Among over 2,000 Canadian medical cannabis patients, 69% reported substituting cannabis for prescription drugs, 44% for alcohol, and among opioid substituters, 59% reported complete cessation of opioid use.
Medical cannabis patients, prescribers, harm reduction workers, and health policy researchers.
59% complete opioid cessation
What the researchers found
69.1% reported substituting cannabis for prescription drugs (35.3% of those for opioids), 44.5% for alcohol, 31.1% for tobacco, and 26.6% for illicit substances. Among the 610 mentions of specific opioid medications, patients reported total cessation in 59.3% of cases. Pain and mental health conditions accounted for 83.7% of respondents.
Why it matters
This is one of the largest and most detailed surveys of medical cannabis substitution patterns. The finding that nearly 60% of opioid substituters reported complete cessation adds significant individual-level data to the population-level evidence.
The numbers in context
2,032 respondents; 62.6% male; mean age 40; 74.6% daily use; mean 1.5g/day; 69.1% substituted for Rx drugs; 35.3% of Rx substitution was opioids; 59.3% reported total opioid cessation; 44.5% substituted for alcohol; 31.1% for tobacco.
How the study worked
A 239-question cross-sectional survey of 2,032 Canadian medical cannabis patients registered with a federally authorized licensed producer (January 2017).
What this study cannot tell us
Self-reported data without medical record verification. Patients registered with licensed producers may not represent all medical cannabis users. Cross-sectional design cannot establish causal substitution. Selection bias likely (patients who benefit from cannabis are more likely to respond).
How to read the evidence
Moderate: large sample from a regulated program, but self-reported and cross-sectional.
When this study was published
Published in 2019.
The bigger picture
This study captures the behavior of patients in Canada's regulated medical cannabis program, providing a cleaner picture than studies of recreational users. The substitution patterns suggest cannabis is being actively used as an alternative to multiple substance categories.
Questions still open
- Are these substitution patterns sustained long-term? Do patients who substitute cannabis for opioids have better health outcomes than those who continue opioids?
Common questions
How many medical cannabis patients stop using opioids?
What conditions did patients use medical cannabis for?
Read the original research
Medical cannabis patterns of use and substitution for opioids & other pharmaceutical drugs, alcohol, tobacco, and illicit substances; results from a cross-sectional survey of authorized patients.
Harm reduction journal, 16(1), 9
Citation
Lucas, Philippe; Baron, Eric P; Jikomes, Nick. (2019). Medical cannabis patterns of use and substitution for opioids & other pharmaceutical drugs, alcohol, tobacco, and illicit substances; results from a cross-sectional survey of authorized patients.. Harm reduction journal, 16(1), 9. https://doi.org/10.1186/s12954-019-0278-6
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