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Combined cannabis, pain medication use not a predictor of substance abuse

Although substance abuse was more common among patients who used medical cannabis and/or prescription pain medication compared with the general population, the combined use was not a reliable risk factor, according to study findings in the Journal of Studies on Alcohol and Drugs.

“Increasingly, medical cannabis is being presented as an alternative to opioids or as an adjunctive approach that could augment the analgesic effects of opioids. However, cannabis may be problematic for some patients, especially those who are prescribed prescription pain medication and use marijuana and prescription pain medication concurrently,” study researcher Brian E. Perron, PhD, of the University of Michigan, and colleagues wrote.

To determine if concurrent use of cannabis and pain medication increased risk for alcohol and drug abuse, researchers assessed 273 patients who reported using cannabis in the past month for pain. Among the patients, 63% also reported use of prescription pain medication within the past month for pain.

The mean age of the participants was 40.3 years. Those who used prescription pain medication were older, had higher levels of pain (P = .007) and lower levels of functioning (P < .001) compared with those who did not use pain medication.

Overall, study participants reported more alcohol and noncannabis drug use in the past 3 months and during their lifetime vs. the general population, according to researchers.

Study participants had similar rates of use of other drugs, including cocaine, sedatives, street opioids and amphetamines, over the lifetime and the past 3 months.

Prescription pain medication users reported that cannabis had greater efficacy vs. pain medication for pain management (P < .0001) and had similar desires to reduce pain medication use.

“These data provide preliminary results that use of [prescription pain medications] among cannabis users might not be a reliable risk indicator for more serious forms of drug involvement,” Perron and colleagues wrote. “At the same time, this claim needs to be examined using a longitudinal research design.”

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