Medical cannabis patients filled slightly fewer opioid prescriptions over 6 months

Among 68 Israeli chronic pain patients, opioid prescription fills decreased modestly after starting medical cannabis, but no changes were seen in other medications or healthcare service use.

Sznitman, Sharon et al.·BMJ supportive & palliative care·2023·lowRetrospective Cohort
RTHC-04972Retrospective Cohortlow2023RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
low
Sample
N=68

What This Study Found

Patients filled fewer opioid prescriptions at 6-month follow-up compared to the 6 months before starting medical cannabis. The reduction was statistically significant but of small effect size. No changes in non-opioid medications or healthcare utilization.

Key Numbers

68 patients. Opioid prescriptions decreased from baseline to 6-month follow-up with small effect size. No significant changes in other medication types or healthcare service utilization.

How They Did This

Retrospective cohort study using medical records of 68 Israeli patients with chronic pain who initiated medical cannabis. Compared prescription fills and healthcare service use 6 months before vs. 6 months after starting treatment. Paired t-tests for within-patient comparisons.

Why This Research Matters

The opioid-sparing potential of medical cannabis is one of its most cited justifications. This small study adds to the mixed evidence, finding a real but modest reduction.

The Bigger Picture

The opioid-sparing narrative around medical cannabis is compelling but the evidence remains mostly observational and small-scale. Definitive answers require randomized trials that can separate cannabis effects from regression to the mean and placebo.

What This Study Doesn't Tell Us

Very small sample (68 patients). No control group. Retrospective design using medical records. Cannot account for other changes in pain management. Small effect size questions clinical significance. Israeli medical cannabis system differs from other countries.

Questions This Raises

  • ?Would a randomized trial confirm the opioid-sparing effect?
  • ?Is the small reduction clinically meaningful for individual patients?
  • ?Do certain pain conditions show larger opioid-sparing effects than others?

Trust & Context

Key Stat:
68 patients; small but significant reduction in opioid prescriptions over 6 months
Evidence Grade:
Small retrospective cohort with no control group. Preliminary evidence only.
Study Age:
Published 2023.
Original Title:
Opioid and healthcare service use in medical cannabis patients with chronic pain: a prospective study.
Published In:
BMJ supportive & palliative care, 13(e2), e464-e468 (2023)
Database ID:
RTHC-04972

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

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Does medical cannabis reduce opioid use?

This small study found a modest reduction in opioid prescriptions after patients started medical cannabis, but the effect was small. Without a control group, it is impossible to know whether cannabis caused the reduction or whether other factors (like natural pain fluctuation or changing prescriber behavior) explain the change.

Did medical cannabis reduce overall healthcare use?

No. While opioid prescriptions decreased slightly, there were no significant changes in non-opioid medication fills or healthcare service utilization, suggesting the impact of medical cannabis on broader healthcare costs may be limited.

Read More on RethinkTHC

Cite This Study

RTHC-04972·https://rethinkthc.com/research/RTHC-04972

APA

Sznitman, Sharon; Mabouk, Carolyn; Said, Zahi; Vulfsons, Simon. (2023). Opioid and healthcare service use in medical cannabis patients with chronic pain: a prospective study.. BMJ supportive & palliative care, 13(e2), e464-e468. https://doi.org/10.1136/bmjspcare-2020-002661

MLA

Sznitman, Sharon, et al. "Opioid and healthcare service use in medical cannabis patients with chronic pain: a prospective study.." BMJ supportive & palliative care, 2023. https://doi.org/10.1136/bmjspcare-2020-002661

RethinkTHC

RethinkTHC Research Database. "Opioid and healthcare service use in medical cannabis patien..." RTHC-04972. Retrieved from https://rethinkthc.com/research/sznitman-2023-opioid-and-healthcare-service

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.