Long-Term Cannabis Oil Therapy Was Linked to Fewer Patients Using Opioids for Chronic Pain

Among chronic pain patients in Italy who used cannabis-based oils long-term, the proportion not using opioids rose from 32% to 55%, though no change was seen in other pain medication classes.

Nunnari, P et al.·European review for medical and pharmacological sciences·2022·Moderate EvidenceObservational
RTHC-04108ObservationalModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

After long-term cannabis-based oil therapy, opioid non-users increased significantly from 32.1% to 55.4% (p=0.0023). No significant changes were found in anticonvulsant, antidepressant, or benzodiazepine prescribing patterns.

Key Numbers

Opioid non-users increased from 32.1% to 55.4% (p=0.0023). No significant changes for anticonvulsants, antidepressants, or benzodiazepines. High benzodiazepine use prevalence was noted. In patients over 65, antidepressant users decreased from 93.7% to 56.2% (p=0.0313).

How They Did This

Retrospective observational study of patients treated with medical cannabis-based oils at a Pain Medicine Unit in Northern Italy from June 2016 to July 2019. Compared pain medication prescriptions before and after cannabis treatment using the McNemar test. Subgroup analyses by sex, age, comorbidity, and treatment duration.

Why This Research Matters

The opioid-sparing potential of cannabis is one of the most debated topics in pain medicine. This real-world Italian data adds to the growing observational evidence that some patients reduce opioid use after starting cannabis, though causation remains uncertain.

The Bigger Picture

This study is consistent with other observational data showing opioid reduction among cannabis users, but it contrasts with randomized trials that generally have not found opioid-sparing effects. The specific finding about antidepressant reduction in older patients is intriguing but needs replication.

What This Study Doesn't Tell Us

Observational and retrospective design cannot establish causation. Patients choosing cannabis may have been more motivated to reduce opioids regardless. No control group for comparison. Single-center study in the Italian healthcare system.

Questions This Raises

  • ?Would a randomized trial in Italian chronic pain patients confirm the opioid reduction finding?
  • ?Why was the antidepressant reduction seen only in patients over 65?
  • ?Does the Italian prescribing context differ meaningfully from other countries?

Trust & Context

Key Stat:
Opioid non-users: 32.1% before vs 55.4% after cannabis oil therapy
Evidence Grade:
Moderate: real-world clinical data with significant results, but limited by retrospective, single-center, uncontrolled design.
Study Age:
Published in 2022, covering data from 2016-2019.
Original Title:
Long-term Cannabis-based oil therapy and pain medications prescribing patterns: an Italian observational study.
Published In:
European review for medical and pharmacological sciences, 26(4), 1224-1234 (2022)
Database ID:
RTHC-04108

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Watches what happens naturally without intervening.

What do these levels mean? →

Frequently Asked Questions

Did cannabis oil replace opioids for these patients?

More patients stopped using opioids after starting cannabis oil (32% to 55%), but the study cannot determine whether cannabis directly caused the reduction or whether other factors were involved.

What type of cannabis oil was used?

The study used cannabis-based oils prescribed through the Italian medical system. Specific formulations and THC/CBD ratios were not detailed in the abstract.

Read More on RethinkTHC

Cite This Study

RTHC-04108·https://rethinkthc.com/research/RTHC-04108

APA

Nunnari, P; Ladiana, N; Ceccarelli, G; Notaro, P. (2022). Long-term Cannabis-based oil therapy and pain medications prescribing patterns: an Italian observational study.. European review for medical and pharmacological sciences, 26(4), 1224-1234. https://doi.org/10.26355/eurrev_202202_28114

MLA

Nunnari, P, et al. "Long-term Cannabis-based oil therapy and pain medications prescribing patterns: an Italian observational study.." European review for medical and pharmacological sciences, 2022. https://doi.org/10.26355/eurrev_202202_28114

RethinkTHC

RethinkTHC Research Database. "Long-term Cannabis-based oil therapy and pain medications pr..." RTHC-04108. Retrieved from https://rethinkthc.com/research/nunnari-2022-longterm-cannabisbased-oil-therapy

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.