When chronic pain patients participated in a program to reduce their use of opioids with medical marijuana, a quarter of them completely stopped taking opioid medications within half a year, a new pilot study reports.
“After 6 months, 156 patients (26%) had ceased taking opioids,” the paper states. “An additional 329 patients (55%) had reduced their opioid use by an average of 30%. One hundred fourteen patients (19%) neither increased nor decreased their opioid use.”
The study, led by Toronto-based chronic pain specialist Dr. Kevin Rod, was published in American Journal of Psychiatry and Neuroscience.
For his pilot study, Rod recruited 600 chronic pain patients who received care at his practice, Toronto Poly Clinic. Their daily opioid doses averaged 120mg morphine equivalent; among the sample, 95 patients were taking between 180mg to 240mg a day to manage their pain.
Rod created a tapering plan for each patient based on their individual needs. Usually, that meant opioid doses were reduced approximately 10 percent every one to two weeks. As the study’s participants lowered the dosage of pharmaceuticals they were taking to deal with pain, they were authorized to consume CBD and THC products in the range of 4 to 6 percent. The cannabis doses were related to the amount of opioids were tapered: that is, half a gram of marijuana a day for each 10 percent reduction in opioid dose as needed. To reduce the risk of additional harm, patients were advised to consume sublingually, orally or by vaping.
Additionally, patients received psychological support via a web-based mental health tool called Zendose, and were monitored regularly by physicians. During their visits to the clinic, patients were assessed for pain, quality of life, whether tapering appeared to be effective, and if there were any withdrawal symptoms, among other things.
Six months after beginning the program, 156 patients were weaned off opioids completely, while more than half of the sample (329) had reduced their intake by an average of 30 percent. These patients reported consuming 1 to 3 grams of cannabis per day. Nineteen percent (114), however, were unable to reduce the amount of opioids they were taking, though they also did not increase their dosage either. One participant did increase their opioid dosage due to “poorly controlled pain and an aggravated pain condition,” the study states. “With that one exception, all patients expressed satisfaction with their pain control, sleep and quality of life. No opioid withdrawal symptoms were noted in follow-up appointments.”
“This [Medical Cannabis – Opioid Reduction Program] pilot study outlines a patient-centered approach, with an individualized program for tapering opioid use,” the study concludes. “The positive results justify further investigation.”
Last year, Rod was a speaker at the World Cannabis Congress in New Brunswick. There, he advocated for the use of cannabis as a tool in the opioid crisis. “As front line fighters in the fight against pain,” he said, “we’re always looking for new ways to treat or manage chronic pain, and it’s not very often that we have a new solution.”