Patients Use Cannabis Instead of Opioids to Treat Pain, Anxiety and Depression, Study Finds

Published in the Journal of Pain Research, the results show that 46 percent of people who used cannabis at least once within the previous 90 days used it as a substitute for prescription drugs that treat pain, anxiety, and depression. The investigators surveyed nearly 3,000 respondents from all over the United States (as well as participants from Canada and Europe). The findings serve as the latest bit of news demonstrating a growing trend of medical cannabis use for conditions traditionally treated with prescription medications.

Survey participants responded to the following question: “Have you ever used cannabis as a substitute for prescription drugs (yes/no)?” Upon answering “yes,” respondents listed the medications that they replaced with cannabis in additional space provided. The results? The most commonly replaced drugs were painkillers (narcotics and opioids) at a nearly 36 percent substitution rate, while anxiety medications (anxiolytics and benzodiazepines) and antidepressants each were replaced with cannabis approximately 13 percent of the time.

Although there has yet to be any definitive medical consensus regarding the effectiveness of cannabis to treat pain, anxiety, and depression, it seems to function as an adequate replacement for prescription medications among medical cannabis users with these conditions.

Who’s Replacing Traditional Pharmaceuticals?

Medical cannabis users were more likely to substitute traditional medicines with cannabis than non-medical users. People who experienced a comorbidity of pain, anxiety, and depression were also more likely use pot than traditional pharmaceuticals, suggesting a versatility of cannabis in treating these conditions.

A majority of the respondents to the survey were young Caucasian-American males (under the age of 36) who characterized themselves as medical cannabis users. However, the results of the inquiry showed that females were more likely to substitute medical cannabis for prescription drugs. This practice of substitution increased with age, perhaps because older populations (compared to a younger and healthier population) are more likely to be prescribed prescription drugs.

All 50 states were represented in the study, though over half of the respondents were from states that have legalized medical cannabis use: Washington, Oregon, California, and Colorado. There was not a statistically significant difference in the rate of substitution in states where medical cannabis was legal versus states that had not legalized its use, suggesting that accessibility of legal medical cannabis is not the driving factor for its rise in popularity in treating pain, anxiety, and depression.

The results of this survey closely matched the trends recorded in another recent Canadian study that showed that over two-thirds of its sample were replacing alcohol and illicit or prescription drugs with cannabis.
Why Medical Cannabis is Bad News for the Opioid Industry

Approximately, 30 percent of cannabis substitutions in the aforementioned Canadian study were for prescription drugs like opioids. The results closely mirror the 36 percent reported in the Journal of Pain Research article. Hence the authors conclude that replacing highly-addictive prescription painkillers with cannabis might function as an effective tool against an opioid epidemic that is contributing to an increasing number of deaths from drug overdoses in the United States.

The U.S. Centers for Disease Control and Prevention (CDC) acknowledges the serious consequences that a patient faces after a dose reduction of opioids. Patients who have developed an addiction to their prescriptions have turned to heroin and illicitly obtained opioids as a replacement for these prescription painkillers.

This dangerous substitution occurs for a couple of reasons. CNN’s Dr. Sanjay Gupta pointed out that heroin is one-tenth the price of prescription opioids, driving up heroin use. Furthermore, counterfeit opioids are readily available online, and these pills can contain fentanyl, a painkilling compound easily sourced from China. Fentanyl is both highly efficient and extremely dangerous; 50 times stronger than heroin and 100 times more potent than morphine, it is part of the reason why drug overdose fatality rates have skyrocketed in recent years.

According to an analysis published in The New York Times, the number of people who died from drug overdoses rose 19 percent between 2015 and 2016; the death toll is estimated to be between 59,000 and 65,000—higher than the number of fatalities due to H.I.V. in 1995, the peak of the H.I.V. epidemic.

Why Medical Cannabis is Good News for Health

An article published in Health Affairs also concluded that medical cannabis was indeed replacing prescription drugs where applicable—and, perhaps more importantly, could serve as an effective cost-saving measure for state Medicare programs where medical cannabis is legal, as well as for enrollees and their out-of-pocket spending on drugs. Analyzing Medicare Part D prescription enrollee data from 2010-2013, the study determined that medical cannabis had saved states and enrollees over $515 million.