Opioid and healthcare service use in medical cannabis patients with chronic pain: a prospective study

Background and Objective

Chronic pain is one of the most common indications for medical cannabis (MC) treatment. In the context of the ongoing opioid crisis, there is growing interest in whether medical cannabis may help reduce reliance on prescription opioids while maintaining pain management. Although previous surveys have reported self-reported reductions in opioid use among medical cannabis patients, objective evidence from healthcare records remains limited.

This study aimed to evaluate whether initiation of medical cannabis treatment was associated with changes in prescription opioid use, use of other medications, and overall healthcare service utilization among patients with chronic pain.

Methods

Researchers analyzed medical records from 68 Israeli patients with chronic pain who were prescribed medical cannabis. Objective healthcare data were collected for two six-month periods: the six months before initiation of medical cannabis treatment and the six months following treatment initiation.

The analysis examined the number of opioid prescriptions filled, use of other prescription medications, and healthcare service utilization. Each patient's post-treatment outcomes were compared with their own baseline data.

Key Findings

Initiation of medical cannabis treatment was associated with a statistically significant reduction in opioid prescriptions during the six-month follow-up period compared with baseline. However, the magnitude of this reduction was relatively small, and its clinical significance remains uncertain.

No significant changes were observed in the use of non-opioid prescription medications following the initiation of medical cannabis treatment.

Similarly, overall healthcare service utilization—including measures such as healthcare visits and other medical services—did not change significantly during the follow-up period.

Conclusion

Among patients with chronic pain, initiation of medical cannabis treatment was associated with a modest reduction in opioid prescription use over a six-month period. However, no significant changes were observed in the use of other medications or in overall healthcare service utilization.

Given the study's small sample size and observational design, the findings do not establish a causal relationship between medical cannabis treatment and reduced opioid use. Nevertheless, the results provide real-world evidence suggesting a potential opioid-sparing association that warrants further investigation.

Larger, prospective studies with representative patient populations and longer follow-up periods are needed to determine whether medical cannabis can play a clinically meaningful role in reducing opioid reliance among individuals living with chronic pain.