The Association of Medical Cannabis Use with Pain Levels and Opioid Use in Illinois’ Opioid Alternative Pilot Program

Abstract

Objective

The state of Illinois’ Opioid Alternative Pilot Program (OAPP) is the first and only official harm-reduction program in the US to address the opioid crisis via facilitation of safe and legal access to medical cannabis. This study evaluates the association of medical cannabis use with pain level and frequency of opioid use in the first cohort of OAPP participants in 2019.

Methods

A survey was sent OAPP enrollees between February and July 2019. Cannabis users (n = 626) were compared to non-users (n = 234) to determine whether there was an association between cannabis use and self-reported (a) pain level and (b) frequency of opioid use. Backward stepwise regression models were used.

Results

A total of 860 participants was included in the analysis. Overall, 75% of the study sample reported pain as their primary medical symptom, and 67% of cannabis users reported having a disability. The mean difference in pain level between cannabis users and non-users was 4.5 units (on a 100-point scale) higher among cannabis users than non-users (p = 0.03); and cannabis use was statistically associated with pain level. High-frequency opioid users had lower odds of reporting cannabis use within the past year than low/no opioid users.

Conclusions

Although there was a statistical association between cannabis use and pain, the difference of 4.5 points in pain level between users and non-users was too small to reflect a clinically meaningful relative difference. This study may provide useful information to providers and clinicians about how the OAPP and similar programs may reduce opioid use and improve health outcomes.

Keywords:

• medical
• cannabis
• opioid
• pain
• harm reduction
• cohort
• epidemiology

Authors’ contribution

CD designed the study and is the primary author of this paper. LD is the statistician that conducted the advanced imputation methods. All other authors (NJ, AAK, JB, and DTE) revised it critically for important intellectual content and approved the final version to be published. All authors are accountable for the work and integrity of the work.

Disclosure statement

There are no competing interests to declare.

Ethics statement

Ethics approval was not applicable nor needed.

Data availability statement

Data extraction supplementary tables can be accessed by request to the corresponding author.

Additional information

Funding

AAK was supported by the National Institutes of Mental Health (K01 MH121854)