Researchers say patients who use both medical marijuana and pain medications don’t have an increased risk for alcohol and substance abuse.

For nearly 5,000 years, since the Chinese began treating various ills by drinking tea brewed from marijuana, the flowering plant has been utilized as a medicine.

Today, medical cannabis is being used increasingly as an alternative to prescription medications for chronic pain or in combination with prescription pain medications.

When medical marijuana was introduced to help manage chronic pain, researchers expected that adding it to prescription medications would lead to heavier or more frequent use of alcohol or drugs.

However, a new study published today in the Journal of Studies on Alcohol and Drugs concludes that patients who use both marijuana and prescription opioids are not at increased risk for alcohol and drug abuse.

Brian Perron, Ph.D., associate professor of social work at the University of Michigan, is the lead author of the study, which examined data gathered from 273 patients (average age 40) in a medical marijuana clinic in Michigan.

More than 60 percent of the patients reported they also had used prescription pain medications within the past month. This simultaneous use has not been widely studied, Perron said, but the results surprised him and his fellow researchers.

“Although persons who received both medical cannabis and prescription opioids reported higher levels of pain, they showed very few differences in their use of alcohol and other street drugs compared with those receiving medical cannabis only,” he said.

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Perron and his colleagues viewed the combined use of opioids and marijuana as a “risk marker” for substance abuse or substance-related problems.

“These individuals have access to more psychoactive substances, which can increase the risk of substance-related problems,” he said. “In addition, they may be relying on heavier doses to manage their pain.”

Little data exists about who is receiving both medical cannabis and prescription pain medications, Perron said.

“Physicians do not actually prescribe medical cannabis. They only certify whether the patient has a qualifying condition, which allows the person to gain access to medical cannabis,” he said. “The system of dispensing medical cannabis is completely separate from prescription medications. So physicians may not know whether a patient is using medical cannabis, how much, and in what form.”

The psychoactive properties of medical cannabis — and the possibility that using the substance may lead to more serious forms of substance abuse — have raised concerns in the medical world, Perron said, “especially when people already have access to and are taking prescription pain medications. Our study shows that use of prescription pain meds among medical cannabis users might not be a reliable indicator for risk.”

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Study participants who were prescribed pain medications reported that cannabis was more effective for managing pain than the prescription medications.

“This is an important finding,” Perron said, “given the risks of opioid dependence and overdose. This study contributes to the growing body of research that medical cannabis may be an effective and potentially safer alternative to prescription pain medications.”

The majority of patients did indicate some form of misuse of their drugs.

The researchers concluded that — as more states legalize cannabis for medical and recreational purposes — it is essential for healthcare providers to become knowledgeable about medical cannabis laws and to speak candidly with patients.

“Managing pain ultimately requires open communication between the healthcare professional and the patient,” Perron said.

Asking chronic-pain patients whether they use marijuana for pain “can be a useful step to improve communication and to reduce the stigma around medical marijuana,” he said.

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