Daily Cannabis Use Linked to 40% Higher Rates of Quitting Illicit Opioids Among People with Chronic Pain

Daily cannabis use was associated with a 40% higher rate of opioid cessation (adjusted HR 1.40, 95% CI 1.08-1.81, p = 0.011). In sex-stratified analysis, the association was significant in men (aHR 1.50, 95% CI 1.09-2.08, p = 0.014) but not women. Over 1,038 person-years, 764 participants experienced an opioid cessation event, yielding a rate of 28.5 per 100 person-years.

Prospective cohort study drawing from three cohort studies of people who use drugs in Vancouver, Canada (June 2014-May 2022). 1,242 participants with chronic pain and unregulated opioid use. Extended Cox regression with time-updated covariates.

During the ongoing opioid overdose crisis, finding tools that help people stop illicit opioid use could save lives. This study provides real-world evidence that daily cannabis use may facilitate opioid cessation in a high-risk population with chronic pain.

This adds to a growing body of evidence suggesting cannabis may serve as an "exit drug" from more dangerous substances. The sex-specific finding that effects are stronger in men points to biological or behavioral differences in how cannabis interacts with opioid use patterns.

Observational design cannot prove cannabis caused opioid cessation. Self-reported substance use. Vancouver-specific population of street-involved PWUD may not generalize. Cannot distinguish between cannabis products or cannabinoid profiles.