(Part 2) Practical Strategies for Using Medical Cannabis to Reduce Harms Associated With Long-Term Opioid Use

Recent studies have shown patients using cannabis combined with opioids may be able to use a lower opioid dose or stop using opioids while still getting pain relief. This can help improve a patient's quality of life while also reducing the risk of serious side effects or death associated with opioids.

We recently discussed the issues of treating chronic pain with opioids (Find part 1 here). Cannabinoids were highlighted as a potential tool to improve the treatment of pain and reduce the risk of using high-dose opioids. In the second-part of this series we will take a closer look at how cannabinoids can provide pain relief.

Our bodies have an endocannabinoid system (ECS) that cannabis acts on, including in ways that can help reduce the feeling of pain. Our bodies also have an opioid system. When someone takes cannabis, the cannabis acts on the endocannabinoid system and the opioid system, and together these actions can help reduce pain. Cannabis may also provide relief from pain-related symptoms like nausea, anxiety, insomnia and depression.

Recent studies have shown patients using cannabis combined with opioids may be able to use a lower opioid dose or stop using opioids while still getting pain relief (Nielson et al., 2022). This can help improve a patient's quality of life while also reducing the risk of serious side effects or death associated with opioids. Despite the need for more research, for some people with pain, cannabis as an adjunctive to opioids may be an option.

Stay tuned for the third-part of this blog series to learn more about what to consider before starting a trial of medical cannabis with opioids to treat chronic pain.
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References:  

Nielsen, Suzanne, et al. "Opioid-sparing effect of cannabinoids for analgesia: an updated systematic review and meta-analysis of preclinical and clinical studies." Neuropsychopharmacology 47.7 (2022): 1315-1330

Dr. Caroline MacCallum is a specialist in internal medicine with expertise in complex pain and cannabinoid medicine. In addition to serving as an advisor to EO Care, she is a clinical instructor in the Department of Medicine; Adjunct Professor in the Faculty of Pharmaceutical Sciences program; and associate member of the Dept. of Palliative Care at the University of British Columbia. An avid researcher, Dr. MacCallum is primary author of Primary Considerations for Medical Cannabis Administration and Dosing, and assistant for Cannabinoids and Pain.

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