Page 18 - Delaware Medical Journal - January/February 2021

Medical Cannabis Certification Is Associated with Decreased Opioid Use in Patients with Chronic Pain: A Retrospective Cohort Study in Delaware
Alan G. Balu; Alex L. Woods, MD, MPH; Jahan Marcu, PhD; Ganesh R. Balu, MD
Opioid medications are commonly used to treat chronic pain around the world. While these medications are quite effective at reducing pain, they can create opioid dependence and lead to further drug addiction. Long- term opioid use has significantly contributed to the “opioid epidemic” that is currently ravaging the United States, leading to opioid overdoses and unintentional deaths, particularly in Delaware. Many previous studies have shown a strong association between medical cannabis legalization and decreases in opioid overdoses, indicating that cannabis use may help individuals reduce or avoid opioids. In this study, our aim was to examine individuals who were provided with legal medical cannabis certifications in the state of Delaware between June 2018 and October 2019 who were concurrently being treated with opioids for chronic pain. Using a posthoc analysis, we conducted a retrospective cohort
study (n = 81) to determine if individuals were able
to decrease their opioid use, measured in morphine milligram equivalent (MME), following medical cannabis certification. Among the included individuals, medical cannabis certification was associated with a 31.3% average decrease in opioid use (n = 63). When examining subgroups based upon pain location, individuals with neck pain displayed a 41.5% average decrease in MME (n = 27), while individuals with low back pain were observed to have a 29.4% decrease in opioid use (n
= 58). This study suggests that medical cannabis use may help individuals to reduce their opioid use along with physician intervention, helping to prevent potential opioid dependence. Future clinical investigations with appropriate controls and verification of cannabis use will help inform dosages and types of cannabis products that could be most effective for reducing reliance on opioids.
18 Del Med J | January/February 2021 | Vol. 93 | No. 1
Abstract