Cannabinoid–Opioid Interaction in Chronic Pain

Abrams, D I; Couey, P; Shade, S B; Kelly, M E; Benowitz, N L

doi:10.1038/clpt.2011.188

Cited by 319Cannabis and Cannabinoid ResearchPain Management and Opioid UseAnesthesia and Pain Management

Cannabinoid–Opioid Interaction in Chronic Pain

Abrams, D I, Couey, P, Shade, S B, Kelly, M E, Benowitz, N L·2011·Clinical Pharmacology & Therapeutics

DOI 10.1038/clpt.2011.188

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Abstract

Cannabinoids and opioids share several pharmacologic properties and may act synergistically. The potential pharmacokinetics and the safety of the combination in humans are unknown. We therefore undertook a study to answer these questions. Twenty-one individuals with chronic pain, on a regimen of twice-daily doses of sustained-release morphine or oxycodone were enrolled in the study and admitted for a 5-day inpatient stay. Participants were asked to inhale vaporized cannabis in the evening of day 1, three times a day on days 2-4, and in the morning of day 5. Blood sampling was performed at 12-h intervals on days 1 and 5. The extent of chronic pain was also assessed daily. Pharmacokinetic investigations revealed no significant change in the area under the plasma concentration-time curves for either morphine or oxycodone after exposure to cannabis. Pain was significantly decreased (average 27%, 95% confidence interval (CI) 9, 46) after the addition of vaporized cannabis. We therefore concluded that vaporized cannabis augments the analgesic effects of opioids without significantly altering plasma opioid levels. The combination may allow for opioid treatment at lower doses with fewer side effects.

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In Abrams 2011, no pharmacokinetic interaction was observed between cannabis and opioids.
“Note: no pharmacokinetic interaction observed”
From Opioid-Sparing Effect of Cannabinoids: A Systematic Review and Meta-Analysis (2017) · cites this paper as Abrams 2011
In Abrams 2011, mean pain score reduction was from 34.8 (95% CI 29.4,40.1) at baseline to 24.1 (95% CI 18.8, 29.4) on day 5 with morphine, and from 43.8 (95% CI 38.6, 49.1) at baseline to 33.6 (95% CI 28.5, 38.6) on day 5 with oxycodone; there was a significant reduction overall.
“Mean pain score reduction, from 34.8 (95% CI 29.4,40.1) at baseline to 24.1 (95% CI 18.8, 29.4) on day 5 with morphine, and from 43.8 (95% CI 38.6, 49.1) at baseline to 33.6 (95% CI 28.5, 38.6) on day 5 with oxycodone.Significant reduction overall.”
From Opioid-Sparing Effect of Cannabinoids: A Systematic Review and Meta-Analysis (2017) · cites this paper as Abrams 2011

A critical review of visual analogue scales in the measurement of clinical phenomena
Wewers, M. E., & Lowe, N. K. (1990) · Research in Nursing & Health · doi:10.1002/nur.4770130405 · Cited by 2,580 · see citing works
Power and sample size calculations
Dupont, W. D., & Plummer, W. D. (1990) · Controlled Clinical Trials · doi:10.1016/0197-2456(90)90005-m · Cited by 2,112 · see citing works
Designing Clinical Research: An Epidemiologic Approach
Hulley, S., Cummings, S., & Browner, W. (1988) · Controlled Clinical Trials · doi:10.1016/0197-2456(89)90023-8 · Cited by 1,043 · see citing works
Neuro‐Psychopharmacology
(1962) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1962.tb27008.x · Cited by 594 · see citing works
Pharmacological and biochemical interactions between opioids and cannabinoids
Manzanares, J., Corchero, J., Romero, J., Fernández‐Ruíz, J., Ramos, J. A., & Fuentes, J. (1999) · Trends in Pharmacological Sciences · doi:10.1016/s0165-6147(99)01339-5 · Cited by 391 · see citing works
Synergistic interactions between cannabinoid and opioid analgesics
Cichewicz, D. L. (2004) · Life Sciences · doi:10.1016/j.lfs.2003.09.038 · Cited by 305 · see citing works
Vaporization as a Smokeless Cannabis Delivery System: A Pilot Study
Abrams, D. I., Vizoso, H., Shade, S., Jay, C., Kelly, M., & Benowitz, N. (2007) · Clinical pharmacology and therapy · doi:10.1038/sj.clpt.6100200 · Cited by 263 · see citing works
Self-citation
Efficacy of Dronabinol as an Adjuvant Treatment for Chronic Pain Patients on Opioid Therapy
Narang, S., Gibson, D., Wasan, A. D., Ross, E. L., Michna, E., Nedeljkovic, S. S., & Jamison, R. N. (2008) · The Journal of Pain · doi:10.1016/j.jpain.2007.10.018 · Cited by 257 · see citing works
Effects of smoked marijuana on food intake and body weight of humans living in a residential laboratory
Foltin, R. W., Fischman, M. W., & Byrne, M. F. (1988) · Appetite · doi:10.1016/s0195-6663(88)80017-5 · Cited by 256 · see citing works
Short-Term Effects of Cannabinoids in Patients with HIV-1 Infection: A Randomized, Placebo-Controlled Clinical Trial
Abrams, D. I., Hilton, J. F., Leiser, R. J., Shade, S. B., Elbeik, T. A., Aweeka, F. T., Benowitz, N. L., Bredt, B. M., Kosel, B., Aberg, J. A., et al. (2003) · Annals of Internal Medicine · doi:10.7326/0003-4819-139-4-200308190-00008 · Cited by 238 · see citing works
Self-citation
The analgesic effect of oral delta-9-tetrahydrocannabinol (THC), morphine, and a THC-morphine combination in healthy subjects under experimental pain conditions
Naef, M., Curatolo, M., Petersen-Felix, S., Arendt-Nielsen, L., Zbinden, A., & Brenneisen, R. (2003) · Pain · doi:10.1016/s0304-3959(03)00163-5 · Cited by 209 · see citing works
Antinociceptive activity of intrathecally administered cannabinoids alone, and in combination with morphine, in mice.
Welch, S. P., & Stevens, D. L. (1992) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/s0022-3565(25)10720-9 · Cited by 208 · see citing works
Evaluation of a vaporizing device (Volcano®) for the pulmonary administration of tetrahydrocannabinol
Hazekamp, A., Ruhaak, L. R., Zuurman, L., van Gerven, J., & Verpoorte, R. (2006) · Journal of Pharmaceutical Sciences · doi:10.1002/jps.20574 · Cited by 197 · see citing works
Synergistic interactions of endogenous opioids and cannabinoid systems
Welch, S. P., & Eads, M. (1999) · Brain Research · doi:10.1016/s0006-8993(99)01908-3 · Cited by 169 · see citing works
Development of reliable and valid measures of nausea and vomiting
Rhodes, V. A., Watson, P. M., & JOHNSON, M. H. (1984) · Cancer Nursing · doi:10.1097/00002820-198402000-00003 · Cited by 162 · see citing works
Antinociceptive Synergy between Δ9-Tetrahydrocannabinol and Opioids after Oral Administration
Cichewicz, D. L., & McCarthy, E. A. (2003) · The Journal of Pharmacology and Experimental Therapeutics · doi:10.1124/jpet.102.045575 · Cited by 154 · see citing works
The Enhancement of Morphine Antinociception in Mice by Î9-Tetrahydrocannabinol
Smith, F. (1998) · Pharmacology Biochemistry and Behavior · doi:10.1016/s0091-3057(98)00012-4 · Cited by 146 · see citing works
Quantitative measurement of Δ9-tetrahydrocannabinol and two major metabolites in physiological specimens using capillary column gas chromatography negative ion chemical ionization mass spectrometry
Foltz, R. L., McGinnis, K., & Chinn, D. M. (1983) · Journal of Mass Spectrometry · doi:10.1002/bms.1200100503 · Cited by 126 · see citing works
Modulation of cannabinoid-induced antinociception after intracerebroventricular versus intrathecal administration to mice: possible mechanisms for interaction with morphine.
Welch, S. P., Thomas, C., & Patrick, G. (1995) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/s0022-3565(25)24328-2 · Cited by 124 · see citing works
The role of endogenous opioids in enhancing the antinociception produced by the combination of delta 9-tetrahydrocannabinol and morphine in the spinal cord.
Pugh, G., Smith, P. B., Dombrowski, D. S., & Welch, S. P. (1996) · The Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/s0022-3565(25)21168-5 · Cited by 123 · see citing works
Enhancement mu opioid antinociception by oral delta9-tetrahydrocannabinol: dose-response analysis and receptor identification.
Cichewicz, D. L., Martin, Z. L., Smith, F. L., & Welch, S. P. (1999) · PubMed · Cited by 121 · see citing works
Normal-release and controlled-release oxycodone: pharmacokinetics, pharmacodynamics, and controversy
Davis, M. P., Varga, J., Dickerson, D., Walsh, D., LeGrand, S. B., & Lagman, R. L. (2003) · Supportive Care in Cancer · doi:10.1007/s00520-002-0385-9 · Cited by 120 · see citing works
The effect of cannabinoids on intestinal motility and their antinociceptive effect in mice
CHESHER, G. B., Dahl, C. J., Everingham, M., Jackson, D. M., MARCHANT‐WILLIAMS, H., & Starmer, G. A. (1973) · British Journal of Pharmacology · doi:10.1111/j.1476-5381.1973.tb08534.x · Cited by 111 · see citing works
Synergistic affective analgesic interaction between delta-9-tetrahydrocannabinol and morphine
Roberts, J. D., Gennings, C., & Shih, M. (2006) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2005.11.036 · Cited by 103 · see citing works
Medicinal Cannabis Does Not Influence the Clinical Pharmacokinetics of Irinotecan and Docetaxel
Engels, F. K., de Jong, F. A., Sparreboom, A., Mathôt, R. A. A., Loos, W. J., Kitzen, J. J. E. M., de Bruijn, P., Verweij, J., & Mathijssen, R. H. J. (2007) · The Oncologist · doi:10.1634/theoncologist.12-3-291 · Cited by 74 · see citing works
Marihuana smoking increases plasma cocaine levels and subjective reports of euphoria in male volunteers
Lukas, S. E., Sholar, M. B., Kouri, E. M., Fukuzako, H., & Mendelson, J. H. (1994) · Pharmacology Biochemistry and Behavior · doi:10.1016/0091-3057(94)90338-7 · Cited by 70 · see citing works
Cannabinoid-induced alterations in brain disposition of drugs of abuse 11Abbreviations: THC, tetrahydrocannabinol; CBD, cannabidiol; PCP, phencyclidine; MDMA, 3,4-methylenedioxyphenyl-methamphetamine HCl.
Reid, M. J. A., & Bornheim, L. M. (2001) · Biochemical Pharmacology · doi:10.1016/s0006-2952(01)00616-5 · Cited by 70 · see citing works
Simultaneous Determination of 9-Tetrahydrocannabinol and 11-nor-9-Carboxy- 9-Tetrahydrocannabinol in Human Plasma by Solid-Phase Extraction and Gas Chromatography-Negative Ion Chemical Ionization-Mass Spectrometry
Huang, W., Moody, D. E., Andrenyak, D. M., Smith, E. K., Foltz, R. L., Huestis, M. A., & Newton, J. F. (2001) · Journal of Analytical Toxicology · doi:10.1093/jat/25.7.531 · Cited by 68 · see citing works
Interactions of several cannabinoids with the hepatic drug metabolizing system
Fernandes, M. S., Warning, N., Christ, W., & Hill, R. (1973) · Biochemical Pharmacology · doi:10.1016/0006-2952(73)90184-6 · Cited by 65 · see citing works
Enhancement of μ Opioid Antinociception by Oral Δ9-Tetrahydrocannabinol: Dose-Response Analysis and Receptor Identification
Cichewicz, D. L., Martin, Z. L., Smith, F. L., & Welch, S. P. (1999) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/s0022-3565(24)38212-6 · Cited by 60 · see citing works
Effects of delta‐9‐tetrahydrocannabinol on drug distribution and metabolism Antipyrine, pentobarbital, and ethanol
Benowitz, N. L., & Jones, R. T. (1977) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt1977223259 · Cited by 57 · see citing works
Self-citation
Comparative characterization in the rat of the interaction between cannabinoids and opiates for their immunosuppressive and analgesic effects
Massi, P., Vaccani, A., Romorini, S., & Parolaro, D. (2001) · Journal of Neuroimmunology · doi:10.1016/s0165-5728(01)00323-x · Cited by 54 · see citing works
Determination of Morphine, Morphine-3-glucuronide, and Morphine-6-glucuronide in Plasma after Intravenous and Intrathecal Morphine Administration Using HPLC with Electrospray Ionization and Tandem Mass Spectrometry
Slawson, M. H., Crouch, D. J., Andrenyak, D. M., Rollins, D. E., Lu, J. K., & Bailey, P. L. (1999) · Journal of Analytical Toxicology · doi:10.1093/jat/23.6.468 · Cited by 53 · see citing works
Marihuana attenuates the rise in plasma ethanol levels in human subjects.
Lukas, S. E., Benedikt, R. A., Mendelson, J. H., Kouri, E. M., Sholar, M. B., & Amass, L. (1992) · PubMed · Cited by 42 · see citing works
Prototype cannabinoid analgetics, prostaglandins and opiates — A search for points of mechanistic interaction
Johnson, M. R., Melvin, L. S., & Milne, G. M. (1982) · Life Sciences · doi:10.1016/0024-3205(82)90190-4 · Cited by 32 · see citing works
The reproducibility of bioavailability of oral morphine from solution under fed and fasted conditions
Gourlay, G. K., Plummer, J. L., Cherry, D. A., & Purser, T. (1991) · Journal of Pain and Symptom Management · doi:10.1016/0885-3924(91)90042-3 · Cited by 22 · see citing works
In vivo and in vitro effects of Δ9-tetrahydrocannabinol on rat liver microsomal drug-metabolizing enzymes
Mitra, G., Poddar, M. K., & Ghosh, J. J. (1976) · Toxicology and Applied Pharmacology · doi:10.1016/0041-008x(76)90075-2 · Cited by 18 · see citing works
Modulation of free intracellular calcium and cAMP by morphine and cannabinoids, alone and in combination in mouse brain and spinal cord synaptosomes
Pugh, G., Welch, S. P., & Bass, P. P. (1994) · Pharmacology Biochemistry and Behavior · doi:10.1016/0091-3057(94)90270-4 · Cited by 16 · see citing works
PHARMACOLOGICAL SIMILARITIES AND INTERACTIONS BETWEEN CANNABIS AND OPIOIDS
KAYMAKÀALAN, S. (1979) · Elsevier eBooks · doi:10.1016/b978-0-08-023759-6.50050-0 · Cited by 9 · see citing works
Pharmacological similarities and interactions between cannabis and opioids.
Kaymakçalan, S. (1980) · PubMed · Cited by 3 · see citing works

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Nugent, S. M., Morasco, B. J., O'Neil, M. E., Freeman, M., Low, A., Kondo, K., Elven, C., Zakher, B., Motu'apuaka, M., Paynter, R., et al. (2017) · Annals of Internal Medicine · doi:10.7326/m17-0155 · Cited by 301 · see citing works
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Pisano, V. D., Putnam, N. P., Kramer, H. M., Franciotti, K., Halpern, J. H., & Holden, S. C. (2017) · Journal of Psychopharmacology · doi:10.1177/0269881117691453 · Cited by 86 · see citing works
Six policy lessons relevant to cannabis legalization
Shover, C. L., & Humphreys, K. N. (2019) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2019.1569669 · Cited by 84 · see citing works
Medical cannabis for the reduction of opioid dosage in the treatment of non-cancer chronic pain: a systematic review
Okusanya, B. O., Asaolu, I. O., Ehiri, J. E., Kimaru, L. J., Okechukwu, A., & Rosales, C. (2020) · Systematic Reviews · doi:10.1186/s13643-020-01425-3 · Cited by 82 · see citing works
Chronic and Acute Pain and Pain Management for Patients in Methadone Maintenance Treatment
Eyler, E. C. H. (2013) · American Journal on Addictions · doi:10.1111/j.1521-0391.2013.00308.x · Cited by 82 · see citing works
The endocannabinoid hydrolysis inhibitor SA-57: intrinsic antinociceptive effects, augmented morphine-induced antinociception, and attenuated heroin seeking behavior in mice
Wilkerson, J. L., Ghosh, S., Mustafa, M., Abdullah, R. A., Niphakis, M. J., Cabrera, R., Maldonado, R. L., Cravatt, B. F., & Lichtman, A. H. (2017) · Neuropharmacology · doi:10.1016/j.neuropharm.2016.11.015 · Cited by 78 · see citing works
Distribution of CB1 cannabinoid receptors and their relationship with mu-opioid receptors in the rat periaqueductal gray
Wilson-Poe, A. R., Morgan, M. M., Aicher, S. A., & Hegarty, D. M. (2012) · Neuroscience · doi:10.1016/j.neuroscience.2012.03.038 · Cited by 79 · see citing works
New York Physicians' Perspectives and Knowledge of the State Medical Marijuana Program
Sideris, A., Khan, F., Boltunova, A., Cuff, G. E., Gharibo, C. G., & Doan, L. (2018) · Cannabis and Cannabinoid Research · doi:10.1089/can.2017.0046 · Cited by 76 · see citing works
The Pharmacokinetics, Efficacy, Safety, and Ease of Use of a Novel Portable Metered-Dose Cannabis Inhaler in Patients With Chronic Neuropathic Pain: A Phase 1a Study
Eisenberg, E., Ogintz, M., & Almog, S. (2014) · Journal of Pain & Palliative Care Pharmacotherapy · doi:10.3109/15360288.2014.941130 · Cited by 79 · see citing works
Clinical Practice Guidelines for Cannabis and Cannabinoid-Based Medicines in the Management of Chronic Pain and Co-Occurring Conditions
Bell, A. D., MacCallum, C., Margolese, S., Walsh, Z., Wright, P., Daeninck, P. J., Mandarino, E., Lacasse, G., Kaur Deol, J., de Freitas, L., et al. (2024) · Cannabis & Cannabinoid Research · doi:10.1089/can.2021.0156 · Cited by 78 · see citing works
“68 These studies demonstrated a reduction in pain with the addition of CBM to their opioid regimen.”
Background
Opioid and cannabinoid synergy in a mouse neuropathic pain model
Kazantzis, N. P., Casey, S. L., Seow, P. W., Mitchell, V. A., & Vaughan, C. W. (2016) · British Journal of Pharmacology · doi:10.1111/bph.13534 · Cited by 71 · see citing works
Effect of Inhaled Cannabis for Pain in Adults With Sickle Cell Disease
Abrams, D. I., Couey, P., Dixit, N., Sagi, V., Hagar, W., Vichinsky, E. P., Kelly, M. E., Connett, J. E., & Gupta, K. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.10874 · Cited by 71 · see citing works
Self-citation
Co-ingestion of prescription opioids and other drugs among high school seniors: Results from a national study
McCabe, S. E., West, B. T., Teter, C. J., & Boyd, C. J. (2012) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2012.04.017 · Cited by 70 · see citing works
Cannabinoids: Current and Future Options to Treat Chronic and Chemotherapy-Induced Neuropathic Pain
Blanton, H. L., Brelsfoard, J., Deturk, N., Pruitt, K., Narasimhan, M., Morgan, D. J., & Guindon, J. (2019) · Drugs · doi:10.1007/s40265-019-01132-x · Cited by 70 · see citing works
Safety Considerations in Cannabinoid-Based Medicine
Gottschling, S., Ayonrinde, O., Bhaskar, A., Blockman, M., D’Agnone, O., Schecter, D., Rodríguez, L. D. S., Yafai, S., & Cyr, C. (2020) · International Journal of General Medicine · doi:10.2147/ijgm.s275049 · Cited by 71 · see citing works
Cannabis and pain: a scoping review
Pantoja‐Ruiz, C., Restrepo-Jiménez, P., Castañeda‐Cardona, C., Ferreirós, A., & Rosselli, D. (2021) · Brazilian Journal of Anesthesiology (English Edition) · doi:10.1016/j.bjane.2021.06.018 · Cited by 76 · see citing works
Cannabinoid receptor-specific mechanisms to alleviate pain in sickle cell anemia via inhibition of mast cell activation and neurogenic inflammation
Vincent, L., Vang, D., Nguyen, J., Benson, B. A., Lei, J.-X., & Gupta, K. (2015) · Haematologica · doi:10.3324/haematol.2015.136523 · Cited by 68 · see citing works
The Selective Monoacylglycerol Lipase Inhibitor MJN110 Produces Opioid-Sparing Effects in a Mouse Neuropathic Pain Model
Wilkerson, J. L., Niphakis, M. J., Grim, T. W., Mustafa, M. A., Abdullah, R. A., Poklis, J. L., Dewey, W. L., Akbarali, H. I., Banks, M. L., Wise, L. E., et al. (2016) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1124/jpet.115.229971 · Cited by 67 · see citing works
Clinical Relevance of Drug Interactions with Cannabis: A Systematic Review
Lopera, V., Rodríguez, A., & Amariles, P. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11051154 · Cited by 66 · see citing works
Cannabinoids for the treatment of rheumatic diseases — where do we stand?
Katz, D., Katz, I., Porat-Katz, B.-S., & Shoenfeld, Y. (2018) · Nature Reviews Rheumatology · doi:10.1038/s41584-018-0025-5 · Cited by 66 · see citing works
Cannabinergic Pain Medicine: A Concise Clinical Primer and Survey of Randomized-controlled Trial Results
Aggarwal, S. K. (2013) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e31824c5e4c · Cited by 62 · see citing works
Role of Cannabinoids in Pain Management
Russo, E. B., & Hohmann, A. G. (2012) · Springer eBooks · doi:10.1007/978-1-4614-1560-2_18 · Cited by 62 · see citing works
Impact of Efficacy at the μ-Opioid Receptor on Antinociceptive Effects of Combinations of μ-Opioid Receptor Agonists and Cannabinoid Receptor Agonists
Maguire, D. R., & France, C. P. (2014) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1124/jpet.114.216648 · Cited by 59 · see citing works
Cannabis and joints: scientific evidence for the alleviation of osteoarthritis pain by cannabinoids
O’Brien, M. S., & McDougall, J. J. (2018) · Current Opinion in Pharmacology · doi:10.1016/j.coph.2018.03.012 · Cited by 60 · see citing works
Cannabis, Cannabinoids and Cannabis-Based Medicines in Cancer Care
Abrams, D. (2022) · Integrative Cancer Therapies · doi:10.1177/15347354221081772 · Cited by 49 · see citing works
Self-citation
Is cannabis use associated with less opioid use among people who inject drugs?
Kral, A. H., Wenger, L. D., Novak, S. P., Chu, D., Corsi, K. F., Coffa, D. A., Shapiro, B. J., & Bluthenthal, R. N. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.05.014 · Cited by 58 · see citing works
Endogenous opiates and behavior: 2011
Bodnar, R. J. (2012) · Peptides · doi:10.1016/j.peptides.2012.09.027 · Cited by 58 · see citing works
Therapeutic potential of medicinal marijuana: an educational primer for health care professionals
Mouhamed, Y., Vishnyakov, A., Qorri, B., Sambi, M., Frank, S. M. S., Nowierski, C., Lamba, A., Bhatti, U., & Szewczuk, M. R. (2018) · Drug Healthcare and Patient Safety · doi:10.2147/dhps.s158592 · Cited by 56 · see citing works
The Impact of Medical Cannabis on Intermittent and Chronic Opioid Users with Back Pain: How Cannabis Diminished Prescription Opioid Usage
Takakuwa, K. M., Hergenrather, J. Y., Shofer, F. S., & Schears, R. M. (2020) · Cannabis and Cannabinoid Research · doi:10.1089/can.2019.0039 · Cited by 56 · see citing works
The periaqueductal gray contributes to bidirectional enhancement of antinociception between morphine and cannabinoids
Wilson‐Poe, A. R., Pocius, E., Herschbach, M., & Morgan, M. M. (2012) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2012.10.002 · Cited by 53 · see citing works
Potential Pharmacokinetic Drug‐Drug Interactions between Cannabinoids and Drugs Used for Chronic Pain
Vázquez, M., Guevara, N., Maldonado, C., Guidó, P. C., & Schaiquevich, P. S. (2020) · BioMed Research International · doi:10.1155/2020/3902740 · Cited by 56 · see citing works
Cannabinoids and Hallucinogens for Headache
McGeeney, B. E. (2012) · Headache The Journal of Head and Face Pain · doi:10.1111/head.12025 · Cited by 55 · see citing works
Δ 9 -tetrahydrocannabinol Attenuates Oxycodone Self-Administration Under Extended Access Conditions
Nguyen, J. D., Grant, Y., Creehan, K. M., Hwang, C. S., Vandewater, S. A., Janda, K. D., Cole, M., & Taffe, M. A. (2017) · Neuropharmacology · doi:10.1016/j.neuropharm.2019.04.010 · Cited by 54 · see citing works
Inhibition of UDP-Glucuronosyltransferase Enzymes by Major Cannabinoids and Their Metabolites
Nasrin, S., Watson, C. J. W., Bardhi, K., Fort, G., Chen, G., & Lazarus, P. J. (2021) · Drug Metabolism and Disposition · doi:10.1124/dmd.121.000530 · Cited by 52 · see citing works
Medical Marijuana Use in Older Adults
Briscoe, J., & Casarett, D. (2018) · Journal of The American Geriatrics Society · doi:10.1111/jgs.15346 · Cited by 52 · see citing works
State marijuana laws and opioid overdose mortality
Chihuri, S. T., & Li, G. (2019) · Injury Epidemiology · doi:10.1186/s40621-019-0213-z · Cited by 51 · see citing works
The dynamic interaction between pain and opioid misuse
Wilson‐Poe, A. R., & Morón, J. A. (2017) · British Journal of Pharmacology · doi:10.1111/bph.13873 · Cited by 48 · see citing works
Cannabinoids and drug metabolizing enzymes: potential for drug-drug interactions and implications for drug safety and efficacy
Bardhi, K., Coates, S., Watson, C. J. W., & Lazarus, P. J. (2022) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2022.2148655 · Cited by 52 · see citing works
Anti-nociceptive interactions between opioids and a cannabinoid receptor 2 agonist in inflammatory pain
Yuill, M. B., Hale, D. E., Guindon, J., & Morgan, D. J. (2017) · Molecular Pain · doi:10.1177/1744806917728227 · Cited by 49 · see citing works
Consensus‐based recommendations for titrating cannabinoids and tapering opioids for chronic pain control
Sihota, A., Smith, B. K., Ahmed, S., Bell, A., Blain, A., Clarke, H. A., Cooper, Z. D., Cyr, C., Daeninck, P. J., Deshpande, A., et al. (2020) · International Journal of Clinical Practice · doi:10.1111/ijcp.13871 · Cited by 49 · see citing works
Cannabis—A Valuable Drug That Deserves Better Treatment
Mechoulam, R. (2012) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2011.12.002 · Cited by 49 · see citing works
Medical cannabis: considerations for the anesthesiologist and pain physician
Beaulieu, P., Boulanger, A., Desroches, J., & Clark, A. J. (2016) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-016-0598-x · Cited by 47 · see citing works
THC and gabapentin interactions in a mouse neuropathic pain model
Atwal, N., Casey, S. L., Mitchell, V. A., & Vaughan, C. W. (2018) · Neuropharmacology · doi:10.1016/j.neuropharm.2018.10.006 · Cited by 47 · see citing works
Practical Strategies Using Medical Cannabis to Reduce Harms Associated With Long Term Opioid Use in Chronic Pain
MacCallum, C. A., Eadie, L., Barr, A. M., Boivin, M. R., & Lu, S. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.633168 · Cited by 47 · see citing works
Cannabis and the skin
Shao, K., Stewart, C. L., & Grant-Kels, J. M. (2021) · Clinics in Dermatology · doi:10.1016/j.clindermatol.2021.05.006 · Cited by 46 · see citing works
Recent progress in non-opioid analgesic peptides
de Vega, M. J. P., Ferrer-Montiel, A. V., & González‐Muñiz, R. (2018) · Archives of Biochemistry and Biophysics · doi:10.1016/j.abb.2018.10.011 · Cited by 46 · see citing works
Brain-Permeant and -Impermeant Inhibitors of Fatty Acid Amide Hydrolase Synergize with the Opioid Analgesic Morphine to Suppress Chemotherapy-Induced Neuropathic Nociception Without Enhancing Effects of Morphine on Gastrointestinal Transit
Slivicki, R. A., Saberi, S. A., Iyer, V., Vemuri, K. V., Makriyannis, A., & Hohmann, A. G. (2018) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1124/jpet.118.252288 · Cited by 45 · see citing works
Legalization of Medical Marijuana and Incidence of Opioid Mortality
Hayes, M. J., & Brown, M. S. (2014) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2014.2716 · Cited by 42 · see citing works
Duration of Neurocognitive Impairment With Medical Cannabis Use: A Scoping Review
Eadie, L., Lo, L. A., Christiansen, A. L., Brubacher, J. R., Barr, A. M., Panenka, W. J., & MacCallum, C. A. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.638962 · Cited by 42 · see citing works
Cannabis Pharmacogenomics: A Path to Personalized Medicine
Babayeva, M., & Loewy, Z. G. (2023) · Current Issues in Molecular Biology · doi:10.3390/cimb45040228 · Cited by 41 · see citing works
Marijuana as a Substitute for Prescription Medications: A Qualitative Study
Mercurio, A. N., Aston, E. R., Claborn, K., Waye, K. M., & Rosen, R. K. (2019) · Substance Use & Misuse · doi:10.1080/10826084.2019.1618336 · Cited by 41 · see citing works
Opioid use and misuse: health impact, prevalence, correlates and interventions
Bolshakova, M., Bluthenthal, R. N., & Sussman, S. Y. (2019) · Psychology and Health · doi:10.1080/08870446.2019.1622013 · Cited by 40 · see citing works
LC–MS/MS quantitation of phytocannabinoids and their metabolites in biological matrices
Abd-Elsalam, W. H., Alsherbiny, M. A., Kung, J. Y. C., Pate, D. W., & Löbenberg, R. (2019) · Talanta · doi:10.1016/j.talanta.2019.06.053 · Cited by 40 · see citing works
Profiles of Medicinal Cannabis Patients Attending Compassion Centers in Rhode Island
Zaller, N. D., Topletz, A. R., Frater, S., Yates, G., & Lally, M. (2015) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2014.999901 · Cited by 37 · see citing works
Exploring the Lived Experience of Adults using Prescription Opioids to Manage Chronic Noncancer Pain
Brooks, E. A., Unruh, A. M., & Lynch, M. E. (2015) · Pain Research and Management · doi:10.1155/2015/314184 · Cited by 37 · see citing works
Therapeutic use of cannabis: Prevalence and characteristics among adults in Ontario, Canada
Hamilton, H. A., Brands, B., Ialomiteanu, A., & Mann, R. E. (2017) · Canadian Journal of Public Health · doi:10.17269/cjph.108.6130 · Cited by 37 · see citing works
Novel analgesic effects of melanin-concentrating hormone on persistent neuropathic and inflammatory pain in mice
Jang, J., Park, J.-Y., Oh, J., Bae, S.-J., Jang, H., Jeon, S., Kim, J., & Park, H. (2018) · Scientific Reports · doi:10.1038/s41598-018-19145-z · Cited by 37 · see citing works
Therapeutic potential of opioid/cannabinoid combinations in humans: Review of the evidence
Babalonis, S. L., & WALSH, S. L. (2020) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2020.03.002 · Cited by 39 · see citing works
Nonopioid Medications for Pain
Tauben, D. J. (2015) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2015.01.005 · Cited by 37 · see citing works

Pharmacodynamic effects following co-administration of cannabinoids and opioids: a scoping review of human experimental studies
Guy, D., Wootten, J. C., Wong, M., Turski, D., Lukewich, M. K., Alboog, A. S., Kandasamy, A. R., Gregory, J., & Poolacherla, R. (2024) · Pain Medicine · doi:10.1093/pm/pnae024 · Cited by 2 · see citing works
Synergistic interactions between cannabinoid and opioid analgesics
Cichewicz, D. L. (2004) · Life Sciences · doi:10.1016/j.lfs.2003.09.038 · Cited by 305 · see citing works
Cannabinoids as a Substitute for Opioids: Basic Science and Clinical Evidence
MacCallum, C. A., de Freitas, L., Eadie, L., & Narouze, S. (2021) · Springer eBooks · doi:10.1007/978-3-030-69186-8_27
Impact of co-administration of oxycodone and smoked cannabis on analgesia and abuse liability
Cooper, Z. D., Bedi, G., Ramesh, D., Balter, R. E., Comer, S. D., & Haney, M. (2018) · Neuropsychopharmacology · doi:10.1038/s41386-018-0011-2 · Cited by 145 · see citing works
Within-subject, double-blind, randomized, placebo-controlled evaluation of combining the cannabinoid dronabinol and the opioid hydromorphone in adults with chronic pain
Campbell, C. M., Mun, C. J., Hamilton, K. R., Bergeria, C. L., Huhn, A. S., Speed, T. J., Vandrey, R. G., & Dunn, K. E. (2023) · Neuropsychopharmacology · doi:10.1038/s41386-023-01597-1 · Cited by 14 · see citing works

Authors: Abrams, D. I., Couey, P., Shade, S. B., Kelly, M. E., & Benowitz, N. L.
Affiliations: San Francisco General Hospital (US)
University of California, San Francisco (US)
Corresponding author: Abrams, D I
ORCID: Abrams, D I
Shade, S B
Kelly, M E
Benowitz, N L
Venue: Clinical Pharmacology & Therapeutics
Publisher: Wiley
Published: 2011-11-02
Volume: 90
Issue: 6
Pages: 844-851
ISSN: 0009-9236 (ISSN-L)
1532-6535
DOI: 10.1038/clpt.2011.188
OpenAlex: W2043579293
Cited by: 319
References: 40
Citations by year: 2026: 10 · 2025: 9 · 2024: 19 · 2023: 20 · 2022: 16 · 2021: 31 · 2020: 35 · 2019: 37 · 2018: 30 · 2017: 25 · 2016: 23 · 2015: 22 · 2014: 16 · 2013: 6 · 2012: 16
FWCI: 9.61
Type: journal article
Language: en
Open access: closed
Locations: Clinical Pharmacology & Therapeutics (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r21da020831-02)
National Institute on Drug Abuse (N01DA-3-8829, N01 DA97767, R21 DA020831-01)
National Center for Research Resources (UL1RR024131)
Topics: Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
Keywords: opioid-cannabinoid interaction, chronic pain, vaporized cannabis, inhaled cannabis, morphine, oxycodone, opioid analgesia, pharmacokinetics, opioid dose reduction
MeSH terms: Administration, Inhalation, Adult, Analgesics, Opioid, Delayed-Action Preparations, Drug Administration Schedule, Drug Synergism, Female, Humans, Male, Middle Aged, Morphine, Oxycodone, Dronabinol, Treatment Outcome, Area Under Curve, Chronic Pain

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Cannabinoid–Opioid Interaction in Chronic Pain

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