Can Cannabinoids Help People Wean Off Opioids?

A study provided a clinical framework designed to help people wean off and eventually replace opioids.

Doctors desperately need tools to battle the opioid epidemic, and they’re turning to cannabinoids for new ways to approach the problem of opioid use disorder (OUD). Recently researchers aimed to create an open-access framework designed to help people wean off and eventually replace opioids with cannabinoids as an alternative. 

Last August, a study provided a clinical framework for cannabinoids in the battle against the opioid epidemic. The study, entitled “An answered call for aid? Cannabinoid clinical framework for the opioid epidemic,” was published in Harm Reduction Journal.

Researchers provided an evidence-based clinical framework for the utilization of cannabinoids to treat patients with chronic pain who are dependent on opioids, seeking alternatives, and tapering off of opioids.

“Based on a comprehensive review of the literature and epidemiological evidence to date, cannabinoids stand to be one of the most interesting, safe, and accessible tools available to attenuate the devastation resulting from the misuse and abuse of opioid narcotics,” researchers wrote. “Considering the urgency of the opioid epidemic and broadening of cannabinoid accessibility amidst absent prescribing guidelines, the authors recommend use of this clinical framework in the contexts of both clinical research continuity and patient care.”

Recent research has shown a role for CBD in treating cannabis use disorder, and likewise, the compound could be useful in treating OUD. Researchers are also exploring the potential of THC and acidic cannabinoids as well. Cannabis is known anecdotally for the treatment of low-to-moderate amounts of pain despite working in very different ways than opiates.

The open-access framework includes opioid tapering recommendations that are in accordance with the CDC’s latest clinical practice guidelines for managing opioids for pain. 

“As opioid deaths continue to be a global problem, patients are increasingly self-medicating with cannabis while researchers struggle to standardize protocols and providers feel uncomfortable recommending cannabinoids amidst absent prescribing guidelines,” researchers wrote. “If we consider cannabis as a harm reduction tool that patients are already using without medical guidance, we can realign our focus to supporting researchers and providers with a clinical framework for standardizing research and recommending cannabinoids more informatively as safe, effective, accessible tools for assisting in the management of chronic pain. To our knowledge, this is one of the first comprehensive evidence-based peer-reviewed clinical frameworks for the safe use of cannabinoid products for chronic pain and OUD.”

The researchers acknowledged that many of their patients have already begun their own self-guided journey into pain management with cannabinoids.

The Devastating Toll of Opioid Overdoses

Opioids continue to wreak havoc on people in America, leading to confusion about who needs powerful opioids and who doesn’t, and overdose deaths continue a steady pace of devastation.

According to The National Center for Health Statistics (NCHS) under the U.S. Centers for Disease Control and Prevention, drug overdose deaths rose from 2019 to 2021 with over 106,000 drug overdose deaths reported in 2021. Deaths involving synthetic opioids—primarily fentanyl and excluding methadone—continued its death march with 70,601 overdose deaths reported in 2021. Fentanyl in particular kills 150 Americans per day.

Over-prescription of opioids could be part of the problem. A 2018 longitudinal analysis showed that prescriptions for all opioids in the U.S. fell by 14.4% when medical cannabis dispensaries opened—particularly for hydrocodone and morphine, but also for benzodiazepines, stimulants, and many other medications known to be over-prescribed and addictive. 

In some states, opioid use disorder is a qualifying condition for the use of medical cannabis. Researchers are still learning about the efficacy of cannabinoids in animal and human trials.

Studies on Cannabis and Opioid Abuse Vary

Opioid addiction is a complex phenomenon, and studies vary in their results of whether or not cannabinoids are effective. One study concluded that there is “no evidence that cannabis reduces opioid misuse.”

According to research published in the American Journal of Psychiatry, researchers instead found “no evidence” showing that cannabis may not be an effective long-term strategy for reducing opioid abuse.

“There are claims that cannabis may help decrease opioid use or help people with opioid use disorders keep up with treatment. But it’s crucial to note those studies examine short-term impact and focus on treatment of chronic pain and pain management, rather than levels of opioid use in other contexts,” Dr Jack Wilson, the lead author of the study and a postdoctoral research fellow at The Matilda Centre for Research in Mental Health and Substance Use at the University of Sydney in Australia, said in a statement.

“Our investigation shows that cannabis use remains common among this population, but it may not be an effective long-term strategy for reducing opioid use,” he added.

Recent studies show the vast potential of cannabis in the fight against the opioid epidemic that continues to ravage the U.S.

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