Can cannabis help people reduce their opioid use for pain? | Research

The takeaway

A growing body of research suggests cannabis may help some pain patients reduce opioid use, though significant challenges remain in standardizing cannabis as a therapeutic option.

Pain patients, clinicians managing chronic pain, and policymakers evaluating medical cannabis programs.

24.8% lower opioid overdose mortality

What the researchers found

The review found evidence from preclinical, clinical, and epidemiological studies suggesting cannabis can complement or partially substitute for opioids in pain management, with some studies showing reduced opioid prescriptions in states with medical cannabis laws.

Why it matters

The opioid crisis has driven urgent interest in alternatives. If cannabis can safely reduce opioid dependence for pain patients, it could save lives, but clinicians need clear evidence to guide recommendations.

The numbers in context

The review references ecological studies showing states with medical cannabis laws had 24.8% lower mean opioid overdose mortality rates compared to states without such laws.

How the study worked

Narrative review examining preclinical data, clinical studies, and population-level research on cannabis-opioid interactions for pain management.

What this study cannot tell us

Narrative review without systematic methodology. Many of the underlying studies are observational or ecological, making causal claims difficult. Cannabis preparation, dosing, and route of administration vary widely across studies.

How to read the evidence

Moderate: narrative review drawing on multiple study types, but lacking systematic methodology.

When this study was published

Published in 2019.

The bigger picture

Cannabis as an opioid substitute sits at the intersection of two major public health issues. The pharmacological rationale is supported by overlapping pain pathways, but translating population-level associations into individual clinical guidance remains a challenge.

Questions still open

What specific cannabis formulations and doses are most effective for opioid-sparing effects? Do the population-level opioid reduction trends hold up with more recent data and legal changes?

Common questions

Can cannabis replace opioids for pain?

Some evidence suggests cannabis can help reduce opioid use in pain patients, but it is unlikely to fully replace opioids for all types of pain.

What are the main challenges of using cannabis for pain?

Lack of standardized dosing, variable product quality, limited clinical trial data, and regulatory barriers all complicate its use as a pain treatment.

Read the original research

Perspectives on cannabis as a substitute for opioid analgesics.

Pain management, 9(2), 191-203

View on PubMed ↗Publisher’s paper ↗

Citation

Khan, Sara P; Pickens, Thomas A; Berlau, Daniel J. (2019). Perspectives on cannabis as a substitute for opioid analgesics.. Pain management, 9(2), 191-203. https://doi.org/10.2217/pmt-2018-0051