Study register · detailQuerschnittserhebung · Opioid Reduction · 2019
Medical cannabis patterns of use and substitution for opioids & other pharmaceutical drugs, alcohol, tobacco, and illicit substances; results from a cross-sectional survey of authorized patients.
Lucas et al.·Harm Reduction Journal
Clear benefitGRADELow129 citations
Samplen = 2.032 Pat.
EndpointSelf-reported substance…
Blindingn.a.
DesignQuerschnittserhebung
Cannabinoidvollspektrum
”Key finding
Medical cannabis patients predominantly report a self-perceived reduction or complete substitution of opioids, alcohol and other substances.
Summary
Cross-sectional survey (n=2032 Canadian medical cannabis patients): 69,1% reported substitution of prescription medications; opioids accounted for 35,3% of all medication substitutions (n=610 opioid mentions); 59,3% of these reported complete cessation of opioid use. Antidepressants were the second most frequent substitution (21,5%).
P
PopulationCanadian medical cannabis patients of a nationally licensed producer, n=2032, predominantly male (62,6%), mean age 40 years, main indications pain and mental illness (83,7%)
I
InterventionMedical cannabis (standardized, state-regulated, average 1,5 g/day, predominantly daily use)
O
Outcome69,1% reported substitution of prescription medications, of which 35,3% opioids; in 59,3% of opioid substitutions complete opioid abstinence; substitution of alcohol 44,5%, tobacco 31,1%, illegal substances 26,6%
Confidence in the evidence
Very lowLowModerateHigh
Low
The second of four GRADE levels, the effect estimate is of limited reliability.
<h4>Background</h4>A 239-question cross-sectional survey was sent out via email in January 2017 to gather comprehensive information on cannabis use from Canadian medical cannabis patients registered with a federally authorized licensed cannabis producer, resulting in 2032 complete surveys.<h4>Methods</h4>The survey gathered detailed demographic data and comprehensive information on patient patterns of medical cannabis use, including questions assessing the self-reported impact of cannabis on the use of prescription drugs, illicit substances, alcohol, and tobacco.<h4>Results</h4>Participants were 62.6% male (n = 1271) and 91% Caucasian (n = 1839). The mean age was 40 years old, and pain and mental health conditions accounted for 83.7% of all respondents (n = 1700). Then, 74.6% of respondents reported daily cannabis use (n = 1515) and mean amount used per day was 1.5 g. The most commonly cited substitution was for prescription drugs (69.1%, n = 953), followed by alcohol (44.5%, n = 515), tobacco (31.1%, n = 406), and illicit substances (26.6%, n = 136). Opioid medications accounted for 35.3% of all prescription drug substitution (n = 610), followed by antidepressants (21.5%, n = 371). Of the 610 mentions of specific opioid medications, patients report total cessation of use of 59.3% (n = 362).<h4>Conclusions</h4>This study offers a unique perspective by focusing on the use of a standardized, government-regulated source of medical cannabis by patients registered in Canada's federal medical cannabis program. The findings provide a granular view of patient patterns of medical cannabis use, and the subsequent self-reported impacts on the use of opioids, alcohol, and other substances, adding to a growing body of academic research suggesting that increased regulated access to medical and recreational cannabis can result in a reduction in the use of and subsequent harms associated with opioids, alcohol, tobacco, and other substances.