, either through peer distribution programs or integration into clinical settings. However, the current evidence is qualitative, and effectiveness outcomes remain unmeasured.

Qualitative design with 30 participants cannot establish effectiveness. Self-selected, English-speaking sample from two sites in one city. No objective measures of opioid reduction. Participants were already using both substances, creating potential confirmation bias.