Legalizing Medical Marijuana In Utah Helped Reduce Opioid Use By Pain Patients, Study Finds

A new study on prescription opioid use in Utah following the state’s legalization of medical marijuana suggests the availability of legal cannabis has both reduced opioid use by patients with chronic pain and also helped drive down prescription overdose deaths statewide.

“Since the legalization of medical cannabis in 2018, there has been a noticeable decrease in deaths related to prescription opioids in the state,” the report says. “This shift suggests that the introduction of cannabis as a therapeutic alternative may have contributed to a reduction in opioid use among patients seeking pain relief.”

Members of Utah’s Medical Cannabis Policy Advisory Board heard a presentation last week on the research, which was prepared by the analytics firm Management Science Associates (MSA). Overall, results of the study indicate that “cannabis has a substantial role to play in pain management and the reduction of opioid use,” it says.

“As the medical community continues to seek safer pain management options,” the report concludes, “cannabis may become a key component of treatment strategies, particularly for chronic pain patients.”

“These findings support the hypothesis that cannabis can significantly reduce opioid use among chronic pain patients,” it adds. “This is crucial as it provides a potential pathway to tackle opioid dependency, offering a less addictive alternative for chronic pain management with fewer side effects.”

The results reinforce findings from a similar study the company conducted in Minnesota, authors said, and additionally “align with previous literature indicating that medical cannabis can serve as an effective adjunctive therapy for chronic pain, leading to a significant reduction in opioid use.”

The new MSA study that was presented at the advisory board meeting evaluated 186 pain patients, looking at transactions at medical marijuana dispensaries and matching that data with medical records “using [an] MSA patented, HIPAA compliant de-identification system.”

Patients were split roughly evenly between female (54 percent) and male (45 percent) and were overwhelmingly white (87 percent). Ages ranged from 23 to 89, with a mean age of 49. Virtually all (98.9 percent) were from Utah, with a small number from Oregon and New Mexico.

More than half (57 percent) had chronic musculoskeletal pain, the study says, while 19 percent had chronic visceral pain, 13 percent had chronic headache and orofacial pain, 4 percent had chronic primary pain, 3 percent had chronic neuropathic pain, and 2 percent had chronic post-traumatic and postsurgical pain.

More than 8 in 10 patients (84.4 percent) decreased their use of opioids, as measured in morphine milligram equivalents (MME).

“Specifically, there was a 53.1% reduction,” the MSA report says. “The mean MME/month in the period before cannabis use was 3832 MMD/Month, and after starting cannabis we observed a mean of 1798 MME/Month.”

While many patients reported more than one type of pain, results showed that most who reduced their opioid prescriptions during cannabis use suffered from chronic musculoskeletal pain. The sharpest reduction in opioids, meanwhile, was among people with chronic neuropathic pain.

Separate research published earlier this year found that more than half (57 percent) of patients with chronic musculoskeletal pain said cannabis was more effective than other analgesic medications, while 40 percent reported reducing their use of other painkillers since they began using marijuana.

Only one category of conditions in the new Utah study—chronic headache and orofacial pain—was associated with increases in opioid use. Those conditions were linked to a 20.6 percent rise in opioid consumption, compared to a 10.9 percent to 73.5 percent reduction among all other conditions in the study.

People who smoked tobacco prior to starting marijuana use also saw an increase in opioid consumption after starting cannabis, the report says.

Despite the new evidence suggesting drops in opioid consumption and overdose deaths in Utah following the legalization of medical marijuana, the new study says more research is needed.

“Our results suggest that while there is evidence supporting the efficacy of cannabis in reducing opioid use, larger studies are needed to confirm these findings and refine cannabis treatment protocols,” authors wrote. They recommended future studies also focus on larger and more diverse populations as well as specific dosages of cannabinoids.

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The new study adds to a body of research showing that cannabis reforms and access to medical marijuana can help reduce opioid consumption and prescribing.

Last month, for example, a yearlong study of prescribed medical marijuana for patients with chronic pain and mental health issues found an association between cannabis use and symptom improvement, with most side effects limited to dry mouth and sleepiness.

“We found that the use of medical cannabis was associated with reduced pain during the first 6 months and improved mental well-being over 12 months,” wrote authors, from the University of Melbourne in Australia. “Patients reported not only less pain but also experienced reduced interference from pain in their daily functions. Furthermore, they reported decreased use of pain medications and a large proportion felt that their pain symptoms had significantly improved, as reflected in their reported changes in the severity of pain.”

Findings of that study showed that at least some of observed benefits appeared to fade as the 12-month study period went on, however, suggesting relief from cannabis may not be everlasting.

A separate review of research on marijuana and chronic nerve pain, meanwhile, recently concluded that treatment with cannabinoids offers “significant relief from chronic pain” with “minimal to no side effects”—potentially providing patients a “life-changing alternative” to conventional pharmaceuticals.

Authors of that work considered thousands of research papers, ultimately including in their analysis five placebo-controlled randomized control studies published between 2000 and 2024. They found that treatment with cannabinoids offered markedly more pain relief than did placebo.

A research letter published by the American Medical Association earlier this year found that 71 percent of chronic pain patients and 59 percent of physicians are in favor of nationally legalizing medical cannabis. The study involved interviews with 1,661 chronic pain patients and 1,000 doctors. It was partly funded by the National Institute on Drug Abuse (NIDA).

The National Cancer Institute (NCI) also recently published a wide-ranging series of scientific reports on marijuana and cancer as part of an effort to better understand “core questions” around patients’ relationship with cannabis—including sourcing, cost, behavioral patterns, patient–provider communications and reasons for use.

One of the studies looked specifically at patients who use medical marijuana as an alternative to opioids to treat their cancer-related pain.

Another study published this fall found that patients who used medical marijuana for three months improved on a variety of health-related quality of life (HRQoL) measures, including physical functioning, bodily pain, social functioning, fatigue and general health.

Patients who used a CBD vaginal suppository in a separate trial, meanwhile, also reported significantly reduced menstrual pain and related symptoms. Participants who used the CBD suppository generally reported less period pain, better mood and lower use of pain medications compared to subjects who underwent conventional treatment.

Yet another study last year, published by the American Medical Association, found that the use of medical marijuana was associated with “significant improvements” in quality of life for people with chronic conditions like pain and insomnia—and those effects were “largely sustained” over time.

Another recent study of 23,500 people in New Zealand found that for many, cannabis may act as a less-dangerous substitute for other drugs, allowing people to reduce their intake of substances such as alcohol, methamphetamine and opioids like morphine.

Separate research also recently found that marijuana is likely to be an effective tool in reducing harm caused by opioid use disorder.

“Upon a review of the literature, it is reasonable to conclude that cannabis has some efficacy in the setting of opiate maintenance, as well as other therapeutic uses,” that paper said. In light of public concerns over opioid overdoses and the possibility of marijuana being rescheduled, it added, “there is a distinct possibility that cannabis use in harm reduction models will increase.”

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