Does cannabis use affect opioid addiction treatment outcomes?
A large Canadian study of 2,315 patients in opioid use disorder treatment found that overall cannabis use was not associated with opioid use during treatment, but among cannabis users, daily use and later age of onset were linked to lower odds of continued opioid use.
Quick Facts
What This Study Found
Any cannabis use vs non-use was not associated with opioid use during treatment (OR 1.03, 95% CI 0.87-1.23). However, among cannabis users, daily use was associated with lower odds of opioid use compared to occasional use (OR 0.61, 95% CI 0.47-0.79, p<0.001). Later age of cannabis onset and reporting cannabis-related side effects also predicted less opioid use. 51% of patients used cannabis; 70% of users were daily users.
Key Numbers
2,315 patients; 51% (n=1,178) used cannabis; 70% of users were daily; overall cannabis use and opioid use OR=1.03 (not significant); daily vs occasional use OR=0.61 (p<0.001); 75% perceived no impact of cannabis on treatment; 50% reported side effects
How They Did This
Prospective cohort study of 2,315 patients receiving pharmacological OUD treatment from community addiction clinics in Ontario, Canada. Three-month follow-up with routine urine drug screens for opioid use. Logistic regression adjusted for confounders. Qualitative analysis of patient perceptions.
Why This Research Matters
With over half of OUD patients using cannabis, understanding its impact on treatment is crucial. The finding that overall cannabis use neither helps nor hinders, but that specific use patterns matter, suggests a more nuanced clinical approach than blanket policies for or against cannabis use in OUD treatment.
The Bigger Picture
The divergent findings (overall use neutral, but daily use beneficial) challenge both pro- and anti-cannabis positions in addiction treatment. Rather than a simple yes/no question, the relationship between cannabis and OUD outcomes depends on specific patterns of use.
What This Study Doesn't Tell Us
Observational design; daily cannabis users may differ systematically from occasional users. Self-reported cannabis use. Urine drug screens detect opioid use but not quantity. Ontario-specific population.
Questions This Raises
- ?Why is daily cannabis use associated with less opioid use while occasional use is not?
- ?Could daily cannabis represent intentional substitution while occasional use represents additional substance use?
- ?Should treatment programs consider cannabis frequency when developing patient plans?
Trust & Context
- Key Stat:
- Daily cannabis: 39% lower odds of opioid use
- Evidence Grade:
- Large prospective study with objective opioid outcome measures (urine screens), but observational design and potential confounding.
- Study Age:
- Published in 2021; the intersection of cannabis policy and opioid treatment continues to evolve.
- Original Title:
- The association between cannabis use and outcome in pharmacological treatment for opioid use disorder.
- Published In:
- Harm reduction journal, 18(1), 24 (2021)
- Authors:
- Rosic, Tea(2), Kapoor, Raveena, Panesar, Balpreet(2), Naji, Leen, Chai, Darren B, Sanger, Nitika, Marsh, David C, Worster, Andrew, Thabane, Lehana, Samaan, Zainab
- Database ID:
- RTHC-03470
Evidence Hierarchy
Enrolls participants and follows them forward in time.
What do these levels mean? →Frequently Asked Questions
Should people in opioid treatment use cannabis?
This study found overall cannabis use neither helped nor hurt treatment outcomes. However, among those who did use cannabis, daily use was associated with less opioid use. The observational design means these findings cannot confirm cannabis caused the better outcomes.
What side effects did cannabis users report?
Half of cannabis users reported side effects, with slower thought processes (26.2%) and lack of motivation (17.3%) being most common. Interestingly, reporting side effects was associated with lower opioid use, possibly reflecting higher awareness of substance effects.
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Cite This Study
https://rethinkthc.com/research/RTHC-03470APA
Rosic, Tea; Kapoor, Raveena; Panesar, Balpreet; Naji, Leen; Chai, Darren B; Sanger, Nitika; Marsh, David C; Worster, Andrew; Thabane, Lehana; Samaan, Zainab. (2021). The association between cannabis use and outcome in pharmacological treatment for opioid use disorder.. Harm reduction journal, 18(1), 24. https://doi.org/10.1186/s12954-021-00468-6
MLA
Rosic, Tea, et al. "The association between cannabis use and outcome in pharmacological treatment for opioid use disorder.." Harm reduction journal, 2021. https://doi.org/10.1186/s12954-021-00468-6
RethinkTHC
RethinkTHC Research Database. "The association between cannabis use and outcome in pharmaco..." RTHC-03470. Retrieved from https://rethinkthc.com/research/rosic-2021-the-association-between-cannabis
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.