Among people on methadone treatment, cannabis use appeared to reduce the association between methadone dose and continued illicit opioid use.
Addiction medicine specialists, harm reduction practitioners, opioid policy researchers, and methadone program administrators.
Less illicit opioid useCannabis users on methadone showed less illicit opioid use at lower doses compared to non-users
What the researchers found
Cannabis use modified the relationship between methadone treatment dose and illicit opioid use, with cannabis users showing less illicit opioid use at lower methadone doses compared to non-cannabis users.
Why it matters
Subtherapeutic methadone dosing often leads to continued illicit opioid use, which carries overdose risk. If cannabis helps reduce this gap, it could improve outcomes for undertreated patients.
The numbers in context
The study examined a community-based cohort of people who use drugs, analyzing whether cannabis use interacts with methadone dose to influence illicit opioid use.
How the study worked
Community-based cohort study examining the interaction between cannabis use, methadone dose, and illicit opioid use outcomes.
Who was studied
Community-based cohort of people who use drugs enrolled in methadone maintenance treatment.
What this study cannot tell us
Observational design; self-reported substance use; potential residual confounding from unmeasured variables; unable to determine cannabis strain, dose, or timing.
How to read the evidence
Community-based cohort with real-world data; observational design prevents causal conclusions.
When this study was published
Recent study reflecting evolving harm reduction perspectives.
The bigger picture
This companion study to RTHC-04697 builds evidence for cannabis as a potential harm reduction tool in opioid use disorder, challenging the paradigm that all non-prescribed substance use during addiction treatment is harmful.
Replication
Companion to RTHC-04697; consistent with preclinical evidence on cannabinoid-opioid interactions.
Funding
Not specified
Conflicts of interest
Not specified
Questions still open
- Through what mechanism might cannabis reduce illicit opioid use?
- Would prescribed cannabis be more effective than self-directed use?
- How do different cannabis products compare in this context?
Read the original research
The Cannabis-Dependent Relationship Between Methadone Treatment Dose and Illicit Opioid Use in a Community-Based Cohort of People Who Use Drugs.
Cannabis and cannabinoid research, 8(1), 155-165
Citation
Lake, Stephanie; Kerr, Thomas; Buxton, Jane; Walsh, Zach; Cooper, Ziva D; Socías, M Eugenia; Fairbairn, Nadia; Hayashi, Kanna; Milloy, M-J. (2023). The Cannabis-Dependent Relationship Between Methadone Treatment Dose and Illicit Opioid Use in a Community-Based Cohort of People Who Use Drugs.. Cannabis and cannabinoid research, 8(1), 155-165. https://doi.org/10.1089/can.2021.0080