Adding to similar observations from multiple other studies, new Australian research indicates the co-use of medical cannabis may reduce prescribed opioid use. But it’s not for everyone.
Opioids are widely prescribed for chronic and severe pain, but are accompanied by risks of dependence; and where abused, death through overdose due to their impact on the respiratory system.
In Australian research involving patients with chronic non-cancer pain, one group of 102 patients attending a pain clinic was co-prescribed cannabinoids and another group of 53 attending a separate pain clinic nearby received only opioids.
Median opioid consumption at the start of the study was 40 mg/day in both groups. Medicinal cannabis in the form of oil was administered to the first group, usually starting at 2.5 mg/day. This would be considered a very low dose, but it was titrated (adjusted) to maximize benefits. At the 12-month mark, the median medical cannabis dose contained 15 mg delta-9-tetrahydrocannabinol (THC) and 15 mg cannabidiol (CBD).
After 12 months, opioid consumption of both groups was reassessed. Opioid consumption had decreased significantly in the medical cannabis group, the final median opioid dose being 2.7 mg/day compared to 42.3 mg/day in the control group. Physical activity and sleep also improved among patients in the medical cannabis cohort.
However, it’s important to note 46 of 102 cases had dropped out of the medical cannabis group due to lack of effect or side effects compared with only one of 53 controls.
“The introduction of cannabinoids can produce useful reductions in opioid consumption in real-world settings, with additional benefits for disability and insomnia,” state the authors. “However, this treatment is tolerated by only a subgroup of patients.”
While not mentioned in the abstract, perhaps some of the patients who dropped out could have benefited from other forms of medicinal cannabis. In its oil form, it can take much longer than conventional opioid medications to work.
Authored by researchers from Murdoch University and other institutions/agencies in Western Australia, the article has been published in the journal Pain Management.
The research adds to the growing body of evidence from around the world suggesting medical cannabis can reduce prescription opioid use, with some patients being able to cease use altogether while still maintaining sufficient pain control and general quality of life.
