97% of Medical Cannabis Patients Said They Could Reduce Their Opioid Use When Using Cannabis | Research

The takeaway

In a survey of nearly 2,900 medical cannabis patients, 97% agreed they could decrease opioid consumption when also using cannabis, and 81% found cannabis alone more effective than cannabis with opioids.

Readers using opioids for pain who are considering medical cannabis.

97% of opioid users agreed they could decrease consumption when using cannabis

What the researchers found

Among 2,897 medical cannabis patients surveyed, 34% reported using opioid-based pain medication in the past six months. The responses from these opioid users were striking:

97% strongly agreed or agreed that they could decrease their opioid use when also using cannabis. 81% strongly agreed or agreed that cannabis alone was more effective at treating their condition than cannabis combined with opioids. Patients overwhelmingly reported that cannabis provided pain relief comparable to their other medications but without the unwanted side effects.

Similar patterns were reported by patients using cannabis alongside non-opioid pain medications, suggesting the substitution effect was not limited to opioids.

Why it matters

Prescription opioid overdoses are the leading cause of accidental death in the United States. Patient-reported data consistently suggests that many opioid users can reduce their consumption when they have access to medical cannabis. While self-report data has limitations, the near-unanimous agreement (97%) is notable and aligns with ecological data showing lower opioid overdose rates in medical cannabis states.

The numbers in context

2,897 patients surveyed. 34% used opioids in past 6 months. 97% agreed cannabis allowed decreased opioid use. 81% agreed cannabis alone was more effective than cannabis with opioids.

How the study worked

Cross-sectional survey of 2,897 medical cannabis patients. Survey collected data on concurrent medication use, perceived effectiveness, and substitution behaviors.

What this study cannot tell us

Self-report survey without clinical verification of opioid reduction. Severe selection bias: patients who found cannabis effective enough to continue using it are overrepresented, while those who tried and abandoned cannabis are absent. No clinical outcomes data (pain scores, functional measures). Cross-sectional design cannot determine causation.

How to read the evidence

Moderate evidence from a large cross-sectional survey, limited by self-selection and self-report.

When this study was published

Published in 2017. The opioid-cannabis substitution debate continues.

The bigger picture

The opioid substitution hypothesis, that medical cannabis access could reduce opioid dependence and overdose deaths, has gained significant attention. This study provides some of the largest patient-reported data supporting the hypothesis. However, the gap between patient-reported effectiveness and clinical trial evidence remains substantial.

Questions still open

Do patients who report reducing opioids actually achieve adequate pain control? Are there clinical risks to unsupervised opioid reduction when starting cannabis? Would randomized trials confirm the substitution effect seen in surveys?

Common questions

Can I replace my opioid painkillers with cannabis?

This survey found that most medical cannabis patients reported being able to reduce opioid use, but this was self-reported data without clinical oversight. Any changes to opioid medication should be made under medical supervision, as abruptly stopping opioids can be dangerous.

Is cannabis really as effective as opioids for pain?

Patients in this survey reported that cannabis provided comparable relief to their other medications. However, self-reported effectiveness in a survey is different from clinical trial evidence. The types and severity of pain conditions varied widely among participants.

Read the original research

Cannabis as a Substitute for Opioid-Based Pain Medication: Patient Self-Report.

Cannabis and cannabinoid research, 2(1), 160-166

View on PubMed ↗Publisher’s paper ↗

Citation

Reiman, Amanda; Welty, Mark; Solomon, Perry. (2017). Cannabis as a Substitute for Opioid-Based Pain Medication: Patient Self-Report.. Cannabis and cannabinoid research, 2(1), 160-166. https://doi.org/10.1089/can.2017.0012