This study examines the efficacy of cannabis for replacing or reducing the use of prescription opioids for pain management.  This appears to be a promising application for medical cannabis, but due to the legal status of cannabis, there has been little research to support these claims, or determine optimal dosing.

To determine the impact medical cannabis has on replacing prescription opioids, we combined dispensary sales and opioid prescription data using MSA’s de-identification technology, which allows us to match the data on an individual level while maintaining the privacy of personal health information.  Looking at patient histories over a period of three years (2019 – 21) we analyzed whether more opioids were prescribed before the first cannabis purchase, during the period when cannabis was being purchased, or after the final cannabis purchase.  While individuals may have unexpected life events that require prescription opioids at any time, averaging over hundreds of patients measures whether cannabis is a practical replacement for opioids as pain medication.  The results showed a 30% reduction in prescription opioids during the period when patients were using cannabis.

Following up on this initial finding, we divided the patients into two groups: those who reduced their opioid use while using cannabis and those who saw no reduction.  Comparing both groups against the average dispensary customer we hoped to identify the most effective dosage and form of cannabis products.  The first result was that the patients who saw no reduction in their opioid use actually purchased more THC (as measured in mg per month).  Although this difference is only significant at the p < 0.1 level, it indicates that the simplistic hypothesis that higher dosage is more effective is not necessarily correct.  We also looked at each group’s distribution of spending across different forms of cannabis, and found that the groups differed from each other, and from the average dispensary customer.

There are many questions yet to be studied using this data set, but this research illustrates several important points:

• The ability to combine multiple data sources on an individual level, while maintaining the privacy of medical data, is a powerful research tool.
• Cannabis can be a practical tool for reducing or replacing opioids as pain medication.
• With further study, we can help patients make informed decisions about the best cannabis products for reducing opioid use.