Occasional Cannabis Use Was Linked to Staying in Opioid Addiction Treatment Longer
Intermittent cannabis users stayed in naltrexone treatment for opioid dependence significantly longer (median 133 days) than abstainers (35 days) or consistent cannabis users (35 days), replicating a previous finding.
Quick Facts
What This Study Found
Sixty-three opioid-dependent patients were enrolled in a naltrexone trial and classified by their cannabis use during treatment: abstinent, intermittent, or consistent users.
Intermittent cannabis users showed dramatically superior treatment retention: median 133 days compared to just 35 days for both abstinent and consistent cannabis users. This difference was highly significant (p=0.002).
The effect remained after adjusting for baseline heroin use and cocaine use during treatment. Intermittent cannabis users also took their naltrexone medication more consistently.
Intensive behavioral therapy appeared to moderate the poor prognosis in the consistent cannabis use group.
Importantly, this replicated a previous finding from an independent sample.
Key Numbers
63 patients. Intermittent cannabis users: median 133 days retention (mean 112.8). Abstinent: median 35 days (mean 47.3). Consistent users: median 35 days (mean 68.3). Log rank test: p=0.002.
How They Did This
Secondary analysis of a randomized trial comparing two behavioral therapies with naltrexone for opioid dependence (N=63). Participants were classified into three cannabis use groups based on biweekly urine tests. Cox proportional hazards model adjusted for baseline heroin and in-treatment cocaine use.
Why This Research Matters
Naltrexone is theoretically promising for opioid dependence but plagued by poor adherence. Finding that intermittent cannabis use predicts dramatically better retention challenges the assumption that all concurrent substance use is detrimental in addiction treatment.
The Bigger Picture
This finding raises provocative questions about harm reduction approaches in opioid addiction treatment. If moderate cannabis use helps people stay in treatment and take their medication, the net benefit could outweigh the concerns about concurrent cannabis use.
What This Study Doesn't Tell Us
Observational classification within a clinical trial (not randomized to cannabis use). Intermittent cannabis users may differ from abstainers and heavy users in ways not captured by the analysis. Small sample size. Association, not causation.
Questions This Raises
- ?Is there a pharmacological mechanism through which cannabis improves naltrexone adherence?
- ?Would prescribing cannabis as part of opioid treatment improve outcomes?
- ?Or is intermittent cannabis use simply a marker for less severe addiction?
Trust & Context
- Key Stat:
- Intermittent cannabis users stayed 133 days vs 35 days for abstainers (p=0.002)
- Evidence Grade:
- Replicated observational finding within a randomized trial. Cannabis use was not experimentally assigned, so selection effects are possible. Small sample (n=63).
- Study Age:
- Published in 2009. The relationship between cannabis use and opioid treatment outcomes has continued to be debated, with some subsequent studies supporting the harm reduction perspective.
- Original Title:
- Intermittent marijuana use is associated with improved retention in naltrexone treatment for opiate-dependence.
- Published In:
- The American journal on addictions, 18(4), 301-8 (2009)
- Authors:
- Raby, Wilfrid Noel, Carpenter, Kenneth M(3), Rothenberg, Jami, Brooks, Adam C, Jiang, Huiping, Sullivan, Maria, Bisaga, Adam, Comer, Sandra, Nunes, Edward V
- Database ID:
- RTHC-00383
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
Why would cannabis help people stay in opioid treatment?
The mechanism is unclear. Cannabis may help manage withdrawal discomfort, anxiety, or insomnia that drive people out of treatment. Alternatively, intermittent cannabis users may simply have different personality or motivational characteristics than abstainers or heavy users.
Does this mean people in addiction treatment should use cannabis?
The study found an association, not a treatment recommendation. While the replication strengthens the finding, randomized trials would be needed to determine whether cannabis use causally improves opioid treatment outcomes.
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Cite This Study
https://rethinkthc.com/research/RTHC-00383APA
Raby, Wilfrid Noel; Carpenter, Kenneth M; Rothenberg, Jami; Brooks, Adam C; Jiang, Huiping; Sullivan, Maria; Bisaga, Adam; Comer, Sandra; Nunes, Edward V. (2009). Intermittent marijuana use is associated with improved retention in naltrexone treatment for opiate-dependence.. The American journal on addictions, 18(4), 301-8. https://doi.org/10.1080/10550490902927785
MLA
Raby, Wilfrid Noel, et al. "Intermittent marijuana use is associated with improved retention in naltrexone treatment for opiate-dependence.." The American journal on addictions, 2009. https://doi.org/10.1080/10550490902927785
RethinkTHC
RethinkTHC Research Database. "Intermittent marijuana use is associated with improved reten..." RTHC-00383. Retrieved from https://rethinkthc.com/research/raby-2009-intermittent-marijuana-use-is
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.