One in five people who use illicit opioids intentionally substitute other substances, with cannabis being common
Among 1,527 people who use drugs in Vancouver, 22% reported intentionally using another substance to reduce opioid use, with stimulants (50%) and cannabis (28%) being the most common substitutes.
Quick Facts
What This Study Found
22% of illicit opioid users reported substituting at least once during the study. Substitutes used: stimulants (50.3%), cannabis (27.6%), alcohol (3.2%), benzodiazepines (4.5%), and others (4.3%). Daily cannabis use was positively associated with reporting substitution attempts (AOR 1.56, 95% CI 1.24-1.96).
Key Numbers
1,527 participants, 4,991 interviews. 336 (22%) reported substitution at least once (467 interviews, 9.4%). Cannabis substitution: 129 (27.6%). Stimulant substitution: 235 (50.3%). Daily cannabis use AOR: 1.56 for substitution attempts.
How They Did This
Analysis of three prospective cohorts of people who use drugs in Vancouver, Canada (June 2012 to June 2016). 1,527 participants contributed 4,991 interviews. Multivariable generalized estimating equations examined correlates of intentional substitution.
Why This Research Matters
Understanding drug substitution patterns is critical as harm reduction strategies evolve. The finding that cannabis is the second most common intentional opioid substitute suggests it may play a role in informal self-managed opioid reduction.
The Bigger Picture
Drug substitution is a widespread but understudied phenomenon. If people who use opioids are already using cannabis as a harm reduction strategy, formal research into whether this works could inform policy.
What This Study Doesn't Tell Us
Observational design cannot determine whether substitution actually reduced opioid use. Vancouver drug-using population may not generalize. Self-reported substitution intentions. Stimulant substitution being most common raises safety concerns of its own.
Questions This Raises
- ?Does cannabis substitution actually reduce opioid use long-term?
- ?Are people substituting stimulants at higher risk of other harms?
- ?Should harm reduction programs formally incorporate substitution strategies?
Trust & Context
- Key Stat:
- 22% intentionally substituted; cannabis used by 28% of substituters
- Evidence Grade:
- Large prospective cohort with repeated measures, but cannot establish whether substitution effectively reduced opioid use.
- Study Age:
- Published in 2022, covering June 2012 to June 2016.
- Original Title:
- Prevalence and correlates of intentional substance use to reduce illicit opioid use in a Canadian setting.
- Published In:
- Journal of substance use, 27(3), 277-282 (2022)
- Authors:
- Klimas, Jan(2), Mok, Wing Yin, Lake, Stephanie(16), Eugenia Socías, M, DeBeck, Kora, Hayashi, Kanna, Wood, Evan, Milloy, M-J
- Database ID:
- RTHC-03972
Evidence Hierarchy
Follows a group of people over time to track how outcomes develop.
What do these levels mean? →Frequently Asked Questions
Do people use cannabis to get off opioids?
In this Vancouver study, 28% of people who intentionally substituted substances to reduce opioid use chose cannabis, making it the second most common substitute after stimulants.
Does substituting cannabis for opioids work?
This study found that daily cannabis use was associated with substitution attempts, but could not determine whether substitution actually reduced opioid use or improved outcomes.
Read More on RethinkTHC
- 420-sober-survival-guide
- CBT-cannabis-recovery
- cannabis-dependence-physical-psychological-addiction-science
- cannabis-perception-vs-evidence-gap
- cannabis-relapse-cycle-pattern
- cannabis-use-disorder-test
- cold-turkey-vs-taper-quit-weed
- cross-addiction-quit-weed-start-drinking
- dating-sober-after-quitting-weed
- exercise-quitting-weed-anxiety-brain
- grieving-quitting-weed-loss
- help-someone-quit-weed
- how-to-quit-weed
- is-weed-addictive
- is-weed-addictive-science
- journaling-weed-withdrawal
- marijuana-anonymous-SMART-recovery-compare
- meditation-mindfulness-weed-withdrawal
- partner-still-smokes-weed
- partner-still-smokes-weed-quitting
- pink-cloud-sobriety-cannabis
- quit-weed-cold-turkey
- quit-weed-or-cut-back-which-is-better
- quit-weed-regret-went-back
- quitting-weed-20s
- quitting-weed-30s
- quitting-weed-after-years
- quitting-weed-and-alcohol
- quitting-weed-during-crisis-divorce-job-loss
- quitting-weed-exercise
- quitting-weed-grief-loss-coping
- quitting-weed-legal-state
- quitting-weed-success-stories
- quitting-weed-triggers-environment
- rehab-for-weed-addiction-necessary
- relapsed-smoking-weed-what-to-do
- relapsed-weed
- should-i-quit-weed
- signs-of-cannabis-use-disorder
- sober-music-festival-concert-without-weed
- supplements-weed-withdrawal
- telling-friends-quitting-weed
- weed-relapse-prevention-plan
- weed-relapse-why-it-happens
- weed-ritual-replacement
- weed-ruined-relationships
- weed-social-media-triggers-quit
- weed-vape-pen-addiction
Cite This Study
https://rethinkthc.com/research/RTHC-03972APA
Klimas, Jan; Mok, Wing Yin; Lake, Stephanie; Eugenia Socías, M; DeBeck, Kora; Hayashi, Kanna; Wood, Evan; Milloy, M-J. (2022). Prevalence and correlates of intentional substance use to reduce illicit opioid use in a Canadian setting.. Journal of substance use, 27(3), 277-282. https://doi.org/10.1080/14659891.2021.1941341
MLA
Klimas, Jan, et al. "Prevalence and correlates of intentional substance use to reduce illicit opioid use in a Canadian setting.." Journal of substance use, 2022. https://doi.org/10.1080/14659891.2021.1941341
RethinkTHC
RethinkTHC Research Database. "Prevalence and correlates of intentional substance use to re..." RTHC-03972. Retrieved from https://rethinkthc.com/research/klimas-2022-prevalence-and-correlates-of
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.