What the Latest Data Indicates About Cannabis, Pain and Prescription Patterns

A new federally funded study published in JAMA Internal Medicine shows patients enrolled in New York’s medical cannabis program were significantly more likely to reduce their use of prescription opioids over time. The findings add to a growing body of real-world evidence suggesting cannabis can function as an alternative for people managing chronic pain and help shift prescribing patterns across populations. 

A Close Look at the Research

The study followed 204 adults with chronic pain who were newly certified into the New York State Medical Cannabis Program between September 2018 and July 2023. Researchers collected prescription data on both cannabis and opioids from the New York State Prescription Monitoring Program over an 18-month period. Cannabis Business Times

At the start of the study, most participants were on high doses of opioids, equivalent to about 73.3 milligrams of morphine per day. Eighteen months later, average daily opioid doses fell to about 57 milligrams, representing a 22 percent reduction compared with baseline. 

Most notably, during months when patients received a 30-day supply of medical cannabis, they used the equivalent of 3.5 fewer milligrams of morphine per day than those who did not receive cannabis in the same timeframe. That might seem like a small shift, but when tracked over many months it reflects a steady trend toward safer pain management and reduced opioid reliance. 

Why This Matters in the Opioid Era

Chronic pain and opioid dependency are among the most urgent public health challenges in the United States. Prescription opioid misuse has fueled widespread addiction, overdose, and mortality. Finding alternatives that can help people manage pain without heavy reliance on opioids is a critical priority for clinicians and policymakers alike. 

This study does more than observe associations it shows clinically meaningful patterns in a regulated, pharmacist-supervised medical cannabis context. Participants were not self-selecting in an informal wellness sense they were enrolled in a state medical program, and their drug use was tracked objectively through prescription monitoring. 

While the reductions in opioid dosing per day may look modest at first glance, gradual tapers over months are often safer and more sustainable for people living with chronic pain than abrupt discontinuation. That kind of slow, managed taper can reduce withdrawal risks and give people time to adapt to different strategies for pain relief. 

How Cannabis Might Be Working

Cannabis and opioids both interact with the nervous system’s pain and reward pathways but through distinct biological mechanisms. Cannabinoids like THC and CBD engage the endocannabinoid system, which modulates pain, inflammation and stress responses. Opioids bind to opioid receptors to blunt pain signals. When patients incorporate cannabis in a supervised therapeutic model, they may experience enough analgesia from cannabinoids to reduce reliance on opioids without abandoning pain management entirely. Cannabis Science and Technology

Further research will be needed to understand mechanistic details for how specific cannabinoids affect different types of pain and how best to integrate cannabis with other therapies. Differences in formulations, doses, patient history and individual biology all shape outcomes in complex ways.

Context Within Broader Evidence

This New York study aligns with other recent research showing links between cannabis access and lower opioid prescribing. For example, federally funded analyses have found that states with medical or recreational cannabis laws tend to see significant reductions in opioid use for conditions such as cancer pain, and broad epidemiological work suggests substitution effects when legal cannabis is available. 

Population-level surveys also indicate a large portion of cannabis users report substituting cannabis for traditional prescription drugs when given the option. Marijuana Moment

Limitations to Consider

Although compelling, this study has limitations common to observational clinical research. It does not randomize patients or control for every confounder, and prescription monitoring data capture what is prescribed rather than how a person experiences pain or daily functioning. A reduction in opioid prescriptions does not on its own guarantee improvements in quality of life, although it is a meaningful clinical indicator. Furthermore, participants in this study were part of a medical program with oversight cannabis remains federally prohibited and access varies widely across states. 

Even with these caveats this kind of evidence helps shift cannabis research beyond anecdote and into measurable health outcomes. It points toward ways licensed cannabis programs may provide practical tools in addressing opioid overuse and chronic pain.