Marijuana Usage and Opioids: What You Should Know

Opioid addiction is an epidemic that is sweeping the nation. While supervised use of the medication can provide relief to many patients suffering from chronic pain, it comes at a high cost. Researchers have been trying to find an effective way to combat this dangerous addiction problem, but relapse rates remain high, at roughly 72-88% with 12-36 months after treatment. The wave of marijuana legalization in the U.S. is prompting some people to look into using marijuana as a possible alternative treatment for opioid use disorder. Before you do so, let’s take a look at what you need to know first.

 

Marijuana and the Acute Withdrawal Period

The first hurdle for patients looking to stop using opioids is to get through the withdrawal period. Withdrawal symptoms from opioids can be severe, including:

 

 Fever and chills
 Nausea and vomiting
 Tremors
 Stomach pain
 Diarrhea
 Anxiety, agitation, and depression
 Racing heart rate

 

While some patients experience mild symptoms, many experience very severe symptoms that last about a week. The knowledge that the drug can make it all go away plus an intense craving for the drug makes relapse highly likely during this period for an unsupported patient.

In some cases, withdrawal symptoms can even be dangerous if the person’s drug use was extensive or their health is poor. This is why doctors often use replacement drugs like buprenorphine. These medications help ease the symptoms of withdrawal in a safe way. They can also be used to bring down a patient’s dependence more slowly.

 

Can Marijuana Be Used the Same Way with Fewer Side Effects?

Some preliminary studies show that cannabinoids appear to affect opioid dependence and withdrawal. Medical marijuana use may be able to mitigate the symptoms experienced during the acute withdrawal period. Other studies do not show such positive data and instead call for more research into the topic before using it as a widespread solution. Researchers express concern with the similar way that cannabis affects the reward centers of the brain.

 

Patients are encouraged to discuss their particular case with their doctor. However, until further research is done, medical marijuana cannot be hailed as a safe and effective opioid use disorder treatment. Alternatively, many of the medications used in medication-assisted treatment, or MAT programs, have extensive research behind them showing that, while there may be some risk, the benefits far outweigh them.

 

Doctor Writing Prescription

 

Medical Marijuana Use in Place of Opioids

Many opioid addictions begin as the result of using opioids to manage chronic pain. Some marijuana advocates are promoting the use of medical marijuana as a method of pain management to reduce the risk of developing an addiction in the first place. However, this study found grave problems with these claims. It found that those who use cannabis are actually 3.5 times more likely to use opioids and subsequently develop opioid use disorder. The odds are even higher for individuals suffering from chronic pain or who had used opioids in the year prior to the study. Rather than give patients a safe alternative to opioid use for controlling pain, using medical marijuana appears to exacerbate the problem.

 

Combining Marijuana with MAT

It is common for people who use opioids to use marijuana as well. As we mentioned earlier, people who use marijuana are more likely to advance to abusing opioids. Many of them continue to use marijuana even while seeking treatment for opioid addiction. Some may find the high provided by marijuana relieves their cravings for opioids. Others may still be looking for a way to manage chronic pain and turn to marijuana as a “safer” alternative. 

 marijuana

Regardless, more research is needed into the interactions of marijuana with opioid treatment drugs. There is a potential for some serious side effects, particularly for certain people.

For example, Suboxone, one of the drugs that treatment providers can prescribe for opioid treatment, is a depressant. Research shows that combining Suboxone with Xanax, another depressant, can have serious side effects — potentially resulting in death. 

 

Marijuana is also a depressant. There is far less research into its interaction with Suboxone, but the potential for major side effects is there. Patients should be open with their doctors about marijuana use so they’re doctors can watch for side effects and provide appropriate guidance. Additionally, this Canadian study found that patients who use marijuana pose a higher risk of dropping out of opioid treatment. 

 

Marijuana Usage and Opioids: Green Light?

At this point, there isn’t enough information about marijuana use and opioids to give it a green light for those in recovery. In fact, there is some evidence that raises serious concerns about using marijuana. This includes increasing the risk of developing opioid use disorder, increasing the risk of dropping out of a treatment program, and having some serious interactions with treatment drugs.

 

 

Opioid treatment patients who desire to use marijuana need to be open with their doctors and educated on the risks. This is the best way for patients and their providers to make the best decisions for each individual’s health.

About the Author

Paula Nicola, M.D.
Dr. Nicola is the Facility Director at Renu. She is a trained and board certified medical doctor with specialized training in addiction medicine.

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