According to the study, cannabis could actually help some people cut down on their opioid use, and in some cases, even quit altogether. Who knew that the green plant known for its chill vibes might also be the secret weapon against one of the most serious public health crises of our time?
“We interviewed 30 people who were using opioids and cannabis and injecting drugs,” said Sid Ganesh, a PhD student at USC’s medical school and the mastermind behind the study. The participants, all receiving services from a methadone clinic and a syringe exchange in Los Angeles, sang the praises of cannabis as a tool for managing their opioid use. One of the main reasons? It’s become much easier to get your hands on it in recent years—no more shady alleyway deals necessary.
Opioid use disorder patients often face more hurdles than an Olympic track star just to access life-saving treatments like suboxone, methadone, or the overdose-reversal drug naloxone. So, when something as accessible as cannabis shows potential to help, it’s worth paying attention. Ganesh’s study, published in Drug and Alcohol Dependence Reports, was backed by federal funding from the National Institute on Drug Abuse—a group that usually focuses on the dark side of cannabis rather than its potential perks. But this study is unique because it dives deep into the real-life experiences of people who use drugs, rather than just crunching numbers.
Ganesh points out that qualitative research—focusing on what actually works for people and why—is crucial, especially when dealing with vulnerable populations. In her study, 57% of participants were either homeless or living in unstable conditions, and 70% were earning less than $2,100 a month. “You need to understand what’s going on in people’s lives,” she explained. After all, life isn’t just a series of data points—it’s messy, complicated, and sometimes a little bit hazy.
With opioid overdose deaths climbing every year—more than 80,000 people died in 2022 alone—any information that can help untangle the complicated relationship between opioid addiction, overdose, and cannabis use is urgently needed. Some studies suggest that cannabis legalization has helped people reduce their opioid use, but the evidence is mixed. Depending on which study you read, states with legal cannabis either have fewer opioid overdoses, more of them, or no change at all. It’s enough to make your head spin—and not in a good way.
Ryan Marino, an addiction medicine specialist and professor at Case Western Reserve University, points out that it’s tough to pin down the exact influence cannabis legalization has on these numbers. “Our drug supply is so toxic, overdoses have continued to increase regardless, because of the prevalence of fentanyl and constant changes in that,” he said. Fentanyl, the sneaky villain in this story, has made the overdose crisis even more deadly, complicating the picture further.
Ganesh and her colleagues found that cannabis might help people get through some of the toughest stages of quitting or cutting down on opioids. Participants described using it to manage withdrawal symptoms, cravings, and anxiety during the period following withdrawal. “When you’re smoking weed, it gets you over the hump and that urge to get high for the first time,” one participant said. “That’s what’s so special about weed.” Special indeed—who knew it could also be a support system?
People who’ve recently quit or cut down on opioids are especially at risk for overdose because their tolerance is lower. Marino has seen some of his patients successfully use cannabis to ease off opioids, while others haven’t had the same luck. The jury’s still out on whether cannabis could help the majority of people struggling with opioid use disorder, but as Marino puts it, “If it helps one person to not use or not have an overdose, I mean, that’s worth more than any amount of evidence. Honestly, a life saved is a life saved.”
To truly understand how effective cannabis could be as a treatment for opioid use disorder, researchers would need to conduct large-scale clinical trials. Unfortunately, federal restrictions have made this type of research about as common as a unicorn sighting, although that could change soon. A small-scale trial from 2015 did find that dronabinol, a synthetic form of THC, helped soothe withdrawal symptoms and kept patients on track with their detox treatment.
The participants in Ganesh’s study weren’t necessarily using cannabis because it’s the best tool for kicking opioids—it’s more like it was the tool they had handy. One participant described using cannabis to cut down on fentanyl while waiting on a prescription for suboxone, a medication that helps people quit opioids. Ganesh’s biggest takeaway from the study? People who use opioids need better access to all kinds of harm reduction tools, from methadone and suboxone to clean syringes, naloxone, and yes, possibly cannabis.
Marino has already noticed changing attitudes toward cannabis affecting his patients. In the past, patients who tested positive for cannabis could be kicked out of opioid treatment programs and even cut off from their suboxone—a move that could lead to relapse, arrest, or even death by overdose. Now, there’s a glimmer of hope that cannabis might be seen not as a barrier to treatment, but as a potential tool in the fight against opioid addiction.
The future of treatment could be greener than we ever imagined.
