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substitution

  • by Paul Armentano, NORML Deputy Director February 1, 2019

    Patients authorized to legally use medical cannabis frequently substitute it in place of benzodiazepines, according to a pair of new studies published this week. Benzodiazepines are class of drugs primarily used for treating anxiety. According to data compiled by the US Centers for Disease Control, the drug was attributed to over 11,500 overdose deaths in 2017.

    In the first study, Canadian researchers assessed the relationship between cannabis and benzodiazepines in a cohort of 146 patients enrolled in the nation’s medical marijuana access program. They reported that 30 percent of participants discontinued their use of anti-anxiety medications within two-months of initiating cannabis therapy, and that 45 percent did so by six-months. “Patients initiated on medical cannabis therapy showed significant benzodiazepine discontinuation rates after their first follow-up visit to their medical cannabis prescriber, and continued to show significant discontinuation rates thereafter,” authors concluded.

    In the second study, investigators at the University of Michigan surveyed over 1,300 state-registered medical cannabis patients with regard to their use of opioids and benzodiazepines. They reported that 53 percent of respondents acknowledged substituting marijuana for opioids, and 22 percent did so for benzodiazepines.

    These findings are consistent with numerous other papers — such as those here, here, here, and here — documenting patients’ use of cannabis in place of a variety of prescription drugs, particularly opioids and anti-anxiety medications.

    Full text of the study, “Reduction of benzodiazepine use in patients prescribed medical cannabis,” appears in the journal Cannabis and Cannabinoid Research here.

    An abstract of the study, “Pills to pot: Observational analyses of cannabis substitution among medical cannabis users with chronic pain,” appears in The Journal of Pain here.

    Additional information is available in NORML’s fact-sheet, “Relationship between marijuana and opioids,” here.

  • by Paul Armentano, NORML Deputy Director June 28, 2017

    medical_mj_shelfPain patients report successfully substituting cannabis for opioids and other analgesics, according to data published online in the journal Cannabis and Cannabinoid Research.

    Researchers from the University of California, Berkeley and Kent State University in Ohio assessed survey data from a cohort of 2,897 self-identified medical cannabis patients.

    Among those who acknowledged having used opioid-based pain medication within the past six months, 97 percent agreed that they were able to decrease their opiate intake with cannabis. Moreover, 92 percent of respondents said that cannabis possessed fewer adverse side-effects than opioids. Eighty percent of respondents said that the use of medical cannabis alone provided greater symptom management than did their use of opioids.

    Among those respondents who acknowledged having recently taken nonopioid-based pain medications, 96 percent said that having access to cannabis reduced their conventional drug intake. Ninety-two percent of these respondents opined that medical cannabis was more effective at treating their condition than traditional analgesics.

    Authors concluded: “[M]ore people are looking at cannabis as a viable treatment for everyday ailments such as muscle soreness and inflammation. … [T]his study can conclude that medical cannabis patients report successfully using cannabis along with or as a substitute for opioid-based pain medication.”

    The study’s conclusions are similar to those of several others, such as these herehereherehere, and here, finding reduced prescription drug use and spending by those with access to cannabis. Separate studies report an association between cannabis access and lower rates of opioid-related abuse, hospitalizations, traffic fatalities, and overdose deaths.

    Full text of the study, “Cannabis as substitute for opioid-based pain medication: patient self-report,” appears online here.

  • by Paul Armentano, NORML Deputy Director May 3, 2017

    Medical marijuanaAdults often substitute cannabis for the use of prescription medications, according to data published in the Journal of Pain Research.

    Investigators from the Bastyr University Research Institute assessed the frequency of drug substitution among a self-selected national sample of 2,774 self-identified marijuana consumers.

    Just under half of respondents (46 percent) reported using cannabis in place of prescription medications. Respondents were most likely to use cannabis in lieu of narcotics/opioids (36 percent), anxiolytics/benzodiazepenes (14 percent), and antidepressants (13 percent).

    Women were more likely than men to report drug substitution, as were older respondents. Those who identified as medical cannabis patients were more than four times as likely as non-medical users to report drug substitution.

    “These data contribute to a growing body of literature suggesting cannabis, legal or otherwise, is being used as a substitute for prescription drugs, particularly prescription pain relievers,” authors concluded.

    The study’s conclusions are similar to those of several others, such as these here, here, here, and here, finding reduced prescription drug use and spending by those with access to cannabis.

    Full text of the study, “Cannabis as a substitute for prescription drugs — a cross sectional study,” appears in the Journal of Pain Research here.

  • by Paul Armentano, NORML Deputy Director April 15, 2014

    Those who report consuming cannabis two or three times per week are less likely to engage in at risk drinking behavior, according to data published online in The American Journal of Addictions.

    Investigators from Sweden’s Lund University, Department of Clinical Sciences, analyzed data from a nationwide survey on alcohol and drug use conducted by the National Institute of Public Health. Over 22,000 respondents between the ages of 15 and 64 participated in the survey.

    Researchers reported that frequent cannabis consumers (defined as having used cannabis two or three times per week) were less likely to engage in hazardous drinking practices compared to infrequent users (those who reported having consumed cannabis fewer than four times per month).

    They concluded: “In the present study, it has been shown that, in the Swedish general population, cannabis use is associated with a higher prevalence of other illicit drug use and hazardous alcohol use. Among cannabis users, frequent cannabis use is associated with a higher prevalence of other illicit drug use and a lower prevalence of hazardous alcohol use when compared to occasional cannabis use. … … The inverse relationship between the frequency of cannabis use and hazardous drinking has not been reported before to our knowledge. … This may indicate that cannabis users and alcohol users are different groups, albeit with a high degree of overlap between groups, with different characteristics and clinical needs.”

    A review paper published in February in the journal Alcohol and Alcoholism similarly acknowledged that some cannabis consumers likely substitute the plant for alcohol. It concluded: “While more research and improved study designs are needed to better identify the extent and impact of cannabis substitution on those affected by AUD (alcohol use disorders), cannabis does appear to be a potential substitute for alcohol. Perhaps more importantly, cannabis is both safer and potentially less addictive than benzodiazepines and other pharmaceuticals that have been evaluated as substitutes for alcohol.”

    An abstract of the study, “Alcohol and drug use in groups of cannabis users: Results from a survey on drug use in the Swedish general population,” appears here.