For many people struggling with opioid use disorder (OUD), accessing life-saving medications like methadone and buprenorphine (MOUD) has been hampered by a surprising hurdle: the requirement to abstain from cannabis.
A new study published in the American Journal of Drug and Alcohol Abuse challenges this policy, finding no significant link between cannabis use and relapse on non-medical opioids among patients receiving MOUD.
“Cannabis use should not be a barrier to receiving life-saving medications for opioid use disorder,” said lead investigator Dr. Joao P. De Aquino of Yale University. “Policies demanding abstinence from cannabinoids as a prerequisite for MOUD should be reconsidered.”
What Happened: The research sheds light on a murky area in addiction treatment. Prior studies offered conflicting evidence, with some suggesting cannabis could worsen OUD outcomes while others hinted at potential benefits. Interested in clarifying this relationship, the research team conducted a meta-analysis of 10 longitudinal studies encompassing over 8,300 individuals with OUD.
Outcome: The results were clear: cannabis use, regardless of the amount or frequency, did not statistically affect the risk of returning to non-medical opioids among participants receiving MOUD. This held true even when examining individual medications like methadone and buprenorphine separately, noted the authors.
“These findings neither confirm concerns about cannabis increasing nonmedical opioid use during MOUD nor do they endorse its efficacy in decreasing nonmedical opioid use with MOUD,” the researchers acknowledged while stressing the need for individualized OUD treatment plans that go beyond blanket cannabis restrictions.
“Effective treatment should involve evaluating patients for cannabis use disorder, providing comprehensive pain management, and addressing co-occurring mental health conditions,” Dr. De Aquino explained.
Commenting on the study, Dr. Scott Hadland of Mass General for Children stressed the importance of patient-centered treatment. “We should work with patients to determine whether they’re interested in and able to cut back on their cannabis use alongside their opioid use,” he said. “Ultimately, we want to meet them where they are and support any positive changes they’re seeking to make.”
Why It Matters: The study does not advocate for cannabis as a treatment for OUD. However, it does challenge the notion that it hinders recovery. This paves the way for more flexible and individualized treatment approaches for people battling opioid addiction, potentially saving lives and reducing unnecessary barriers to much-needed medications.
Opioid-Related Drug Overdoses Continue To Rise
Meanwhile, more than 107,000 Americans died from a drug overdose in 2021 mainly due to fentanyl, which is being produced and smuggled into the U.S. from Mexico primarily by the Sinaloa Cartel, say US authorities.
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