Patients with chronic pain and mental-health conditions prefer taking cannabis to prescribed opioid medication, a study published in the International Journal of Drug Policy has found.

Researchers from the University of British Columbia and the University of Victoria tracked more than 250 patients who were being treated for conditions such as chronic pain, mental health and gastrointestinal issues. They were prescribed medical cannabis in addition to more traditional drugs, and 63 per cent reported using cannabis instead of opioids, sedatives and anti-depressants.

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The most common reason for the switch was fewer adverse side-effects, says Philippe Lucas, graduate researcher at the Centre for Addictions Research of British Columbia, a lead on the study and vice-president of patient advocacy at Tilray, the medical cannabis production and research company that funded the study. The next most common reasons were patients feeling that cannabis is safer and experiencing better symptom management.

“When we’re talking about highly dependence-forming substances like opioids and benzodiazepines, which are the two main classes of drugs that patients cite substitution for, undoubtedly for the majority of patients under the majority of circumstances, cannabis would be considered less dependence-forming,” says Lucas. “There’s no risk for addiction or overdose, and therefore there’s no mortality issue when it comes to cannabis. Both those things would continue to be a concern for Canadians’ public health when it comes to opioids or benzodiazepines.”

The study also found patients prefer to consume cannabis through vaporizers or as edibles instead of smoking it.

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Insurance plans should increase their coverage of medical marijuana, argues Lucas. “There are significant health cost savings associated with the use of medical cannabis as an alternative to some of these commonly used and, unfortunately, all to often abused prescription drugs,” he says. “So certainly from a socio-economic point of view, as well as from a public health point of view, I think it makes sense to be considering medical cannabis as a front-line rather than a third- or fourth-line treatment when we’re talking about conditions like chronic pain or mental-health conditions.”

Lucas also points to North America’s current opioid overdose and dependence epidemic, and suggests that reducing opioid prescriptions could help. He notes research out of the United States suggests states where medical marijuana is legal “have seen a 25 per cent decrease in opioid overdose deaths compared to those neighbouring states that have not approved the medical use of cannabis.”

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