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Cited by 144Opioid Use Disorder TreatmentCannabis and Cannabinoid ResearchPain Management and Opioid Use

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Associations between medical cannabis and prescription opioid use in chronic pain patients: A preliminary cohort study

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Vigil, Jacob M., Stith, Sarah S., Adams, Ian M., Reeve, Anthony P.·2017·PLOS ONE
DOI 10.1371/journal.pone.0187795PMC PMC5690609
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Abstract

BACKGROUND: Current levels and dangers of opioid use in the U.S. warrant the investigation of harm-reducing treatment alternatives. PURPOSE: A preliminary, historical, cohort study was used to examine the association between enrollment in the New Mexico Medical Cannabis Program (MCP) and opioid prescription use. METHODS: Thirty-seven habitual opioid using, chronic pain patients (mean age = 54 years; 54% male; 86% chronic back pain) enrolled in the MCP between 4/1/2010 and 10/3/2015 were compared to 29 non-enrolled patients (mean age = 60 years; 69% male; 100% chronic back pain). We used Prescription Monitoring Program opioid records over a 21 month period (first three months prior to enrollment for the MCP patients) to measure cessation (defined as the absence of opioid prescriptions activity during the last three months of observation) and reduction (calculated in average daily intravenous [IV] morphine dosages). MCP patient-reported benefits and side effects of using cannabis one year after enrollment were also collected. RESULTS: By the end of the 21 month observation period, MCP enrollment was associated with 17.27 higher age- and gender-adjusted odds of ceasing opioid prescriptions (CI 1.89 to 157.36, p = 0.012), 5.12 higher odds of reducing daily prescription opioid dosages (CI 1.56 to 16.88, p = 0.007), and a 47 percentage point reduction in daily opioid dosages relative to a mean change of positive 10.4 percentage points in the comparison group (CI -90.68 to -3.59, p = 0.034). The monthly trend in opioid prescriptions over time was negative among MCP patients (-0.64mg IV morphine, CI -1.10 to -0.18, p = 0.008), but not statistically different from zero in the comparison group (0.18mg IV morphine, CI -0.02 to 0.39, p = 0.081). Survey responses indicated improvements in pain reduction, quality of life, social life, activity levels, and concentration, and few side effects from using cannabis one year after enrollment in the MCP (ps<0.001). CONCLUSIONS: The clinically and statistically significant evidence of an association between MCP enrollment and opioid prescription cessation and reductions and improved quality of life warrants further investigations on cannabis as a potential alternative to prescription opioids for treating chronic pain.

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Authors
Vigil, J. M., Stith, S. S., Adams, I. M., & Reeve, A. P.
Affiliations
University of New Mexico (US)
Corresponding author
Vigil, Jacob M.
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2017-11-16
Volume
12
Issue
11
Pages
e0187795
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0187795
PMC
PMC5690609
OpenAlex
W2767379958
Cited by
143
References
35
Citations by year
2026: 6 · 2025: 12 · 2024: 9 · 2023: 10 · 2022: 26 · 2021: 21 · 2020: 26 · 2019: 25 · 2018: 8
FWCI
15.13
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
medical cannabis, prescription opioid use, chronic pain, chronic back pain, opioid cessation, opioid dose reduction, harm reduction, prescription drug monitoring programs, intravenous morphine, cannabis side effects, quality of life, opioid epidemic, New Mexico, Colorado, Washington State, Oregon, Washington, D.C., California
MeSH terms
Analgesics, Opioid, Female, Humans, Male, Middle Aged, Quality of Life, Cohort Studies, Chronic Pain, Medical Marijuana

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