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Medical Cannabis: Effects on Opioid and Benzodiazepine Requirements for Pain Control

Journal: Annals of Pharmacotherapy
Publication Year: 2019
Authors: Megan O’Connell, PharmD , Megan Sandgren, PharmD, MS, BCPS, Leah Frantzen, PharmD, BCPS, Erika Bower, PharmD, BCACP, and Brian Erickson, MD

Abstract

The United States is currently undergoing a tragic opioid epidemic. We have a duty to try to curb this disaster. This study shows that by taking cannabis as an adjunct treatment, patients may be able to lower the amount of opioids needed to find pain relief.

Abstract
Background: There is currently little evidence regarding the use of medical cannabis for the treatment of intractable
pain. Literature published on the subject to date has yielded mixed results concerning the efficacy of medical cannabis and
has been limited by study design and regulatory issues. Objective: The objective of this study was to determine if the
use of medical cannabis affects the amount of opioids and benzodiazepines used by patients on a daily basis. Methods:
This single-center, retrospective cohort study evaluated opioid and benzodiazepine doses over a 6-month time period for
patients certified to use medical cannabis for intractable pain. All available daily milligram morphine equivalents (MMEs) and
daily diazepam equivalents (DEs) were calculated at baseline and at 3 and 6 months. Results: A total of 77 patients were
included in the final analysis. There was a statistically significant decrease in median MME from baseline to 3 months (−32.5
mg; P = 0.013) and 6 months (−39.1 mg; P = 0.001). Additionally, there was a non–statistically significant decrease in
median DE at 3 months (−3.75 mg; P = 0.285) and no change in median DE from baseline to 6 months (−0 mg; P = 0.833).
Conclusion and Relevance: Over the course of this 6-month retrospective study, patients using medical cannabis for
intractable pain experienced a significant reduction in the number of MMEs available to use for pain control. No significant
difference was noted in DE from baseline. Further prospective studies are warranted to confirm or deny the opioid-sparing
effects of medical cannabis when used to treat intractable pain.

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