First Long-Term Study to Test if Medical Marijuana Reduces Opioid Use Among Adults with Chronic Pain

Researchers at Albert Einstein College of Medicine and Montefiore Health System were awarded a five-year, $3.8 million grant by the National Institutes of Health (NIH) Tuesday for the first long-term study on whether medical cannabis effectively treats opioid dependence among adults suffering from chronic pain.

While studies have reported evidence supporting the use of medical cannabis for chronic pain, successful treatment depends on a host of variables including: Dosage, method of consumption, strain and the type of chronic pain experienced. Additionally, everyone reacts differently to cannabis based on biochemistry, genetics, diet, lifestyle, tolerance and sex.

While positive studies concerning medical cannabis are reassuring, Chinazo Cunningham, M.D., M.S., associate chief of general internal medicine at Einstein and Montefiore, and chief investigator on the grant, says information about the impact of medical cannabis on opioid use is lacking. “We hope this study will fill in the gaps and provide doctors and patients with some much needed guidance,” Dr. Cunningham said in a news release for Albert Einstein College of Medicine.

Opioids are not only extremely addictive, but overprescribed. When users are unable to obtain them from a physician, they often turn to street dealers and alternatives like heroin. And when pain becomes increasingly severe, the need for a higher dosage can result in death. The CDC (Centers for Disease Control and Prevention) reported more than 33,000 Americans died from an opioid overdose in 2015. Opioid overdoses have become so commonplace, President Trump declared the American opioid epidemic a national emergency.

Whether or not cannabis reduces the use of opioids over time has never been studied in any population. As a new study, Dr. Cunningham acknowledges the complexity of state and federal government involvement surrounding opioids and cannabis. Dr. Cunningham told Albert Einstein College of Medicine that she and her team of researchers, “hope to provide evidence-based recommendations that will help shape responsible and effective healthcare practices and public policies.”

Many Americans suffer from chronic pain, but both chronic pain and opioid use are more common among people with HIV. It is estimated between 25 and 90 percent of adults with HIV experience chronic pain and are therefore likely to be prescribed opioids to manage it. Where it is legally available, HIV is a qualifying condition for medical cannabis. 250 HIV-positive and HIV-negative adults with chronic pain and opioid dependence—as well as certification from their physicians to use medical cannabis—will be enrolled in the study which is being provided through approved dispensaries in New York State. Over a period of 18 months, the subjects will participate in web-based questionnaires every two weeks—focusing on pain levels and the illicit and medical use of cannabis and opioids; the study subjects will provide blood and urine samples in-person every three months—and a select few participants will engage in in-depth interviews examining their perception of medical cannabis’ effect on the use of opioids.

While some tolerate opioids better than others, they are prone to unwanted side-effects and nearly half of all opioid deaths involve a prescription. As patients increasingly advocate cannabis for their pain treatment, one can only hope that evidence supports a positive impact on opioid dependence.