Cannabis as an adjunct to or substitute for opiates in the treatment of chronic pain

J Psychoactive Drugs. 2012 Apr-Jun;44(2):125-33. doi: 10.1080/02791072.2012.684624.

Abstract

There is a growing body of evidence to support the use of medical cannabis as an adjunct to or substitute for prescription opiates in the treatment of chronic pain. When used in conjunction with opiates, cannabinoids lead to a greater cumulative relief of pain, resulting in a reduction in the use of opiates (and associated side-effects) by patients in a clinical setting. Additionally, cannabinoids can prevent the development of tolerance to and withdrawal from opiates, and can even rekindle opiate analgesia after a prior dosage has become ineffective. Novel research suggests that cannabis may be useful in the treatment of problematic substance use. These findings suggest that increasing safe access to medical cannabis may reduce the personal and social harms associated with addiction, particularly in relation to the growing problematic use of pharmaceutical opiates. Despite a lack of regulatory oversight by federal governments in North America, community-based medical cannabis dispensaries have proven successful at supplying patients with a safe source of cannabis within an environment conducive to healing, and may be reducing the problematic use of pharmaceutical opiates and other potentially harmful substances in their communities.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Animals
  • Cannabinoids / therapeutic use*
  • Chronic Pain / diagnosis
  • Chronic Pain / drug therapy*
  • Chronic Pain / psychology
  • Combined Modality Therapy
  • Harm Reduction
  • Humans
  • Marijuana Smoking* / adverse effects
  • Marijuana Smoking* / psychology
  • Opioid-Related Disorders / etiology
  • Opioid-Related Disorders / prevention & control*
  • Opioid-Related Disorders / psychology
  • Patient Safety
  • Treatment Outcome

Substances

  • Analgesics, Opioid
  • Cannabinoids