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Illustration by Wenzdai Figueroa

This story is part of our Ethical Cannabis series, which explores quandaries in the cannabis space and empowers readers to become conscious consumers. Got an issue to unpack? Email kmorrell@healthline.com.


In addition to killing more than 500,000 people in the United States in just 1 year, COVID-19 has had devastating effects on health and well-being in other ways.

Between June 2019 and May 2020, there were more than 81,000 overdose deaths — the highest number ever recorded, according to the Centers for Disease Control and Prevention (CDC).

Many of those deaths are being attributed to synthetic opioids, especially fentanyl.

Across the 10 states reporting relevant data, synthetic opioid-involved deaths have increased by 98 percent compared with the previous 12 months.

“The disruption to daily life due to the COVID-19 pandemic has hit those with substance use disorder hard,” said former CDC Director Dr. Robert Redfield in a press release. “We need to take care of people suffering from unintended consequences.”

Access to cannabis — once (falsely) thought of as a “gateway drug” — could be one way to do this, according to several recent studies. Here’s how.

The Tilray Observational Patient Study, published in December 2020, surveyed 1,145 registered medical cannabis consumers in 21 clinics across Canada to see how cannabis affected their quality of life and prescription opioid use over a 6-month period.

At the start of the study, 28 percent of participants reported having one or more active opioid prescriptions. After 6 months, that percentage dropped to 11.

Of those still managing pain with prescription opioids, doses dropped from 152 milligrams (mg) of morphine milligram equivalent (MME) to 32.2 mg MME — a 78 percent reduction in average opioid doses among the group.

The authors concluded that cannabis may have the potential to not only reduce the harms associated with opioid use, but also improve the quality of life of those who use opioids.

A study published in January 2021 reached a similar conclusion after following visitors at cannabis clinics in Ontario over 3 years.

Some people worry that increased access to legal cannabis will lead to an increase in the use of other drugs, including opioids.

But an October 2020 study suggests otherwise for people who inject drugs, a common consumption method for people who use opioids.

The results of the study show a correlation between daily cannabis use and decreased injections in the context of opioids. The authors concluded that regularly using cannabis — even multiple times throughout the day — didn’t seem to increase someone’s chances of going back to injecting opioids.

On top of the pandemic, many teens without stable housing are also juggling mental health concerns and an often contaminated drug supply.

To better understand how cannabis legalization and use affects this particularly vulnerable group, the University of British Columbia and the British Columbia Centre on Substance Use conducted a series of interviews between 2017 and 2019.

The majority of participants used cannabis daily and other drugs (namely alcohol, fentanyl, heroin, and meth) on and off. Interestingly, many participants identified their cannabis use as being medical, not recreational.

They talked about cannabis as a mental health support and a “healthier,” more accessible alternative to psychopharmaceuticals and opioid agonist therapies like suboxone and methadone.

Other participants reported using cannabis to manage opioid withdrawal symptoms, allowing them to lower their dosage.

Several participants also mentioned that not being able to use cannabis in residential treatment was a major barrier to them seeking help for substance use disorder.

Still, a small number of participants reported experiencing harm with regular cannabis use, including dependence and addiction. When seeking help, these participants felt judged by those who didn’t consider cannabis a “real drug.”

While all this research is promising, results aren’t conclusive.

It’s too early to say that cannabis will help someone who is hoping to reduce or stop their use of opioids, but it certainly doesn’t seem to hurt.

And with no sign of the opioid crisis letting up anytime soon, anything that can potentially reduce the ever-growing number of overdose deaths is worth exploring.


Kate Robertson is a Toronto-based editor and writer who has focused on drugs, primarily cannabis, since 2017. She has been published in The Guardian, Maclean’s magazine, the Globe and Mail, Leafly, and more. Find her at @katierowboat.