Cannabis Reduces Use of Opioids by Cancer Patients
/By Pat Anson
The opening of cannabis dispensaries is associated with a significant decline in opioid prescriptions, according to a large new study that suggests cannabis is effective for cancer pain and reduces the need for opioids.
Researchers analyzed the health records of over 3 million commercially insured patients enrolled in Optum, the health services arm of UnitedHealth Group, and focused on those who had a cancer diagnosis.
Cancer patients who lived in states with medical or recreational cannabis dispensaries had significantly lower rates of opioid prescriptions, a lower daily supply of opioids, and fewer prescriptions per patient.
Although the study did not look at a cause-and-effect relationship between cannabis and relief from cancer pain, researchers say their findings suggest that cannabis can be an effective substitute for opioids.
Cancer pain is one of the most commonly approved conditions for medical cannabis, but there has been limited research on whether cannabis is an effective analgesic for cancer pain.
“Results of this study suggest that cannabis may serve as a substitute for opioids in managing cancer-related pain, underscoring the potential of cannabis policies to impact opioid use,” researchers reported in JAMA Health Forum.
“While opioids remain the recommended treatment for cancer pain, these patients may benefit from cannabis availability for adjuvant therapy. Further, cannabis use may reduce opioid use more among patients with cancer whose pain is not well managed with opioids or who experience negative effects of opioid use.”
Researchers believe cancer patients with lower pain levels are more likely to substitute cannabis for opioids once cannabis becomes an option.
Although opioid use by cancer patients is lower in states where medical and recreational cannabis are legal, the most significant reductions were in states with medical cannabis dispensaries. The rate of patients with opioid prescriptions was over 24% lower where there was access to a medical dispensary, while the daily supply of opioids was nearly 10% lower and the number of prescriptions per patient was over 5% lower.
Smaller reductions in opioid prescribing were associated with recreational cannabis dispensaries.
Although cancer patients are exempt from most medical guidelines that discourage the use of opioids, many were still cutoff from opioids or had their doses reduced by doctors. A recent study found a 24% decline in opioid prescribing to Medicare patients with cancer after the CDC’s 2016 opioid guideline was released.
Last year, the FDA shutdown a special program that supplied potent fentanyl lozenges and tablets to patients suffering from severe cancer pain. The FDA decision came after it was notified by Teva Pharmaceutical that it would no longer make fentanyl lozenges or tablets.
It could become even harder for some cancer patients to obtain opioids. VA researchers recently proposed that cancer patients no longer be exempt from VA and Department of Defense guidelines that discourage the prescribing of opioids for chronic pain. The researchers said cancer patients were living longer and were at risk of “persistent opioid use.”
