Nearly 58% of People Who Use Opioids Reported Using Cannabis to Manage Cravings, and It Was Linked to Reduced Opioid Use | Research

The takeaway

Among 205 people who use both cannabis and unregulated opioids in Vancouver, using cannabis to manage opioid cravings was associated with self-reported reductions in opioid use, especially among women and people with moderate-to-severe pain.

Harm reduction advocates, addiction clinicians, drug policy researchers, public health officials.

57.6% of people who use opioids reported using cannabis to manage cravings

What the researchers found

Cannabis use to manage opioid cravings was reported by 57.6% of participants and was significantly associated with self-reported opioid reduction (aOR=2.13, 95% CI: 1.07-4.27). The association was strongest among people with moderate-to-severe pain (aOR=4.44) and among women (aOR=8.19).

Why it matters

During an ongoing drug toxicity crisis driven by contaminated opioid supplies, understanding any strategy that helps people reduce unregulated opioid use is critical. The strong effect among people with pain suggests cannabis may address a root driver of opioid use.

The numbers in context

N=205. Cannabis for craving management: 57.6%. Overall aOR=2.13 (95% CI: 1.07-4.27). Pain subgroup aOR=4.44 (95% CI: 1.52-12.97). Female subgroup aOR=8.19 (95% CI: 1.20-55.81).

How the study worked

Cross-sectional questionnaire administered to 205 people who use both cannabis and unregulated opioids in Vancouver, Canada, from December 2019 to November 2021. Binary logistic regression with multivariable adjustment.

What this study cannot tell us

Cross-sectional design cannot determine causation. Self-reported opioid reductions without objective verification. Structurally marginalized population in Vancouver may not generalize broadly. Wide confidence intervals in subgroup analyses (especially female subgroup).

How to read the evidence

Cross-sectional survey with multivariable adjustment. Self-reported outcomes without objective verification.

When this study was published

Published in 2023 using data from December 2019 to November 2021.

The bigger picture

This study adds to a growing body of evidence that some people who use opioids intentionally use cannabis as a harm reduction tool. The gender difference raises questions about whether women process cannabis differently or use it differently in relation to opioid cravings.

Questions still open

Why was the cannabis-craving association so much stronger among women?
Would providing cannabis access as part of harm reduction programs reduce opioid overdose deaths?

Common questions

Do people use cannabis to manage opioid cravings?

In this Vancouver study, 57.6% of people who use both cannabis and opioids reported using cannabis specifically to manage opioid cravings.

Did cannabis reduce opioid use?

People who used cannabis for craving management were about twice as likely to report reducing their opioid use, with stronger effects among women and people with moderate-to-severe pain.

Read the original research

Cannabis use to manage opioid cravings among people who use unregulated opioids during a drug toxicity crisis.

The International journal on drug policy, 119, 104113

View on PubMed ↗Publisher’s paper ↗

Citation

Reddon, Hudson; Lake, Stephanie; Socias, Maria Eugenia; Hayashi, Kanna; DeBeck, Kora; Walsh, Zach; Milloy, M-J. (2023). Cannabis use to manage opioid cravings among people who use unregulated opioids during a drug toxicity crisis.. The International journal on drug policy, 119, 104113. https://doi.org/10.1016/j.drugpo.2023.104113