The association between cannabis use and risk of non-medical pain reliever misuse onset among young adults in a legal cannabis context

Rhew, Isaac C.; Le, Vi T.; Ramirez, Jason J.; Fleming, Charles B.; Kilmer, Jason R.; Delawalla, Miranda L. M.; Hultgren, Brittney A.; Lee, Christine M.; Larimer, Mary E.; Guttmannova, Katarína

doi:10.1016/j.addbeh.2023.107711

Cited by 5 publications

(10 citation statements)

References 38 publications

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“…We selected confounders a priori based on prior literature. 4,5,6 We adjusted for insurance status, sex, age category, race, household income, year of survey, education level, and having at least one comorbidity. Insurance status was based on two variables.…”

Section: Methodsmentioning

confidence: 99%

“…Recent studies exploring the association between cannabis use on opioid misuse are conflicting. 4,5,6 In three recent studies exploring the association between cannabis and opioid use, two observed a positive association and one observed an inverse association. 4,5,6 The inverse association was observed in a clinical population in treatment for OUD in Ontario, Canada.…”

Section: Introductionmentioning

confidence: 99%

“…4,5,6 In three recent studies exploring the association between cannabis and opioid use, two observed a positive association and one observed an inverse association. 4,5,6 The inverse association was observed in a clinical population in treatment for OUD in Ontario, Canada. 4 This study found no association between cannabis use and opioid use.…”

Section: Introductionmentioning

confidence: 99%

“…Cannabis use has been implicated as both a positive and negative influence on opioid use in prior literature, however, no studies have investigated this association in the aftermath of COVID-19. 4,5,6 The additional stressors of the COVID-19 pandemic, such as increased stress and anxiety, limited access to pain-management and/or mental health providers, and disruptions in healthcare services, may have led individuals to use cannabis as a means of self-medication for various physical and emotional distress, potentially impacting the use of opioids. 8…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, studies in the context of WA are limited to the best of our knowledge; the only study in WA established the relationship between cannabis use and opioid misuse in a narrow population and did not assess the relationship between the frequency of cannabis use and opioid-related outcomes. 4,6 Our study will fill these gaps in the literature through an evaluation of the association between cannabis use and opioid use among adults in WA in 2019 and 2021, allowing us to assess if COVID-19 modified the association and if individuals who use cannabis in varying frequencies for medical use or other use may have higher or lower uptake of opioid. We hypothesized that there would be a higher prevalence of opioid use among participants who reported cannabis use compared to participants who did not report cannabis use and that the association between cannabis and opioid use would be stronger during COVID-19 relative to pre-COVID.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the association between cannabis and opioid use among adults in Washington State: Estimates from a Cross-Sectional Survey

Abousamra,

Andres,

Litman

2023

Preprint

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IntroductionCannabis and opioids are commonly used for pain management. However, studies examining the association between use of both substances conflict. Furthermore, disruptions to healthcare services and access due to COVID-19 may have affected opioid use in favor of cannabis because of accessibility. Our objective was to examine associations between cannabis and opioid use in Washington State (WA), COVID-19’s impact on these associations, and the association between frequency of cannabis use and misuse of opioids.MethodsWe pooled cross-sectional data from 2019 and 2021 WA Behavior Risk Factors Surveillance Systems surveys to examine associations between cannabis use in the past 30 days and prescription or non-prescription opioid use and misuse during the past 12 months among adults 18 and older. Survey-weighted adjusted prevalence ratios were estimated using multivariable Poisson regression. A proportion test and adjusted trend test were used to examine trends between cannabis use frequency (no use, 1-5 days, 6-9 days, 10-29 days, and 30 days) and opioid misuse among those reported opioid use.ResultsAmong 25,540 participants, the prevalence of opioid use was 19.2% among those who used cannabis and 13.8% among those who did not use cannabis (aPR=1.32; 95%CI: 1.20,1.46). COVID-19 did not modify the association between cannabis and opioid use. Among those who used opioids (n=2,168), daily cannabis use was associated with higher opioid misuse prevalence (aPR=2.64; 95% CI: 1.71,4.10), though less than daily use was not.ConclusionCannabis and opioid use were positively associated. Our findings emphasize the need for cautious policy decisions on cannabis regulations. Promoting cannabis use may not correlate with a reduction in other substance misuse. Further research is warranted to explore patterns of cannabis and opioid misuse.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exploring the association between cannabis and opioid use among adults in Washington State: Estimates from a Cross-Sectional Survey

Abousamra,

Andres,

Litman

2023

Preprint

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Indirect effects of emotion regulation in the relationship between pain and cannabis use in adults 18–64 years

Schepis,

Rogers,

Munoz

et al. 2024

Addictive Behaviors

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Impact of Δ⁹-Tetrahydrocannabinol and oxycodone co-administration on measures of antinociception, dependence, circadian activity, and reward in mice

Slivicki,

Wang,

Nhat

et al. 2023

Preprint

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Oxycodone is commonly prescribed for moderate to severe pain disorders. While efficacious, long-term use can result in tolerance, physical dependence, and the development of opioid use disorder. Cannabis and its derivatives such as Δ9-Tetrahydrocannabinol (Δ9-THC) have been reported to enhance oxycodone analgesia in animal models and in humans. However, it remains unclear if Δ9-THC may facilitate unwanted aspects of oxycodone intake, such as tolerance, dependence, and reward at analgesic doses. This study sought to evaluate the impact of co-administration of Δ9-THC and oxycodone across behavioral measures related to antinociception, dependence, circadian activity, and reward in both male and female mice. Oxycodone and Δ9-THC produced dose-dependent antinociceptive effects in the hotplate assay that were similar between sexes. Repeated treatment (twice daily for 5 days) resulted in antinociceptive tolerance. Combination treatment of oxycodone and Δ9-THC produced a greater antinociceptive effect than either administered alone, and delayed the development of antinociceptive tolerance. Repeated treatment with oxycodone produced physical dependence and alterations in circadian activity, neither of which were exacerbated by co-treatment with Δ9-THC. Combination treatment of oxycodone and Δ9-THC produced CPP when co-administered at doses that did not produce preference when administered alone. These data indicate that Δ9-THC may facilitate oxycodone-induced antinociception without augmenting certain unwanted features of opioid intake (e.g. dependence, circadian rhythm alterations). However, our findings also indicate that Δ9-THC may facilitate rewarding properties of oxycodone at therapeutically relevant doses which warrant consideration when evaluating this combination for its potential therapeutic utility.

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The association between cannabis use and risk of non-medical pain reliever misuse onset among young adults in a legal cannabis context

Cited by 5 publications

References 38 publications

Exploring the association between cannabis and opioid use among adults in Washington State: Estimates from a Cross-Sectional Survey

Exploring the association between cannabis and opioid use among adults in Washington State: Estimates from a Cross-Sectional Survey

Indirect effects of emotion regulation in the relationship between pain and cannabis use in adults 18–64 years

Impact of Δ⁹-Tetrahydrocannabinol and oxycodone co-administration on measures of antinociception, dependence, circadian activity, and reward in mice

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The association between cannabis use and risk of non-medical pain reliever misuse onset among young adults in a legal cannabis context

Cited by 5 publications

References 38 publications

Exploring the association between cannabis and opioid use among adults in Washington State: Estimates from a Cross-Sectional Survey

Exploring the association between cannabis and opioid use among adults in Washington State: Estimates from a Cross-Sectional Survey

Indirect effects of emotion regulation in the relationship between pain and cannabis use in adults 18–64 years

Impact of Δ9-Tetrahydrocannabinol and oxycodone co-administration on measures of antinociception, dependence, circadian activity, and reward in mice

Contact Info

Product

Resources

About

Impact of Δ⁹-Tetrahydrocannabinol and oxycodone co-administration on measures of antinociception, dependence, circadian activity, and reward in mice