Survey: almost half of patients authorized to use medical cannabis say they replace marijuana with other substances, in particular opioids and alcohol

Nearly one in two Canadian patients cleared to access medical cannabis products say their use of marijuana has allowed them to reduce or quit their use of other controlled substances, including opioids and alcohol, according to data published in the Journal of Cannabis Research.

A team of researchers from Canada and the United States interviewed 2,697 Canadian patients enrolled in the national federal medical marijuana program, which began more than two decades ago. (Canada separately legalized the possession and retail sale of marijuana for adults in 2018.)

Investigators reported that 47% of respondents acknowledged having replaced cannabis with other controlled substances. Of those who said they used cannabis instead of prescription drugs, half admitted to doing so for opioids – a finding that is consistent with dozens of other studies. Many respondents also reported using cannabis to reduce their alcohol intake, a finding that has also been reported in other studies.

About one-third of respondents did not inform their primary care providers that they were practicing drug substitution.

The authors concluded, “This study examined patient-provider communication patterns regarding cannabis use and substitution in Canada. The results suggest that patients often replace cannabis with other medications without the help of PCP. The lack of integration between traditional health care and medical cannabis could likely be improved through increased training and clinical experience of physicians. …Future studies should investigate strategies to effectively engage PCPs in patient care around medical cannabis with a particular focus on substitution and harm reduction practices.

Commenting on the results, NORML Deputy Director Paul Armentano said: “Cannabis has established efficacy in the treatment of several conditions, including chronic pain, and has a safety profile comparable to or better than other conditions. other controlled substances. It is therefore not surprising that those who have legal access to it replace cannabis with other potentially less effective and more harmful substances. As legal access continues to expand, one would expect the substitution effect of cannabis to become even more pronounced in the future.

Other studies have shown that patients also frequently reduce their use of benzodiazepines, sleep aids, and antidepressants after initiation with medical cannabis.

The full text of the study, “Communication Between Health Care Providers and Medical Cannabis Patients Regarding Medication Referral and Substitution: The Canadian Context,” appears in the Journal of Cannabis Research. Additional information is available in NORML’s fact sheet, “Relationship Between Marijuana and Opioids.”

Amanda J. Marsh