Daily Cannabis Use Was Linked to Better Retention in Opioid Treatment Programs

People who used cannabis daily had 21% greater odds of staying in opioid agonist treatment (methadone or buprenorphine) compared to less-than-daily users, in a large cohort followed for nearly 7 years.

Socías, Maria Eugenia et al.·Addiction (Abingdon·2018·Moderate EvidenceLongitudinal Cohort
RTHC-01841Longitudinal CohortModerate Evidence2018RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Moderate Evidence
Sample
N=820

What This Study Found

Daily cannabis use was positively associated with retention in OAT (adjusted OR 1.21, 95% CI 1.04-1.41). Compared to non-users, daily users had increased odds of retention (aOR 1.20, 95% CI 1.02-1.43), but less-than-daily users did not (aOR 1.00, 95% CI 0.87-1.14), suggesting a dose-response relationship.

Key Numbers

820 participants, 57.8% men, 32.2% HIV-positive. Median follow-up 81 months. Daily cannabis use: aOR 1.21 (95% CI 1.04-1.41) for treatment retention. Less-than-daily use showed no association.

How They Did This

Longitudinal analysis of 820 participants from two community-recruited prospective cohorts of people who use illicit drugs in Vancouver, Canada. Followed for a median of 81 months with 6-month assessment periods.

Why This Research Matters

Retention in opioid agonist treatment is the single strongest predictor of reduced opioid-related morbidity and mortality. If daily cannabis use supports treatment retention, it could be an important harm reduction consideration during the opioid crisis.

The Bigger Picture

While some treatment providers worry about cannabis use during opioid treatment, this study suggests daily cannabis use may actually support treatment engagement. This challenges policies that penalize cannabis use in opioid treatment programs.

What This Study Doesn't Tell Us

Observational study cannot prove causation. Self-reported cannabis use. Vancouver population may not generalize. Unmeasured confounders possible. Cannot determine why cannabis use might support retention.

Questions This Raises

  • ?What mechanism explains the association - does cannabis reduce withdrawal symptoms, cravings, or anxiety?
  • ?Should opioid treatment programs adopt more permissive cannabis policies?
  • ?Would this finding replicate in randomized trials?

Trust & Context

Key Stat:
Daily cannabis use was associated with 21% greater odds of retention in opioid treatment (aOR 1.21, 95% CI 1.04-1.41).
Evidence Grade:
Moderate - large prospective cohort with long follow-up and appropriate adjustments, but observational.
Study Age:
Published in 2018. Data collected 1996-2016 in Vancouver.
Original Title:
High-intensity cannabis use is associated with retention in opioid agonist treatment: a longitudinal analysis.
Published In:
Addiction (Abingdon, England), 113(12), 2250-2258 (2018)
Database ID:
RTHC-01841

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked Questions

Does cannabis use help people stay in opioid treatment?

This large study found daily cannabis users had 21% greater odds of remaining in opioid agonist treatment. Interestingly, less-than-daily use showed no benefit, suggesting only regular cannabis use was associated with improved retention.

Should opioid treatment programs allow cannabis use?

This study suggests daily cannabis use during opioid treatment may support retention rather than hinder it. Since treatment retention is the strongest predictor of reduced opioid-related death, policies that penalize cannabis use in these programs may need reconsideration.

Read More on RethinkTHC

Cite This Study

RTHC-01841·https://rethinkthc.com/research/RTHC-01841

APA

Socías, Maria Eugenia; Wood, Evan; Lake, Stephanie; Nolan, Seonaid; Fairbairn, Nadia; Hayashi, Kanna; Shulha, Hennady P; Liu, Seagle; Kerr, Thomas; Milloy, M-J. (2018). High-intensity cannabis use is associated with retention in opioid agonist treatment: a longitudinal analysis.. Addiction (Abingdon, England), 113(12), 2250-2258. https://doi.org/10.1111/add.14398

MLA

Socías, Maria Eugenia, et al. "High-intensity cannabis use is associated with retention in opioid agonist treatment: a longitudinal analysis.." Addiction (Abingdon, 2018. https://doi.org/10.1111/add.14398

RethinkTHC

RethinkTHC Research Database. "High-intensity cannabis use is associated with retention in ..." RTHC-01841. Retrieved from https://rethinkthc.com/research/socias-2018-highintensity-cannabis-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.