Study: Kicking The Opiate Habit, With Cannabis

Via: aastock | Shutterstock


by Paul Armentano

on November 20, 2015

Can cannabis play a role in helping people kick opioid dependency? Several recent studies says ‘yes.’

Researchers at New York’s Columbia University assessed the use of cannabinoids versus placebo in opioid-dependent subjects undergoing in-patient detoxification and outpatient treatment with naltrexone, an opiate receptor antagonist. Investigators reported that the administration of oral THC (dronabinol) during the detoxification process lowered the severity of subjects’ withdrawal symptoms compared to placebo, but that these effects did not persist long-term. By contrast, patients who consumed herbal cannabis during the outpatient treatment phase were more readily able to sleep, reported experiencing less anxiety, and were more likely to complete their treatment as compared to those subjects who did not.

“One of the interesting study findings was the observed beneficial effect of marijuana smoking on treatment retention,” authors concluded. “Participants who smoked marijuana had less difficulty with sleep and anxiety and were more likely to remain in treatment as compared to those who were not using marijuana, regardless of whether they were taking dronabinol or placebo.”

The team’s findings appear online ahead of print in the journal Drug and Alcohol Dependence.

Via: Africa Studio | Shutterstock

Via: Africa Studio | Shutterstock

The study’s findings are not unique. In a 2001 study published in The American Journal of Drug and Alcohol Abuse, researchers at the New York State Psychiatric Institute assessed treatment retention rates among 47 opiate-dependent subjects participating in a six-month outpatient program. Authors reported that participants who consumed marijuana intermittently were significantly less likely to reinitiate their opiate use during the program as compared to those who either used it habitually or abstained from using it altogether. Those who used cannabis during the program were also more likely to adhere to naltrexone treatment. The authors concluded that occasional marijuana use is associated with better overall outcomes, which “may support a harm reduction approach to naltrexone maintenance.”

In 2009, investigators at the New York State Psychiatric Institute again assessed the relationship between cannabis use and opioid-treatment therapy in a cohort of 63 outpatient subjects. The researchers’ results replicated those of the 2001 study, finding that intermittent cannabis consumers were more likely to adhere to their treatment regiment and complete the outpatient program than were those who never used the substance.

Recent observational data from medical marijuana states further substantiates the theory that legal cannabis access may be a significant harm reducer for patients at risk of opioid dependency or mortality. According to data published in 2014 in The Journal of the American Medical Association, states with medical marijuana laws experience far fewer opiate-related deaths than do states that prohibit the plant. Investigators from the University of Pennsylvania, the Albert Einstein College of Medicine in New York City, and the Johns Hopkins Bloomberg School of Public Health in Baltimore conducted a time-series analysis of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010 — a period during which 13 states instituted laws allowing for cannabis therapy. They reported, “States with medical cannabis laws had a 24.8 percent lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws.”

Investigators from the RAND Corporation and the University of California, Irvine reported similar findings earlier this year in a policy paper for the non-partisan think-tank, the National Bureau of Economic Research. “[S]tates permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not,” they concluded.

Some scientists believe that cannabis may act synergistically with opiates. Clinical data published in 2011 in the journal Clinical Pharmacology & Therapeutics reports that the administration of vaporized cannabis “safely augments the analgesic effect of opioids.” Authors speculated that this “synergistic interaction” between cannabinoids and opiods “may allow for opioid treatment at lower doses with fewer [patient] side effects.” Consequently, some pain physicians are now recommending that patients use cannabis adjunctively or, in some cases, prior to using opiates as a “harm reduction strategy [to] reduce the morbidity and mortality rates associated with prescription pain medications.”


Paul Armentano is the deputy director of NORML (National Organization for the Reform of Marijuana Laws) and serves as a senior policy advisor for Freedom Leaf, Inc. He is the co-author of the book, Marijuana Is Safer: So Why Are We Driving People to Drink? (Chelsea Green, 2013) and the book, The Citizen’s Guide to State-By-State Marijuana Laws (Whitman, 2015).

  • Raymond Pelfrey

    My VA Dr. Ordered me to Stop cannabis or lose my Pain Meds. He is starting to UA test me.

  • David Snyder

    Is that even legal for him to do that???

  • Raymond Pelfrey

    I don’t think so, but he made me sign something.

  • David Snyder

    Get a copy and take it to a lawyer.

  • Michael Nielsen

    This is a follow-up response to your letter requesting clarification of the Veterans Health Administration’s (VHA) policy regarding the practice of prescribing opioid therapy for pain management for Veterans who provide documentation of the use of medical marijuana in accordance with state law if a Veteran obtains and uses medical marijuana in a manner consistent with state law, testing positive for marijuana would not preclude the Veteran from
    receiving opioids for pain management in a Department of Veterans Affairs (VA) facility.

    The Veteran would need to inform his provider of the use of medical marijuana, and of any other non-VA prescribed medications he or she is taking to ensure that all medications,
    including opioids, are prescribed in a safe manner.

    Standard pain management agreements should draw a clear distinction between the use of illegal drugs, and legal medical marijuana. However, the discretion to prescribe or not prescribe, opioids in conjunction with medical marijuana, should be determined on clinical grounds, and thus will remain the decision of the individual health care provider.

    The provider will take the use of medical marijuana into account in all prescribing decisions,
    just as the provider would for any other medication. This is a case-by-case decision, based upon the provider’s judgment, and the needs of the patient.

    Robert A. Petzel M.D.

    Department of Veterans Affairs
    2010, jul. 06

  • Adam Rubin

    There is a typo in this article, it says “tates” instead of “states”. Also, why isn’t there a link to get a print-friendly version so I could show it to my doc? Thank you!

  • Zoie

    I am currently 5 weeks off of opiate dependency after almost 20 years of prescribed use. I suffer from fibromyalgia, and PTSD. I did quite a lot of research before committing to use CBD and THC in place of my meds. I live in a legal medical and recreational state but still my Dr. would not (or could not because of FDA regulations) allow me to use both. I am tired of someone else determining my health care. It took some time of experimenting prior to making the commitment. Finally found that CBD trans dermal application, then a drink at night that was a combination of CBD and THC helped me taper off my meds with very little withdrawal issues (I did a 5 mg drop a week with the last 10 mg at once). I still occasionally have RLS type feelings sometimes in the evening but a 2mg application to my wrist of the CBD trans dermal lotion stops it in about 10 minutes. I do not smoke at all, everything I take is either internal or lotion.. I use a cannibus pain lotion locally for my fibromialgia related flare ups. I am still taking the drink at night as well, I probably will always continue that after finding out all the good affects it can have on the body. I use the CBD dose throughout the day when necessary, usually when I am working.

  • Bradley Hannah

    My VA Doctors have said ok on cannabis even the head Doc. Its legal here in Washington.

  • Bradley Hannah

    I quit my 10 year heroin, methadone and morphine addiction with cannabis. It works to reduce pain and works great for PTSD. I havent used heroin for 31 months not saying I didnt want too at times. Still clean AA helps too. I did cold turkey getting off the mixture and smoked Cannabis which helps with sickness.

  • Michael Nielsen

    Do Medical Marijuana Laws Reduce Addictions and Deaths Related to Pain Killers?

    Do Medical
    Marijuana Laws Reduce Addictions and Deaths Related to Pain Killers?

    David Powell, Rosalie Liccardo Pacula, Mireille Jacobson, et al, – NBER Working Paper No. 21345, Issued in July 2015

    Many medical marijuana patients report using marijuana to alleviate chronic pain from musculoskeletal problems and other sources. If marijuana is used as a substitute for powerful and addictive pain relievers in medical marijuana states, a potential overlooked positive impact of medical marijuana laws may bea reduction in harms associated with opioid pain relievers, a far more addictive and potentially deadly substance.

    To assess this issue, we study the impact of medical marijuana laws on problematic opioid use. We use two measures of problematic use: treatment admissions for opioid pain reliever addiction from the Treatment Episode Data Set (TEDS) and state-level opioid overdose deaths in the National Vital Statistics System (NVSS).

    Using both standard differences-in-differences models as well as synthetic control models, we find that states permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not.

    We find no impact of medical marijuana laws more broadly; the mitigating effect of medical marijuana laws is specific to states that permit dispensaries.

    We evaluate potential mechanisms. Our findings suggest that providing broader access to medical marijuana may have the potential benefit of reducing abuse of highly addictive painkillers.

  • Mark Randagio

    Great job my friend.. I’m happy for u. Have a good life