When it comes to managing chronic pain, we’re always looking for new and better ways to help patients control their discomfort. If you’re a regular follower of our blog, you probably know that we’ve written a number of blogs on opioids and medical marijuana, but a recent study decided to take a look at what happened when these two treatment plans were used simultaneously. You might be surprised at the findings.

According to research presented at the 2019 American Pain Society Scientific Meeting, individuals with chronic pain who used both prescription opioids and recreational marijuana showed higher levels of mental health and substance abuse problems than those who use opioids alone. Now, the study makes a big distinction noting that patients were using marijuana recreationally and not medicinally, but it still shines a light on how problems can occur when people try to supplement their opioids with other substances.

Study Results

Those weren’t the only findings that were of concern according to researchers. The team said that anxiety and depression scores were also significantly higher for patients who used both opioids and recreational marijuana, as were measurements of opioid dependence severity and alcohol and cocaine involvement. Researchers also noted that there was no difference in pain severity or pain disability between the group of individuals just using opioids and those using opioids and recreational marijuana.

“The things psychologists would be most worried about were worse, but the thing patients were using the cannabis to hopefully help with — namely pain — was no different,” said Andrew Rogers, University of Houston, who worked on the study. “Co-use of substances generally leads to worse outcomes. As you pour on more substances to regulate anxiety and depression, symptoms can go up.”

Abhiram Bhashyam, MD, MPP, of Massachusetts General Hospital in Boston, who was not involved with the study, said the findings provide even more evidence that patients shouldn’t assume that recreational marijuana will help with the effects of their chronic pain if they are already on opioids.

“This study provides further evidence that cannabis may not be an effective substitute or alternative to opioids for pain management,” said Dr. Bhashyam. “Studies like these are important for clinicians as patients increasingly ask about opioid-cannabis co-use for managing their pain. We lack robust evidence to provide appropriate guidance due to a paucity of research on this topic at present.”

Both opioids and medical marijuana can be helpful if you’re dealing with chronic pain, but it’s important to realize that there’s a significant difference between regulated medical marijuana and recreational marijuana, so don’t assume that what you pick up on the street will be beneficial in combination with opioids for your pain. As this study suggests, it doesn’t appear to help and it can certainly make some problems worse. If you’re considering medical marijuana or another treatment plan for your pain, consult with a physical medicine specialist first to ensure you’re making the right choice for your individualized condition.