What does the ecological and epidemiological evidence indicate about the potential for cannabinoids to reduce opioid use and harms? A comprehensive review

Gabrielle Campbell; Wayne Hall; Suzanne Nielsen

doi:10.1080/09540261.2018.1509842

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What does the ecological and epidemiological evidence indicate about the potential for cannabinoids to reduce opioid use and harms? A comprehensive review

Journal article

Peer reviewed

What does the ecological and epidemiological evidence indicate about the potential for cannabinoids to reduce opioid use and harms? A comprehensive review

Gabrielle Campbell, Wayne Hall and Suzanne Nielsen

International Review of Psychiatry: Opioid Epidemic, Vol.30(5), pp.91-106

2018

DOI: https://doi.org/10.1080/09540261.2018.1509842

PMID: 30522342

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Abstract

Mortality

Opioid

overdose

opioid-sparing

cannabinoid

Review

Pre-clinical research supports that cannabinoids reduce opioid dose requirements, but few studies have tested this in humans. This review evaluates ecological and epidemiological studies that have been cited as evidence that medical cannabis use may reduce opioid use and opioid-related harms. Medline and Embase were searched for relevant articles. Data were extracted on study setting, analyses approach, covariates, and outcomes. Eleven ecological and 14 epidemiological studies were found. In ecological studies, states that allow medical cannabis laws have reported a slower rate of increase in opioid overdose deaths compared with states without such laws. These differences have increased over time and persisted after controlling for state sociodemographic characteristics and use of prescription monitoring programmes. Few studies have controlled for other potential confounders such as opioid dependence treatment and imprisonment rates. Some epidemiological studies provide evidence that cannabis availability may reduce opioid use, but are limited by selection bias, cross-sectional designs, and self-reported assessments of the opioid-sparing effects of cannabis. Some epidemiological and ecological studies suggest that cannabis may reduce opioid use and harms, although important methodological weaknesses were identified. Well-designed clinical studies may provide more conclusive evidence on whether cannabinoids can reduce opioid use and related harm.

Details

Title: What does the ecological and epidemiological evidence indicate about the potential for cannabinoids to reduce opioid use and harms? A comprehensive review
Authors: Gabrielle Campbell (Author) - UNSW Australia
Wayne Hall (Author) - The University of Queensland
Suzanne Nielsen (Author) - UNSW Australia
Publication details: International Review of Psychiatry: Opioid Epidemic, Vol.30(5), pp.91-106
Publisher: Taylor & Francis
Date published: 2018
DOI: 10.1080/09540261.2018.1509842
ISSN: 1369-1627
PMID: 30522342
Grants: The extent and impact of pharmaceutical opioids for chronic non-cancer pain, 1119992, National Health and Medical Research Council (Australia, Canberra) - NHMRC
Increasing the capacity of community pharmacy for screening, brief intervention and referral for treatment of pharmaceutical opioid use disorders, 1132433, National Health and Medical Research Council (Australia, Canberra) - NHMRC
Grant note: The Australian National Drug and Alcohol Research Centre, UNSW Sydney, is supported by funding from the Australian Government, under the Substance Misuse Prevention and Service Improvements Grant Fund.
Organisation Unit: School of Health and Sport Sciences - Legacy; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99472500802621
Output Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Web Of Science research areas: Psychiatry

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