Over half of medical cannabis users reported substituting it for prescription drugs | Research

The takeaway

Among 2,841 medical cannabis users, 54.6% used cannabis to replace prescription drugs, with 38% stopping and 46% substantially reducing their prescriptions, most commonly pain medications.

Clinicians prescribing for chronic pain, patients considering cannabis as an alternative, and public health researchers.

54.6% used cannabis to replace prescription drugs, primarily pain medications

What the researchers found

Of 2,841 respondents using cannabis medically (91% non-prescribed), 54.6% used it to replace a prescription drug. Pain medication (67.2%), antidepressants (24.5%), and arthritis medication (20.7%) were most commonly replaced. Among substituters, 38.1% completely stopped and 45.9% substantially decreased prescription use. CBD oil was the most common substitute (65.2%). 65.8% found cannabis "much more effective" than prescriptions, and 85.5% rated prescription side effects as "much worse."

Why it matters

If cannabis is enabling people to reduce or eliminate prescription drug use, particularly opioids, this has enormous public health implications. The scale of self-reported substitution (over half of medical users) and the specific drugs being replaced deserve clinical attention.

The numbers in context

2,841 respondents. 91% used non-prescribed cannabis. 54.6% substituted prescriptions. Drugs replaced: pain meds (67.2%), antidepressants (24.5%), arthritis meds (20.7%). 38.1% stopped prescriptions, 45.9% substantially decreased. CBD oil: 65.2% of substitutes. 65.8% found cannabis "much more effective."

How the study worked

Self-selected convenience sample recruited through social media, public media, and patient organizations. Anonymous online survey of adults using cannabis (prescribed or non-prescribed) for medical purposes. Compared substitution and non-substitution users.

What this study cannot tell us

Self-selected convenience sample with strong selection bias. Non-prescribed cannabis users may differ from prescribed users. Self-reported effectiveness is subjective. No clinical verification of conditions or outcomes.

How to read the evidence

Large sample but self-selected convenience sample with inherent bias. Cannot verify clinical outcomes or prescription changes.

When this study was published

2021 online survey study.

The bigger picture

The dominance of CBD oil (65.2%) among substitution products suggests many people are using non-intoxicating cannabis products for medical purposes, challenging the stereotype that medical cannabis is primarily about getting high. The opioid substitution finding aligns with ecological studies showing lower opioid prescribing in states with cannabis access.

Questions still open

Are patients reducing prescriptions safely with medical guidance? Does cannabis actually provide equivalent or better outcomes vs. prescription drugs? Could unsupervised substitution lead to undertreated conditions?

Common questions

Which prescription drugs are people replacing with cannabis?

Pain medication topped the list at 67.2%, followed by antidepressants (24.5%) and arthritis medication (20.7%). The most common cannabis substitute was CBD oil (65.2%).

Were people satisfied after switching to cannabis?

Yes, strongly. 65.8% rated cannabis as "much more effective" than their prescription drugs, and 85.5% rated prescription side effects as "much worse" than cannabis side effects.

Read the original research

Exploring the use of cannabis as a substitute for prescription drugs in a convenience sample.

Harm reduction journal, 18(1), 72

View on PubMed ↗Publisher’s paper ↗

Citation

Kvamme, Sinikka L; Pedersen, Michael M; Rømer Thomsen, Kristine; Thylstrup, Birgitte. (2021). Exploring the use of cannabis as a substitute for prescription drugs in a convenience sample.. Harm reduction journal, 18(1), 72. https://doi.org/10.1186/s12954-021-00520-5