Study: Long-Term Cannabis Use Associated With Improved Pain Relief, Reduced Opioid Use

  • by Paul Armentano, NORML Deputy Director February 22, 2016

    for_painThe long-term, daily use of cannabis is associated with improved analgesia and reduced opioid use in patients with treatment-resistant chronic pain conditions, according to clinical trial data reported online ahead of print in The Clinical Journal of Pain.

    Investigators with Hebrew University in Israel evaluated the use of cannabis on pain in a cohort of 176 patients, each of whom had been previously unresponsive to all conventional pain medications. Subjects inhaled THC-dominant cannabis daily (up to 20 grams per month) for a period of at least six months.

    A majority of participants (66 percent) experienced improvement in their pain symptom scores after cannabis therapy, and most reported “robust” improvements in their quality of life. Subjects’ overall consumption of opioid drugs declined 44 percent by the end of the trial, and a significant percentage of participants discontinued opioid therapy altogether over the course of the study.

    Authors concluded, “In summary, this long-term prospective cohort suggests that cannabis treatment in a mixed group of patients with treatment-resistant chronic pain may result in improved pain, sleep and quality of life outcomes, as well as reduced opioid use.”

    The Israeli results are similar to those reported in a 2015 Canadian trial which concluded that chronic pain patients who use herbal cannabis daily for one-year experienced reduced discomfort and increased quality of life compared to controls, and did not possess an increased risk of serious side effects.

    According to data published in 2014 in The Journal of the American Medical Association, US states with medical marijuana laws experience far fewer opiate-related deaths than do states that prohibit the plant. Investigators from the RAND Corporation and the University of California, Irvine reported similar findings in 2015, concluding, “States permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not.” Clinical data published in 2011 in the journal Clinical Pharmacology & Therapeutics previously reported that the administration of vaporized cannabis “safely augments the analgesic effect of opioids.”

    A review published earlier this year in the Canadian Journal of Anesthesia assessing the clinical use of cannabinoids for pain in over 1,300 subjects concludes, “Overall, the recent literature supports the idea that currently available cannabinoids are modestly effective analgesics that provide a safe, reasonable therapeutic option for managing chronic non-cancer-related pain and possibly cancer-related pain.”

    An abstract of the study, “The effect of medicinal cannabis on pain and quality of life outcomes in chronic pain: A prospective open-label study,” appears online here.

    22 Responses to “Study: Long-Term Cannabis Use Associated With Improved Pain Relief, Reduced Opioid Use”

    1. mexweed says:

      RAND: “[vaporized cannabis safely augments opioid benefit”– the good news lesson is if the patient gets an augmented opioid payoff they won’t need to use as much opioid… won’t get desperate and try using a lot, etc. etc.

      Those benefits can happen even if the cannabis doesn’t entirely REPLACE the $$ opiates, maybe Mr.Ms. so-and-so will continue just spending a tenth as much on it??

      Uh oh. Somebody with lots of money to hire polit-thugs against you if you speak up is making selfsame money off patients’ opiate purchase QUANTITY & don’t want that reduced.

      Furthermore, a LARGE part of that opiate pain relief is for results of Hot Burning-Overdose-Monoxide-Paperroll-$igarette-attributed illnesses, 2014-Surg.-Gen. estimated US economic “$moking” cost $289-bil. includes $135-bil. just for “medical” which I presume includes drugs!

      Substitute (a) cannabis for tobacco, (b) vape for $moke, (c) 25-mg sifted single toke for 700-mg $ig, 500-mg Joint, etc., see pathology disappear, shrink opiate prescriptions 89% in a decade, win Knowitwell Prize for Keith & Co.

      Taxpayer, please help buy off the idled $ig and pHARMa workers with great Fed vocational retraining programs under a Vapey Sanders administration.

    2. Mark Mitcham says:

      As a recovering alcoholic myself, I experience a spirit of solidarity with anyone who might be struggling with addiction to opiates or other substances. (In terms of sheer numbers of deaths, tobacco is the deadliest, by far.) Addiction is baffling; yet sometimes recovery is possible, even when it doesn’t seem so.

      And as an unapologetic stoner, I am well aware of the benefits of cannabis in relationship to my alcoholic recovery, and would recommend it to anyone “trying to quit” (unless they personally felt it might threaten their recovery, in which case I wouldn’t push it. Do what you got to do, brother or sister.)

      But there will be those who will say that people who use cannabis in this way are merely switching one drug for another, and therefore achieving nothing with respect to their “drug problem.”

      I reject that argument both personally and intellectually. Personally, the fact that I’ve survived my drinking is huge to me, and frankly I don’t care if that violates someone’s anti-drug ideology; and intellectually, I consider the notion of harm reduction more valid than the notion of drug-free, for an individual or a society.

      So, it turns out that marijuana is “your anti-drug!” Well, imagine that!

      • Michael says:

        Well said, Mr. Mitcham. We need a lot more sensible, honest voices like yours.

      • Julian says:

        I agree; marijuana provides me an alternative that leaves me consuming less alcohol. In fact Im driving all the way to the SouthWest Cannabis Convention Expo this Saturday in Dallas just so I can take my non-marijuana consuming wife and ask Dr. Sue Sisley or Dr. Mechoulam; (Don’t get ahead of me…)

        ” Can you please explain to my lovely wife that consuming marijuana allows me a safer, more conscious alternative to alcohol that can potentially help me consume less alcohol?
        I mean, it’s not only that her strict Mexican upbringing rightfully prevents her from consuming anything illegal, but to make matters worse, Im her husband… and as a result, nothing I say really matters… Just being honest… So can we please stop for one second from convincing Congress prohibition is wrong, and… I beg of you… just for this moment… convince my wife!?”

        Ive already booked a hotel suite with the fold out sofa just in case. :-)

      • Frank See says:

        I was abusing alcohol and Oxycodone, until I smoked my home grown. Home grown took the place of 4 oxycodones and a bottle of vodka.
        My home grown is super strong. Thanks to Terpinator. I will never use that crappy oxy again, and no oxy hang over or alcoholic amnesia either. I strongly believe in medicinal marijuana. I mean seriously!

      • Fireweed says:

        the reason why using pot to get off alcohol is NOT like “switching one drug for another” is that pot doesn’t have all the harmful effects that other drugs including prescription opioids have.

    3. Galileo Galilei says:

      Somebody tell presidential candidate/Ohio governor John Kaisch the good news.

      Don’t leave your kitchen to vote for him.

    4. St. Nick 'n' Dime says:

      We have to keep fighting, doing more and more until it is legal Nationwide. Bernie Sanders could help with this although I’m voting for whatever Democrat is running.

      It’s hard for the DEA and other government departments to up and change their views because they’ve been lying to us for 75+ years. That doesn’t mean we let it in their hands! We have the numbers if we can join up and unite WE can change the laws of this country. Some people can’t handle their smoke. Some freak out if they think bad things while high. I can’t even handle some drugs sometimes. If I’m tripping on something like cough medicine or shrooms and even smoking too I could freak out. Does that mean no one should have access to certain drugs? No! Especially weed. It’s so good, your body stores it in your fat cells because it likes it so much!And it’s not as though these unwanted times can’t be avoided or fixed when happening.

      But the truth is so many people CAN handle these dreaming while awake experiences. Should 8% of all people ruin it for 92%? No.

      Anyway that’s actually not a big deal. I’ve freaked out – I still think weed should be legal not worrying about those handful of times. Anyway, keep on doing the right thing and help us have safe access to a drug that will give probably 98% good times and help our lives be better than now to Cannabis, a drug with 1000s of good uses, very few if at all negative(with certain people) and so safe you CANNOT overdose from it. Safer than K-2.. and Aspirin for that matter.

      Peace out everyone.

      • Cjakibob says:

        I agree we need to change the laws, but it shouldn’t matter what party is in charge. I’m a Democrat, but look at our 2 choices. A Socialist, or someone under federal investigation. Don’t we deserve better than that? Remember a Government that’s strong enough to give you everything is also strong enough to take it away.

    5. Julian says:

      And Take THAT society! Opiates are destroying our children and killing our veterans while legally regulated marijuana is a solution!

      Well, ok, society’s opinion has already changed, so it’s really Congress we’re talking to, and by that I mean soecifically Democratic Chair from Miami-Dade County, Debbie Wasserman Shultz. Still gonna defend opiate prescriptions and marijuana prohibition ol’ Dirty Debbie Money-Washerman Shultz?

      Boy, that bitc# is the rotten, moldy stem in our freshly rolled Democratic joint, isn’t she?

    6. Lynn Kempen says:

      We’ve known this for at least a decade.
      No wonder pain management policies deem that cannabis users can’t be prescribed opioids……it reduces the need for opioids, thereby lessening Big Pharma’s bottom line. If forced to make the choice, go natural. It comes down to the right to life.

    7. Frank See says:

      Wow, my thoughts exactly. I had depression, family deaths, arthritis, suicidal thoughts.
      Mixing Oxycodone and vodka to kill the pain.
      Until I smoked my home grown. I was stoned for 24 hours, with no alcohol and no oxycodone. Marijuana is my only drug of choice, because I went thru pills and alcohol
      that are a certain death trap!

    8. Hempopotomus says:

      6 Surgeries – 2 skin grafts & pain everyday from Hidradenitis Suppurativa (HS). Opiates steal your soul, and suck your energy through CNS depression. All of the sudden – your taking them just to not feel WORSE! Anyone considering opiate based pain management, please think hard about it.

      Cannabis is a natural medicine like no other. Honestly besides hallucinogenic plants, what has as many medical and industrial uses as cannabis? NOTHING!

      It’s a freaking super plant that can change the world. How much longer until we bring up charges against those who deny freedom to a safe plant? No one has the right to say you can’t enjoy a good sativa to help pain from Hidradenitis Suppurativa. Especially if they don’t have HS!

      Don’t the overlords (the uber rich people that pull the strings) realize that every single state is constantly going to have legalization bills until they pass?

      Every day more and more people realize the lies the establishment pumps out are ridiculous. Please help out by educating the idiots that think the reefer madness BS is true.

      We’re close people! Keep the pressure on those senators, and representatives so we can look back and feel proud about righting a horrible wrong.

      To the demon fodder that will see a dark place in the next life from keeping a PLANT illegal while people die from your greed..Effff You!

    9. Miles says:

      This is great news. Unfortunately, it is not the kind of news the media (like Fox News) typically reports… Those idiots are hopping on a study that using cannabis leads to other drugs…

    10. Paul Appleton says:

      Not apparently true in Connecticut…deaths still going up

      • Anonymous says:

        Here’s a cut and paste from the study; Connecticut was apparently considered a non-medical marijuana state.

        Design, Setting, and Participants A time-series analysis was conducted of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010; all 50 states were included.

        Main Outcomes and Measures Age-adjusted opioid analgesic overdose death rate per 100 000 population in each state. Regression models were developed including state and year fixed effects, the presence of 3 different policies regarding opioid analgesics, and the state-specific unemployment rate.

        Results Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999. Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate (95% CI, ?37.5% to ?9.5%; P?=?.003) compared with states without medical cannabis laws. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time: year 1 (?19.9%; 95% CI, ?30.6% to ?7.7%; P?=?.002), year 2 (?25.2%; 95% CI, ?40.6% to ?5.9%; P?=?.01), year 3 (?23.6%; 95% CI, ?41.1% to ?1.0%; P?=?.04), year 4 (?20.2%; 95% CI, ?33.6% to ?4.0%; P?=?.02), year 5 (?33.7%; 95% CI, ?50.9% to ?10.4%; P?=?.008), and year 6 (?33.3%; 95% CI, ?44.7% to ?19.6%; P?<?.001). In secondary analyses, the findings remained similar.

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