NYS Medical Cannabis Program reduces chronic pain patients' reliance on opioids

Adults with chronic pain who participated in New York State's (NYS) Medical Cannabis Program were significantly less likely to require prescription opioids, according to a new study published today in JAMA Internal Medicine and led by researchers at Albert Einstein College of Medicine and Montefiore Health System.

Chronic pain and opioid addiction are two of the most pressing health challenges in the United States. Our findings indicate that medical cannabis, when dispensed through a pharmacist-supervised system, can relieve chronic pain while also meaningfully reducing patients' reliance on prescription opioids. Supervised use of medical cannabis could be an important tool in combatting the opioid crisis."

 Deepika E. Slawek, M.D., M.S., study's lead author, associate professor of medicine at Einstein, and an internal medicine and addiction medicine specialist at Montefiore

The study involved 204 adults who were prescribed opioids for chronic pain and were newly certified for medical cannabis between September 2018 and July 2023. Participants were tracked for 18 months, with data on both their cannabis and opioid use collected from the New York State Prescription Monitoring Program.

At the beginning of the study, most participants reported high levels of pain and were taking an average daily opioid dose equivalent to 73.3 mg of morphine. Over the 18-month follow-up period, that average daily dose fell to 57 mg, a 22% reduction.

More specifically, those participants who received a 30-day supply of medical cannabis used the equivalent of 3.5 fewer mg of morphine per day than those who received no cannabis during the same month. "Those changes may seem small, but gradual reductions in opioid use are safer and more sustainable for people managing chronic pain than stopping suddenly," Dr. Slawek noted.

"This research adds to the growing body of evidence supporting a medicalized model of cannabis use, where pharmacists are actively involved in dispensaries and cannabis is treated like other prescription drugs," said Julia Arnsten, M.D., M.P.H., the study's senior author, chief of the division of general internal medicine at Montefiore Einstein, and professor of medicine, of epidemiology & population health, and of psychiatry and behavioral sciences. "We hope these findings will lead to new policies encouraging the effective management of chronic pain through use of regulated substances."

Other Montefiore Einstein authors were Chenshu Zhang, Ph.D.; Yuval Zolotov, Ph.D.; Joanna L. Starrels, M.D., M.S.; Yuting Deng, Ph.D.; Giovanna Calderon DiFrancesca, B.A.; Jonathan Ross, M.D., M.S.; and Chinazo O. Cunningham, M.D., M.S.