63% of Medical Cannabis Patients Said They Used It as a Substitute for Prescription Drugs | Research

The takeaway

In a survey of 271 Canadian medical cannabis patients, 63% reported substituting cannabis for prescriptions, with 30% replacing opioids, 16% benzodiazepines, and 25% replacing alcohol.

Read this if you use medical cannabis or are considering it as an alternative to prescription pain medications or other drugs.

30% of medical cannabis patients reported substituting cannabis for opioids

What the researchers found

This survey of 271 patients enrolled in Canada's medical cannabis program revealed widespread substitution of cannabis for other substances.

The headline finding: 63% of patients reported using cannabis as a substitute for prescription drugs. The most commonly substituted drug classes were pharmaceutical opioids (30%), benzodiazepines (16%), and antidepressants (12%). Patients also reported replacing alcohol (25%), tobacco (12%), and illicit drugs (3%).

Pain and mental health were the most prominent conditions for which patients found cannabis effective. The study was notable for being the first to match specific prescription drug substitution patterns to specific diagnostic categories.

Two policy-relevant findings emerged: 42% of authorized patients still purchased cannabis from illegal sources in addition to licensed producers, and over 55% were charged a fee to receive their medical recommendation, with nearly 25% paying $300 or more.

Why it matters

The opioid crisis makes any potential substitution effect of cannabis highly relevant. If medical cannabis patients are genuinely replacing opioids, benzodiazepines, and antidepressants, this has implications for prescribing patterns, public health policy, and insurance coverage.

The numbers in context

271 respondents. 63% substituted cannabis for prescriptions. 30% replaced opioids. 16% replaced benzodiazepines. 12% replaced antidepressants. 25% replaced alcohol. 12% replaced tobacco. 42% still bought from illegal sources. 55% paid for medical recommendation.

How the study worked

Online survey of 271 patients registered to purchase cannabis from Tilray, a federally authorized Licensed Producer under Canada's MMPR program. The 107-question survey covered demographics, patterns of use, and cannabis substitution effects.

What this study cannot tell us

Self-reported data from a single licensed producer's patient base may not represent all medical cannabis users. Substitution is self-perceived and not verified by prescription records. The survey cannot determine whether patients achieved equivalent therapeutic outcomes with cannabis versus their previous medications.

How to read the evidence

Cross-sectional survey with self-reported substitution data from a single producer's patient base. Preliminary because substitution is self-perceived and cannot be verified.

When this study was published

Published in 2017, surveying patients under Canada's MMPR program.

The bigger picture

This study adds to growing evidence of cannabis substitution effects, particularly for opioids. The policy findings about illegal sourcing and paid recommendations highlight tension between the medical cannabis system's goals and its practical implementation in Canada.

Questions still open

Do patients who substitute cannabis for opioids actually achieve comparable pain relief? Is the substitution stable long-term or do patients return to prescriptions? Does cannabis substitution reduce overall healthcare utilization and costs?

Common questions

Can medical cannabis replace prescription painkillers?

In this survey, 30% of patients reported using cannabis as a substitute for opioids. However, this is self-reported and does not prove equivalent pain relief. Whether cannabis truly replaces these medications or supplements them requires further study.

What prescriptions do medical cannabis patients replace?

The most commonly substituted drug classes were opioids (30%), benzodiazepines (16%), and antidepressants (12%). Patients also reported reducing alcohol (25%) and tobacco (12%) use.

Read the original research

Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients.

The International journal on drug policy, 42, 30-35

View on PubMed ↗Publisher’s paper ↗

Citation

Lucas, Philippe; Walsh, Zach. (2017). Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients.. The International journal on drug policy, 42, 30-35. https://doi.org/10.1016/j.drugpo.2017.01.011