Another study has found legal cannabis availability is linked to decreased opioid prescription use among cancer patients in the USA.
Pain is a common cancer-associated symptom impacting more than 65% of patients with advanced cancer. While the prescription of opioids for managing cancer pain is common, these medicines aren’t without their risks — ranging from constipation to dependence and abuse. However, cannabis has potential in more safely managing cancer-related pain and also alleviating adverse effects from cancer treatments; such as chemotherapy related nausea and lack of appetite.
Researchers from universities in Georgia, Indiana and Chicago set out to determine if medical or recreational cannabis dispensary openings were associated with lower opioid prescription use among commercially insured cancer patients.
The study applied synthetic control with data extracted from Optum’s deidentified Clinformatics Data Mart database from January 1, 2007, to December 31, 2020. It included patients aged 18 to 64 years with a cancer diagnosis and at least 6 months of continuous enrolment.
The researchers reported medical cannabis dispensary openings were associated with significant reductions in all opioid outcomes: −41.07 per 10,000 prescriptions. Recreational dispensary openings were also associated with reductions, in opioid outcomes, albeit smaller (−20.63 per 10 000).
The analysis found larger reductions in extensive rather than intensive measures in patients; suggesting patients with less severe pain levels were more likely to substitute cannabis for opioids; or that prescriber behavior changes following cannabis availability.
Heterogeneous associations across age, sex, or race and ethnicity were not identified; suggesting cannabis availability may help a diverse range of patients equally manage cancer-related pain; assuming the observed reductions reflect substitution to cannabis.
The researchers concluded:
“This study’s findings indicate cannabis may be a substitute for opioids in the management of cancer-related pain. However, further research directly observing cannabis use is needed to evaluate the efficacy of cannabis as a treatment for cancer-related pain.”
The study has been published in JAMA Health Forum and adds to the growing body of evidence, including this relatively recent Australian study indicating the co-use of medical cannabis may reduce prescribed opioid use, of cannabis potentially being a useful alternative to opioid medicines.
