title: Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep.
abstract: A prior epidemiological study identified a reduction in opioid overdose deaths in US states that legalized medical cannabis (MC). One theory to explain this phenomenon is a potential substitution effect of MC for opioids. This study evaluated whether this substitution effect of MC for opioids also applies to other psychoactive medications. New England dispensary members ( n = 1,513) completed an online survey about their medical history and MC experiences. Among respondents that regularly used opioids, over three-quarters (76.7%) indicated that they reduced their use since they started MC. This was significantly ( p < 0.0001) greater than the patients that reduced their use of antidepressants (37.6%) or alcohol (42.0%). Approximately two-thirds of patients decreased their use of anti-anxiety (71.8%), migraine (66.7%), and sleep (65.2%) medications following MC which significantly ( p < 0.0001) exceeded the reduction in antidepressants or alcohol use. The patient's spouse, family, and other friends were more likely to know about their MC use than was their primary care provider. In conclusion, a majority of patients reported using less opioids as well as fewer medications to treat anxiety, migraines, and sleep after initiating MC. A smaller portion used less antidepressants or alcohol. Additional research is needed to corroborate these self-reported, retrospective, cross-sectional findings using other data sources.
authors.affiliation: 1 Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton, PA, USA.|2 Department of Basic Pharmaceutical Sciences, Husson University School of Pharmacy, Bangor, ME, USA.|3 Neuroscience Program, Bowdoin College, Brunswick, ME, USA.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Piper
authors.affiliation: 4 Wellness Connection of Maine, Gardiner, ME, USA.|12 Calyx Concepts LLC, Sidney, ME, USA.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: DeKeuster
authors.affiliation: 5 Department of Psychologcal Sciences, Northern Arizona University, Flagstaff, AZ, USA.
authors.forename: Monica L
authors.initials: ML
authors.lastname: Beals
authors.affiliation: 4 Wellness Connection of Maine, Gardiner, ME, USA.|6 Center for Wellness Leadership, Portland, ME, USA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Cobb
authors.affiliation: 7 Department of Anesthesiology and Perioperative Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.|8 Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.
authors.forename: Corey A
authors.initials: CA
authors.lastname: Burchman
authors.affiliation: 9 Champlain Valley Dispensary, Burlington, VT, USA.
authors.forename: Leah
authors.initials: L
authors.lastname: Perkinson
authors.affiliation: 9 Champlain Valley Dispensary, Burlington, VT, USA.
authors.forename: Shayne T
authors.initials: ST
authors.lastname: Lynn
authors.affiliation: 10 Department of Pharmacy Practice, Husson University School of Pharmacy, Bangor, ME, USA.
authors.forename: Stephanie D
authors.initials: SD
authors.lastname: Nichols
authors.affiliation: 11 Maine Medical Center, Portland, ME, USA.
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Abess
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000188:drug therapy*; D001008:Anxiety Disorders / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D064086:Medical Marijuana / Q000627:therapeutic use*; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D012189:Retrospective Studies; D012890:Sleep / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000928:Antidepressive Agents; D064086:Medical Marijuana
keywords: Marijuana; opioids; stigma