In a single participant with opioid use disorder, pretreatment with vaped cannabis reduced naloxone-precipitated withdrawal severity in a dose-dependent manner without dangerous vital sign changes.
Addiction medicine researchers, harm reduction innovators, and overdose reversal developers.
Cannabis pretreatment reduced opioid withdrawal severity score from 22 to 14 in one patient
What the researchers found
In one male participant (age 52) with OUD stabilized on oral morphine (120 mg/day), naloxone alone produced a COWS score of 22 at 30 minutes. Cannabis pretreatment at 12.5 mg reduced COWS to 17, and at 25 mg reduced it to 14. Combined naloxone and cannabis produced elevated heart rate and blood pressure, but not more than naloxone alone.
Why it matters
Fear of precipitated withdrawal is a major barrier to naloxone use. If cannabis can reduce withdrawal severity, combined naloxone-cannabis formulations could increase willingness to administer naloxone during overdose emergencies.
The numbers in context
N=1 (male, age 52). Morphine stabilization: 120 mg/day. COWS scores at T+30: naloxone alone=22; naloxone+cannabis 12.5mg=17; naloxone+cannabis 25mg=14. Dose-dependent reduction.
How the study worked
Proof-of-concept inpatient crossover study. Single participant completed 6 dose combinations of vaped cannabis (0, 12.5, 25 mg) and intranasal naloxone (0, 4 mg) during morphine stabilization (120 mg/day). Primary outcome: COWS withdrawal score.
What this study cannot tell us
Single participant limits any conclusions. Major methodological redesign was needed during the study (reasons not detailed). Cannot generalize from n=1. Cannabis formulation and dose may not reflect real-world use. Inpatient setting is highly controlled.
How to read the evidence
Single participant proof-of-concept provides the lowest level of evidence. Study required major methodological redesign, suggesting feasibility challenges.
When this study was published
2025 publication.
The bigger picture
This preliminary finding complements preclinical evidence that cannabinoids can reduce opioid withdrawal symptoms. If confirmed in larger studies, it could transform overdose reversal strategies.
Questions still open
- Would this withdrawal reduction replicate in a larger sample?
- Could a combined naloxone-cannabinoid nasal spray be developed for overdose reversal?
Read the original research
The effects of vaped cannabis on the severity of naloxone-precipitated opioid withdrawal.
Experimental and clinical psychopharmacology
Citation
Jones, Jermaine D; Martinez, Suky; Arout, Caroline; Haney, Margaret; Castillo, Felipe; Manubay, Jeanne; Perez, Freymon; Luba, Rachel R; Comer, Sandra D. (2025). The effects of vaped cannabis on the severity of naloxone-precipitated opioid withdrawal.. Experimental and clinical psychopharmacology. https://doi.org/10.1037/pha0000796
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