Nearly Half of Patients on Opioid Treatment Use Cannabis — Mostly to Manage Symptoms | Research

The takeaway

47.5% of patients on medication for opioid use disorder use cannabis, with most frequent users doing so to manage stress, anxiety, pain, and insomnia rather than purely for recreation.

Addiction medicine specialists, MOUD program administrators, harm reduction advocates, mental health clinicians

What the researchers found

47.5% of MOUD patients used cannabis, 27% frequently (≥3 days/week). Frequent use was associated with anxiety, nausea, and lower employment. Among those surveyed in depth, 56% used for both recreation and symptom management, 30% for symptom management only. Top medical reasons: stress (100%), anxiety (83%), insomnia (79%), pain (75%), depression (75%), PTSD (67%). No significant differences in MOUD outcomes.

Why it matters

Many opioid treatment programs discourage or penalize cannabis use, but most patients using it are self-medicating real symptoms. Understanding these motivations could shift policy toward addressing underlying conditions rather than policing cannabis use.

The numbers in context

303 participants, 47.5% used cannabis, 27% frequently. Subsample of 27 frequent users: 100% used for stress, 83% anxiety, 79% insomnia, 75% pain, 75% depression, 67% PTSD. 52% wanted to cut down. Employment associated with less frequent use (OR 0.54).

How the study worked

Analysis of 303 participants from a randomized trial of a mind-body intervention adjunct to MOUD. Frequent cannabis users (≥3 days/week) were compared with less frequent/non-users on demographics and clinical characteristics. A subsample (n=27) completed detailed telephone surveys on cannabis use patterns and motivations.

What this study cannot tell us

Cross-sectional design from a clinical trial population may not represent all MOUD patients. Small subsample (n=27) for detailed motivations. Self-reported cannabis use subject to bias. Cannot determine whether cannabis actually helps the reported symptoms.

How to read the evidence

Moderate-sized clinical trial sample with detailed subsample interviews, limited by cross-sectional design and self-reported data.

When this study was published

Published 2026, reflecting current MOUD treatment landscape.

The bigger picture

The finding that cannabis use doesn't worsen MOUD outcomes but patients are using it for untreated symptoms suggests a systemic failure — patients aren't getting adequate treatment for stress, anxiety, pain, and trauma, so they self-medicate with cannabis.

Questions still open

Would treating the underlying conditions (anxiety, pain, PTSD) reduce cannabis self-medication? Should MOUD programs integrate medical cannabis screening? Could cannabis be formally incorporated as adjunctive therapy in some cases?

Common questions

Do people in opioid treatment use cannabis?

Nearly half (47.5%) do, with about a quarter using it three or more times per week. Most aren't using purely for recreation — they're self-managing real symptoms like stress, anxiety, pain, and insomnia.

Does cannabis interfere with opioid treatment?

In this study, frequent cannabis use was not associated with significant differences in key MOUD outcomes including substance use and treatment retention, though it was associated with more anxiety and nausea.

Read the original research

Cannabis Use Among Individuals Treated with Medication for Opioid Use Disorder: Correlates, Patterns, and Motivations for Use.

Substance use & addiction journal, 29767342251401312

View on PubMed ↗Publisher’s paper ↗

Citation

Leyde, Sarah E; Merrill, Joseph O; Treadway, Anna J; Pike, Kenneth C; Price, Cynthia J. (2026). Cannabis Use Among Individuals Treated with Medication for Opioid Use Disorder: Correlates, Patterns, and Motivations for Use.. Substance use & addiction journal, 29767342251401312. https://doi.org/10.1177/29767342251401312