Here's an analysis of the role of cannabis in opioid use disorder (OUD) treatment, based on the provided sources and my knowledge:
Cannabis and Opioid Use Disorder: A Complex Relationship
Potential Benefits: Managing Withdrawal Symptoms
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The relationship between cannabis and OUD is complex and not fully understood. Research suggests that cannabis may have both potential benefits and risks in the context of OUD treatment.
Potential Risks: Polysubstance Use and Relapse
One potential benefit of cannabis is its ability to help manage opioid withdrawal symptoms. Several studies have found that individuals with OUD report using cannabis to alleviate symptoms like anxiety, insomnia, and body aches during withdrawal.[1] This aligns with findings from a study where people in recovery reported using cannabis to manage withdrawal symptoms, often alongside other "comfort meds" like anti-anxiety medications.[2]
However, there are also potential risks associated with cannabis use in the context of OUD. Some studies suggest that cannabis use may increase the risk of non-medical opioid use and OUD, particularly among adolescents and young adults.[3] Furthermore, some individuals may use cannabis in conjunction with opioids to enhance the "high," which could lead to polysubstance use and potentially hinder recovery.[2]
Conflicting Evidence and Research Gaps
Treatment Implications
The existing research presents conflicting evidence regarding the impact of cannabis on OUD treatment outcomes. Some studies have found that cannabis use is associated with reduced opioid use and improved treatment retention, while others have found no significant association or even a negative impact.[4] The National Academies of Sciences, Engineering, and Medicine (NASEM) 2017 report found some evidence that cannabinoids may be an effective treatment for some types of chronic pain in adults, but no evidence to support or refute the use of cannabinoids for treating addiction.[5]
More research is needed to clarify the role of cannabis in OUD treatment. This includes:
Research Needs
Given the mixed evidence, treatment professionals face a challenge in advising patients with OUD who are considering or using cannabis. Some treatment programs may have policies that restrict cannabis use, while others may be more permissive. The decision of whether to permit or discourage cannabis use during OUD treatment should be made on a case-by-case basis, considering the individual's circumstances, the potential benefits and risks, and the available evidence.[6]
- Controlled studies: Randomized controlled trials are needed to determine whether cannabis is a risk factor for opioid use and OUD, or if it may provide benefit in more controlled studies.[7]
- Specific cannabinoids: Research should examine the effects of different cannabinoids (e.g., THC, CBD) and their dosages, as well as different routes of administration (e.g., inhalation vs. ingestion).[7]
- Diverse populations: Studies should include participants from diverse OUD treatment and community settings.[7]
**In summary, the current research does not provide a definitive answer on whether cannabis aids or hinders opioid dependency recovery. However, the use of cannabis to manage withdrawal symptoms is a common motivation, and the relationship between cannabis use and opioid use disorder is complex and requires further investigation. The most relevant answer part is: The current research does not provide a definitive answer on whether cannabis aids or hinders opioid dependency recovery.
Authoritative Sources
- Meacham MC, Nobles AL, Tompkins DA, Thrul J (2022) “I got a bunch of weed to help me through the withdrawals”: Naturalistic cannabis use reported in online opioid and opioid recovery community discussion forums. [PLoS ONE]↩
- Kudrich, C., Chen, R., Meng, Y. et al. Use and perceptions of Cannabidiol among individuals in treatment for opioid use disorder. [Harm Reduction Journal]↩
- Olfson, M., Wall, M. M., Liu, S. M., & Blanco, C. (2017). Cannabis use and risk of prescription opioid use disorder in the United States. [American Journal of Psychiatry]↩
- Costa, G., De Aquino, J. P., & al. (2024). The Impact of Cannabis on Non-Medical Opioid Use Among Individuals Receiving Pharmacotherapies for Opioid Use Disorder: A Systematic Review and Meta-Analysis of Longitudinal Studies. [The American Journal of Drug and Alcohol Abuse]↩
- Abrams DI. The therapeutic effects of Cannabis and cannabinoids: An update from the National Academies of Sciences, Engineering and Medicine report. [European Journal of Internal Medicine]↩
- Huhn AS, Berry MS, & Dunn KE (2019). Review: Sex-based differences in treatment outcomes for persons with opioid use disorder. [The American Journal of Addictions]↩
- Kudrich, C., Chen, R., Meng, Y. et al. Use and perceptions of Cannabidiol among individuals in treatment for opioid use disorder. [Harm Reduction Journal]↩
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