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

The takeaway

Among 1,242 people who use drugs with chronic pain in Vancouver, daily cannabis use was associated with a 40% higher rate of stopping illicit opioid use, with stronger effects in men.

Harm reduction practitioners, addiction specialists, chronic pain patients, opioid crisis researchers

40% higher opioid cessation rate with daily cannabis use

What the researchers found

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.

Why it matters

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.

The numbers in context

1,242 participants; 764 cessation events over 1,038 person-years; daily cannabis aHR 1.40 (95% CI 1.08-1.81); men aHR 1.50 (95% CI 1.09-2.08); cessation rate 28.5 per 100 person-years.

How the study worked

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.

What this study cannot tell us

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.

How to read the evidence

Large prospective cohort with time-updated covariates, but observational design and self-reported outcomes.

When this study was published

2025 publication with 2014-2022 data

The bigger picture

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.

Questions still open

Why is the association stronger in men than women?
Would structured cannabis therapy programs enhance opioid cessation rates beyond what naturalistic use achieves?

Common questions

Can cannabis help people stop using opioids?

In this Vancouver study of 1,242 people with chronic pain, daily cannabis users were 40% more likely to stop using illicit opioids. However, this was observational, so it cannot prove cannabis caused the opioid cessation.

Does cannabis work the same for men and women in reducing opioid use?

The association between daily cannabis use and opioid cessation was significant in men (50% higher cessation) but not statistically significant in women, suggesting potential sex-specific differences.

Read the original research

Cannabis use and illicit opioid cessation among people who use drugs living with chronic pain.

Drug and alcohol review, 44(3), 799-810

View on PubMed ↗Publisher’s paper ↗

Citation

Kitchen, Chenai; Socias, Eugenia; Sayre, Eric C; Hayashi, Kanna; DeBeck, Kora; Milloy, M-J; Kerr, Thomas; Reddon, Hudson. (2025). Cannabis use and illicit opioid cessation among people who use drugs living with chronic pain.. Drug and alcohol review, 44(3), 799-810. https://doi.org/10.1111/dar.14014