A cohort study found that people who use drugs employed cannabis as a deliberate harm reduction strategy to reduce use of more dangerous substances.
Harm reduction workers, addiction medicine specialists, drug policy researchers, and public health advocates.
Deliberate strategyPeople who use drugs reported intentionally using cannabis to reduce use of more harmful substances
What the researchers found
Participants in the cohort used cannabis intentionally as a harm reduction strategy, reporting reduced use of more harmful substances like opioids, stimulants, and alcohol when using cannabis as a substitute or complement.
Why it matters
With limited access to evidence-based harm reduction services, understanding how people self-manage substance use risks with cannabis could inform pragmatic public health approaches.
The numbers in context
Cohort study of people who use drugs, examining cannabis as a harm reduction strategy amid limited access to evidence-based interventions.
How the study worked
Prospective cohort study examining patterns and motivations for cannabis use as a harm reduction strategy among people who use drugs.
Who was studied
People who use drugs participating in a cohort study, reporting cannabis use as a harm reduction strategy.
What this study cannot tell us
Self-reported harm reduction behavior; cohort may not represent all PWUD; cannot establish that cannabis substitution actually reduces overall harm; potential for cannabis use disorder.
How to read the evidence
Prospective cohort study provides moderate evidence; self-reported motivations cannot establish actual harm reduction.
When this study was published
Recent cohort study reflecting growing interest in cannabis as harm reduction.
The bigger picture
This study documents bottom-up harm reduction practices that emerge when formal services are unavailable, challenging abstinence-only approaches and supporting patient-directed care models.
Replication
Adds prospective data to growing cannabis-as-harm-reduction literature.
Funding
Not specified
Conflicts of interest
Not specified
Questions still open
- Does cannabis substitution actually reduce mortality risk?
- Should harm reduction programs integrate cannabis access?
- How do healthcare providers respond to cannabis substitution?
Read the original research
Use of Cannabis as a Harm Reduction Strategy Among People Who Use Drugs: A Cohort Study.
Cannabis and cannabinoid research, 8(4), 670-678
Citation
Mok, Janice; Milloy, M-J; Grant, Cameron; Lake, Stephanie; DeBeck, Kora; Hayashi, Kanna; Kerr, Thomas; Socías, M Eugenia. (2023). Use of Cannabis as a Harm Reduction Strategy Among People Who Use Drugs: A Cohort Study.. Cannabis and cannabinoid research, 8(4), 670-678. https://doi.org/10.1089/can.2021.0229