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. 2025 Mar;44(3):799-810.
doi: 10.1111/dar.14014. Epub 2025 Feb 26.

Cannabis use and illicit opioid cessation among people who use drugs living with chronic pain

Chenai Kitchen  1   2 , Eugenia Socias  1   2 , Eric C Sayre  1 , Kanna Hayashi  1   3 , Kora DeBeck  1   4 , M-J Milloy  1   2 , Thomas Kerr  1   2 , Hudson Reddon  1   2
Affiliations

Cannabis use and illicit opioid cessation among people who use drugs living with chronic pain

Chenai Kitchen et al. Drug Alcohol Rev. 2025 Mar.

Abstract

Introduction: Amidst the opioid overdose crisis, there is interest in cannabis use for pain management and harm reduction. We investigated the relationship between cannabis use and cessation of unregulated opioid use among people who use drugs (PWUD) living with chronic pain.

Method: Data for analyses were collected from three prospective cohort studies in Vancouver, Canada. All cohort participants who completed at least two study visits and reported both pain and unregulated opioid use in the past 6 months were included in the present study. We analysed the association between cannabis use frequency and opioid cessation rates using extended Cox regression models with time-updated covariates.

Results: Between June 2014 and May 2022, 2340 PWUD were initially recruited and of those 1242 PWUD reported chronic pain, use of unregulated opioids and completed at least two follow-up visits. Of these 1242 participants, 764 experienced a cessation event over 1038.2 person-years resulting in a cessation rate of 28.5 per 100 person-years (95% confidence interval [CI] 25.4-31.9). Daily cannabis use was positively associated with opioid cessation (adjusted hazard ratio 1.40, 95% CI 1.08-1.81; p = 0.011). In the sex-stratified sub-analyses, daily cannabis use was significantly associated with increased rates of opioid cessation among males (adjusted hazard ratio 1.50, 95% CI 1.09-2.08; p = 0.014).

Discussion and conclusions: Participants reporting daily cannabis use exhibited higher rates of cessation compared to less frequent users or non-users. Observed sex-specific differences in cannabis use and opioid cessation suggest potential differences in cannabis use behaviours and effects. Our findings add to the growing evidence supporting the potential benefits of cannabis use among PWUD, underlining the need for further research.

Keywords: cannabis; chronic pain; people who use drugs.

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Conflict of interest statement

Declarations of competing interest

M-JM is the Canopy Growth professor of cannabis science at the University of British Columbia (UBC), a position created using unstructured arms’ length gifts to the university from Canopy Growth, a licensed producer of cannabis, and the Government of British Columbia’s Ministry of Mental Health and Addictions. He has no personal financial relationships with the cannabis industry. KH holds the St. Paul’s Hospital Chair in Substance Use Research and is supported in part by the NIH (U01DA038886), a Michael Smith Health Research BC (MSHRBC) Scholar Award, and the St. Paul’s Foundation. KD is supported in part by the NIH (U01DA038886). HR is supported by a MSHRBC Scholar Award. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Conflicts of interest

M-JM is the Canopy Growth professor of cannabis science at the University of British Columbia, a position created using unstructured arms’ length gifts to the university from Canopy Growth, a licensed producer of cannabis, and the Government of British Columbia’s Ministry of Mental Health and Addictions. He has no personal financial relationships with the cannabis industry. KH holds the St. Paul’s Hospital Chair in Substance Use Research and is supported in part by the NIH (U01DA038886), a Michael Smith Foundation for Health Research Scholar Award and the St. Paul’s Foundation. KD is supported in part by the NIH (U01DA038886). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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