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Opioids & Cannabis: Gaining an Upper Hand on Pain

How Opioids and Cannabis Interact
Photo by Gracie Malley for Cannabis Now


Opioids & Cannabis: Gaining an Upper Hand on Pain

Opioids deployed in the treatment of chronic pain can wind up causing more harm than they alleviate. Enter cannabis, which might just be what America needs to wean itself off of pharmaceuticals.

When it comes to cannabis and opioids, there are important (and beneficial) chemical interactions between the two substances — but the real story is in how cannabis can push back against the opioid crisis.

The raw numbers of opioid abuse are enough to shock the system. From 1999 to 2017, the number of deaths from an opioid overdose increased nearly six-fold, from 8,048 to 47,600 in the United States, according to the National Institute on Drug Abuse. Throughout that period, prescription opioids account for about 40% of those deaths.

A full accounting of what is happening here is well beyond the scope of this post (this New Yorker article on the role of prescription drug companies in pushing opioid prescriptions is a good place to start), but it all comes back to one word: pain.

Do No Harm?

Pain is notoriously hard to track, especially at a population scale, and this is reflected in the range of estimates of how many people cope with it. According to the Centers for Disease Control and Protection, 11-40% of Americans experience chronic pain. That’s a huge range, but even at the low end, that means 35 million Americans have this issue, with the higher estimates over 100 million. Any way you slice it, that’s an enormous market.

Furthermore, opioids only treat the symptom — pain itself — not its underlying cause, meaning patients often need daily treatment. Opioids can be horrifically addictive, and often make one numb to everything, not just pain. And they can be fatal when over-consumed.

Enter cannabis.

While many people remove or avoid opioids entirely because they use cannabis to treat their pain, others may simply use both, with fewer opioids entering their system as a result. Research has found a 27% decrease in pain when cannabis was included alongside opioids — and importantly, it also found that cannabis did not cause an increase in opioid levels in the bloodstream.

Furthermore, the two may be used in concert at doses that, though too small to do much individually, cause a significant reduction in pain when combined.

A Substitute, If Not a Solution

The plant has been the direct cause of exactly zero reported deaths and has nowhere near the addictive properties of opioids. It also has similar palliative effects when it comes to pain, and we now have good evidence that states with legal and available cannabis (medical or recreational) show lower rates of opioid abuse. One study found a 64% decrease in opioid use among medical cannabis patients, alongside a 45% increase in quality of life.

We see these personal stories represented en masse in the statistics: One study found a 24.8% reduction in opioid mortality rates in states that have legalized medical cannabis. It is not an exaggeration to say that legalizing cannabis across the entire U.S. could potentially save tens of millions of lives.

So much of the public discourse on cannabis is on mitigating its alleged harms and deciding where and how it can be used. When it comes to opioids, it appears thus far that available cannabis is a tremendous win for public health — and though certain experts contest its efficacy for “solving” the opioid crisis, it could potentially hold treatment options for those struggling with addiction.  

But for the chronic pain experienced by tens, maybe hundreds of millions of Americans, cannabis may be the best medicine.

TELL US, do you know anyone who combines opioids and cannabis to treat chronic pain?



  1. C

    May 12, 2019 at 7:43 pm

    Yes u do use both an it helps my pain alot more. However its getting harder an harder in these illegal states to find much of anything an not ention drs not wanting to give u a script bc u cant pass a drug test. Thc

  2. Henry

    May 8, 2019 at 2:40 pm

    Yes I do. I get much better relief using both. I also use less opiates while I use pot. I have chronic back pain (degenerative disc disease). One day I could barely move and a buddy came over with a joint. I smoked it with him and instantly was so relived it was amazing. Ever since then I try to use both when I can . Ive been told I cant get medical weed and opiates (I go to a pain clinic) both. So I keep getting the opiates and buy street weed. I know if I could get both I would have a much better quality of life than I do now. I dont trust black market weed dealers also. So why cant I just get both from doctors? It is so idiotic . Not sure it is the law but its just what my pain doctor told me. maybe I can do both ? Im in Ohio.
    please respond if you know any different. Thanks

    • Cervical_fusion

      August 6, 2019 at 3:18 pm

      Yes you can.. go to another dr who can do the medical marijuana. I gave someone who treats me for my back and neck. I was taking 6 meds for pain, I started with med, marijuana April. For 3 months I used both, pain was totally improved.., then came last week of June. When going to get refills the scripts would not go through. Now I no longer have the opioids.. taken be some time to get them out of system. Pain is being controlled by med pot only right now.

  3. ginster

    May 8, 2019 at 5:54 am

    Yes I do. I am a Licensed Addiction counselor who has worked in Methadone Maintenance Clinics. Marijuana consumption in most reputable clinics is not even an issue. Many individuals use marijuana to self medicate pain, trauma and as a sleep aid.It is time for marijuana to be legal nationwide, and this is coming from an `addiction specialist’ who has worked in behavioral health for over twenty years.

  4. Michael Philipone

    May 7, 2019 at 2:08 pm

    Yes…ME in the last decade I’ve had five spinal fusions four total shoulder revision surgeries due to failed implants. I’ve been using cannabis daily for pain and after the opioid cutback to chronic pain patients my cannabis use grew.
    Now two 10mg slow release opioid a day and three grams of cannabis.

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