Cannabis use for symptom relief among recreational users may help diminish opioid consumption, promise results of a study published in last week in the Journal of Psychoactive Drugs. A staggering 88% of adults who had been taking opioids for pain relief reported that they had reduced or completely eliminated opioid use in favor of cannabis.

The research was based on an anonymous survey of 1,000 adult-use-only cannabis dispensary customers conducted as part of a customer feedback program at two retail outlets of a Colorado cannabis dispensary organization.

Prior research and anecdotal data of medical marijuana users has shown consistent substitution of cannabis for prescription medication. However, the study’s authors noted that little information is available on individuals who access cannabis through the adult-use market.

Researchers used the survey to learn how cannabis was being employed for symptom relief by recreational users and whether prescription and over-the-counter medications were being substituted as in the case of medical users.

The results allowed them to examine policy implications in states with adult use laws as compared to those with medical use only or where completely illegal.

Cannabis the preferred option for pain relief

Comparing previous studies of medical cannabis patients, researchers found that adult-use customers were generally younger and were using significantly fewer prescription sleep aids and opioid analgesics.

Yet despite differing demographics, most medical cannabis patients and adult-use customers seemed to consider cannabis a better pain relief option than over-the-counter and prescription alternatives.

Of the 1,000 adult-use customers who agreed to fill out the Colorado dispensary survey, 65% said they were taking cannabis for pain relief, with 80% of them finding it very or extremely helpful. Their top complaints were back pain, headaches and daily chronic pain.

Close to half said that they had used opioid analgesics, including oxycodone, hydrocodone, tramadol or morphine, in the past six months. Among this group, 37 % decreased their use of opioid analgesics and just over half — 51% — reported that they had discontinued using them completely.

The report notes studies of medical cannabis patients that reveal similar patterns of substitution. For example, a 2017 survey of medical cannabis patients in New England reported over 76% of those taking opioids and 65% of those taking sleep aids reduced use of those medications.

In another recent survey of 244 people with chronic non-cancer pain conducted through a Michigan cannabis dispensary, respondents estimated that after starting medical cannabis their opioid use decreased by 64%. Nearly half also reported fewer medication side effects and improved quality of life.

Combating insomnia with cannabis

Using cannabis to promote sleep was even more popular among the Colorado dispensary respondents with the majority claiming to be taking less over-the-counter medications as a result. Of the 742 individuals taking cannabis to help them sleep better, 500 reported that they were using it daily. Half had found cannabis extremely helpful in improving their sleep pattern and another 33% considered it very helpful.

Among the 303 respondents who had been taking over-the-counter sleep aids during the six months prior to the survey, 87% reported reducing or terminating use of those medications along with 83% of the 174 individuals taking prescription sleep aids.

Significance for state cannabis policy and broadening access

Researchers outlined the study’s limitations, such as the self-selected nature of the respondents as well as the fact that responses were not verified against medical or prescription records. Nonetheless, the results reinforce previous studies showing cannabis as a viable alternative to opioids. This is worth further study.

Equally important, the study’s authors state, "Adult-use cannabis laws may broaden access to cannabis for the purpose of symptom relief."

For example, the presence of an adult-use cannabis law was associated with a 6.38% lower rate of opioid prescribing in comparison to states where cannabis was still illegal, according to a 2018 study of Medicaid enrollees.

Since many states require certification from a physician and registration in a state database to obtain a medical marijuana card, some individuals in need may hesitate to enroll either due to lack of healthcare access or the absence of legal employment protection in that particular state for registered medical cannabis patients.

"While adult-use laws are frequently called ‘recreational,’ implying that cannabis obtained through the adult use system is only for pleasure or experience-seeking, our findings suggest that many customers use cannabis for symptom relief," concluded the researchers.