In light of Canada’s recent move towards the legalization of cannabis, authors of a new study published in Biology of Sex Differences, that investigated the association between cannabis use and methadone treatment outcome, discuss their findings and the implications.
There is a growing popular belief that cannabis is natural and therefore harmless to use. In fact, many people who are addicted to opioids believe that cannabis use is a substitute to methadone and can help them control opioid withdrawal symptoms. In addition, there are an increasing number of studies advocating for the use of cannabis instead of opioids for chronic pain. Is cannabis harmless for everyone as claimed? Will making cannabis legal and eventually more accessible do harm or good?
Public perception of cannabis is that it is a harmless substance, mainly because it is unlikely to lead to death due to overdose. While there are no documented reports of fatal overdoses from cannabis, other adverse consequences have been noted, including cognitive impairment, respiratory problems, and psychotic symptoms. Vulnerable populations, such as those with existing addictions, are at greater risk of experiencing these adverse events.
Opioid addiction (or opioid use disorder) has skyrocketed around the globe and is especially pervasive in Canada where it was declared a public health crisis. Deaths from opioid overdoses have become commonplace in Canada; the urgent need for adequate treatment options for those with opioid addictions has been emphasized by clinicians and the public.
Methadone maintenance treatment is currently the oldest and most widely used pharmacological treatment for opioid addiction. Those in treatment receive a daily dose of methadone, a long-acting synthetic opioid, to reduce cravings and relieve withdrawal symptoms without producing the same euphoric effects of other opioids.
Previous research has found differences in clinical profile and treatment outcomes between men and women, and therefore our study aimed to explore sex differences in cannabis use.
777 participants in this study (414 men and 363 women). About 60% of men and 44% of women reported using cannabis. After controlling for age, methadone dose, and length of time in treatment, we found women were 82% more likely to also use illicit opioids while on methadone treatment if they were cannabis users.
A recent study found the motivation for using cannabis varied between men and women, whereby women tended to report the primary purpose for using it was for self-medication, whereas men more often reported using cannabis was for recreational purposes. However what we see in this study is that women who use cannabis are not faring well compared to men. Cannabis has not helped women and was associated with worse health outcomes for them.