Older veterans using medical cannabis reported improved pain and sleep, with some reducing opioid use | Research

The takeaway

In a longitudinal survey of older US veterans enrolled in Illinois' medical cannabis program, participants reported improvements in pain, sleep, and emotional problems, and 44% of those initially co-using opioids stopped opioid use by follow-up.

VA healthcare providers, geriatric pain specialists, and veteran health researchers

44% of opioid co-users stopped opioids at follow-up

What the researchers found

Older veterans reported positive outcomes for pain, sleep, and emotional problems across two survey periods. Among co-users, 44.1% of those using both cannabis and opioids initially reported stopping opioids by follow-up, while 20.4% of cannabis-only users added opioids. About 62% and 85% reported no change in memory and falls, respectively.

Why it matters

Older veterans face high rates of chronic pain and opioid use. Evidence that medical cannabis may help some reduce opioid reliance while maintaining pain relief is relevant to veteran healthcare policy.

The numbers in context

44.1% of cannabis-opioid co-users stopped opioids at follow-up; 20.4% of cannabis-only users started opioids; 62% no change in memory; 85% no change in falls; only 3% and 1% reported negative memory and fall outcomes; changes in opioid use not statistically significant

How the study worked

Longitudinal survey of older US veterans enrolled in the Illinois Medical Cannabis Patient Program, with two survey periods assessing health outcomes, substance use, and opioid co-use patterns. Logistic regression examined factors associated with cannabis-opioid co-use.

What this study cannot tell us

Small self-selected sample; self-reported outcomes without clinical verification; changes in opioid use were not statistically significant; no control group; enrolled in medical cannabis program so inherently favorable toward cannabis

How to read the evidence

Small longitudinal survey of self-selected medical cannabis patients. Suggestive findings but changes in opioid use did not reach statistical significance.

When this study was published

2024 publication with longitudinal survey data

The bigger picture

As the veteran population ages, finding alternatives to opioids for chronic pain management becomes increasingly important. Medical cannabis may play a role, though the non-significant statistical findings underscore the need for larger studies.

Questions still open

Would these opioid reduction trends reach significance in a larger sample? What clinical and contextual factors determine which veterans successfully substitute cannabis for opioids?

Common questions

Did medical cannabis help older veterans reduce opioid use?

Among veterans who were using both cannabis and opioids at the start of the study, 44.1% reported no longer using opioids at follow-up. However, this change was not statistically significant due to the small sample size, so the finding needs confirmation in larger studies.

Were there cognitive or safety concerns?

Most veterans reported no changes in memory (62%) or falls (85%), with only 3% and 1% reporting negative outcomes for these measures respectively. Veterans also reported positive effects on pain, sleep, and emotional problems across both survey periods.

Read the original research

Characteristics of Cannabis and Opioid Users Among Older U.S. Veterans and Their Health Outcomes: A Longitudinal Perspective.

Journal of psychoactive drugs, 56(2), 157-167

View on PubMed ↗Publisher’s paper ↗

Citation

Kang, Hyojung; Clary, Kelly; Zhao, Ziang; Quintero Silva, Laura; Bobitt, Julie. (2024). Characteristics of Cannabis and Opioid Users Among Older U.S. Veterans and Their Health Outcomes: A Longitudinal Perspective.. Journal of psychoactive drugs, 56(2), 157-167. https://doi.org/10.1080/02791072.2023.2186286