Author Interviews, Cannabis, JAMA, Opiods / 13.11.2025
Cancer Patients May Be able to Manage Pain with Cannabis Instead of Opioids
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Victoria Bethel[/caption]
MedicalResearch.com Interview with:
Victoria Bethel, MSN
Department of Public Administration and Policy
University of Georgia, Athens
MedicalResearch.com: What is the background for this study?
Response: From the same pool of commercially insured patients, we found that cannabis dispensary openings were associated with reduced opioid prescribing among patients with non-cancer pain.
For this study, we examined whether cannabis dispensary openings were also associated with reduced opioid prescribing among commercially insured patients who do have a cancer diagnosis.
Similar to patients without cancer, we estimated reductions in opioid prescribing after medical and recreational cannabis dispensaries open. These findings may suggest that patients who experience cancer pain are able to manage their pain with cannabis instead of requiring opioids, although we cannot directly observe substitution.
Victoria Bethel[/caption]
MedicalResearch.com Interview with:
Victoria Bethel, MSN
Department of Public Administration and Policy
University of Georgia, Athens
MedicalResearch.com: What is the background for this study?
Response: From the same pool of commercially insured patients, we found that cannabis dispensary openings were associated with reduced opioid prescribing among patients with non-cancer pain.
For this study, we examined whether cannabis dispensary openings were also associated with reduced opioid prescribing among commercially insured patients who do have a cancer diagnosis.
Similar to patients without cancer, we estimated reductions in opioid prescribing after medical and recreational cannabis dispensaries open. These findings may suggest that patients who experience cancer pain are able to manage their pain with cannabis instead of requiring opioids, although we cannot directly observe substitution.
Elena Stains
Medical Student
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton, PA
MedicalResearch.com: What is the background for this study?
Response: Opioid use has been an increasing problem since the early 2000s in the United States (US) with a surge around 2010. Twenty-five percent of those having abused pain relievers in 2013 and 2014 got those drugs from physicians1. Physicians are particularly well-known for fueling the opioid crisis in Florida in the 2000s. Of the United States’ top 100 opioid prescribing physicians in 2010, an astounding 98 were prescribing in Florida2. Florida taking the main stage of the opioid crisis can be attributed to several factors, including ability of physicians to dispense opioids directly from their offices to patients (i.e. without pharmacists) and the presence of many infamous “pill mills” in the state3–6.
The researchers at Geisinger Commonwealth School of Medicine aimed to analyze the amount of hydrocodone (including brand names of Vicodin and Lortab) and oxycodone (OxyContin and Percocet) distributed in Florida from 2006 to 2021, paying close attention to the peak year of the opioid crisis, 2010. The team used the Washington Post and the US Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS) databases to compile this compelling information.
Dr. Solgama[/caption]
Jay P. Solgama
Medical Student
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton PA
MedicalResearch.com: What is the background for this study?
Response: The opioid crisis in the United States continues to escalate, with opioid-related deaths increasing by over 800% since 2000. Prescription opioids, particularly oxycodone, have been a contributor to this crisis, with substantial variations in their distribution observed across different states [1,2,3].
Against this backdrop, the study conducted by researchers from the Geisinger Commonwealth School of Medicine aimed to characterize the distribution of oxycodone across US states from 2000 to 2021. By analyzing data from the Drug Enforcement Administration’s comprehensive Automation of Reports and Consolidated Orders System (ARCOS) and the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (WONDER) databases, the study sought to identify trends and patterns in oxycodone distribution and their potential implications for opioid-related deaths [4,5].
Leana Pande[/caption]
MedicalResearch.com Interview with:
Leana Pande
Touro College of Osteopathic Medicine
MedicalResearch.com: What is the background for this study?
Response: Buprenorphine is not a new drug. It was developed in the 1960s with the intent of providing the benefits of opioids, without the addictive side effects. Unlike many prescription opioids,1 use of this Schedule III drug is increasing.2 It is often characterized as a partial agonist at the mu-opioid receptor (Figure-Right). Buprenorphine is available in many routes of administration and also with (brand name Suboxone) or without naloxone. Buprenorphine is a first-line pharmacotherapy for pregnant women with OUD.3 This review was completed in order for the benefits, and risks, of buprenorphine to be more fully appreciated and inform utilization for both opioid use disorder (OUD) and the treatment of pain.
Dr. Potnuru[/caption]
Paul Potnuru, MD
Assistant Professor
Anesthesiology, Critical Care and Pain Medicine
The John P. and Kathrine G. McGovern Medical School
The University of Texas Health Science Center at Houston
Alden Mileto, BA
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton, PA
MedicalResearch.com: What is the background for this study?
Response: The drug buprenorphine is a partial opioid agonist, originally developed in the 1960s as an alternative to the stronger full opioid mu receptor agonists like morphine. Today, the drug is sometimes used for pain, but is more often used as a treatment for Opioid Use Disorder (OUD). Since the 2002 federal approval for buprenorphine use in treatment of OUD, there has been an increase in buprenorphine prescription across all states.
However recent studies have showed a disproportionate increase in buprenorphine prescriptions to rural/ less populated areas in comparison to urban/densely populated areas. The objective of this study [1] was to analyze the trends in buprenorphine distribution, overall and by three-digit zip codes, in Pennsylvania from 2010-2020.
Colleen Jordan[/caption]
Colleen G. Jordan, MBS
Department of Medical Education
Geisinger Commonwealth School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Opioid addiction and misuse remain a prevalent issue in the United States (U.S.). There have been more than one-million drug overdoses in the U.S. since 1999 [1], largely driven by opioids, which exacerbate the strain on resources in hospitals, treatment centers, first responders, patients, and their families. The existing pharmacotherapies for opioid use disorder (OUD) are not working.
Naloxone is a competitive mu opioid receptor antagonist used to reverse respiratory and CNS depression in those experiencing an opioid overdose but requires further dosing to prevent subsequent overdose. Naltrexone is a competitive mu opioid receptor antagonist, and has extended-release formulations intended to reduce relapse and promote adherence, yet patient noncompliance and retention continue to be limiting factors. Methadone is commonly used to treat opioid addiction as a replacement for illicit opiates but is itself an addictive substance which can result in overdoses [2] and can lead to withdrawal if not closely monitored by a licensed professional. Buprenorphine is currently used to treat opioid use disorder (OUD), and while it reduces illicit drug use, it is less effective than methadone for retaining patients in treatment. For these reasons, there is an urgent need for new opioid misuse interventions.
The objectives of this study [3] were to understand the implications of OUD and overdose treatments and determine the strengths and shortcomings of current treatments in comparison with the novel drug candidate methocinnamox (MCAM). These were completed through an extensive literature review into the history of the opioid epidemic in the United States, opioid receptors in the brain, current pharmacological treatments, and the pharmacological properties of MCAM.
Dr. O'Donnell[/caption]
Julie O’Donnell, PhD MPH
Division of Overdose Prevention
National Center for Injury Prevention and Control
CDC
National Network of Public Health Institutes
New Orleans, Louisiana
MedicalResearch.com: What is the background for this study?
Response: The estimated number of drug overdose deaths in the US surpassed 100,000 over a 12-month period for the first time during May 2020-April 2021, driven by the involvement of synthetic opioids other than methadone (mainly illicitly manufactured fentanyl (IMF)), according to data from the National Vital Statistics System.
The State Unintentional Drug Overdose Reporting System (SUDORS) is a CDC-funded surveillance program that has collected detailed data on unintentional and undetermined intent drug overdose deaths since 2016 from death certificates, medical examiner and coroner reports, and full postmortem toxicology reports. SUDORS data allow for the analysis specifically of deaths involving fentanyl (rather than the larger category of synthetic opioids), and contain information about decedent demographics and other characteristics, as well as circumstances surrounding the overdose that might help inform prevention.
Dr. Thakrar[/caption]
Ashish Thakrar, MD
Internal Medicine & Addiction Medicine
National Clinician Scholars Program
University of Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: About 1.8 million Americans are currently incarcerated, more than any other country in the world per capita. Of those 1.8 million, about 1 in 7 suffers from opioid addiction, putting them at high risk of overdose and death, particularly in the weeks following release.
Opioid use disorder is a treatable condition, particularly with the medications buprenorphine or methadone, but historically, prisons and jails have not offered treatment. Over the past five years, a few states and municipalities have enacted policies to provide access for OUD treatment. We examined whether these policies were actually improving access to treatment. 
Dr. Kovács[/caption]
Balázs Kovács PhD
Associate Professor of Organizational Behavior
Yale School of Management
MedicalResearch.com: What is the background for this study?
Response: Our study looks at the association between the prevalence of legal cannabis stores, called “dispensaries”, and opioid-related mortality rates in the U.S. We find that higher cannabis dispensary counts are associated with reduced opioid-related mortality rates. We find this relationship holds for both medical dispensaries, which only serve patients who have a state-approved medical card or doctor’s recommendation, as well as for recreational dispensaries, which sell to adults 21 years and older. The statistical associations we find appears most pronounced with the class of opioids that includes fentanyl and its analogs. 
Dr. Desai[/caption]
Nimesh D. Desai, MD, PhD
Director, Thoracic Aortic Surgery Research Program
Associate Professor of Surgery
Hospital of the University of Pennsylvania
MedicalResearch.com: What is the background for this study?
Dr. Chase Brown: Opioid use in the United States is a public health emergency. We know that opioids prescribed after general surgery operations to patients who never received them within the year prior to their surgery are at increased risk for continuing to take opioids months later. However, this has not been studied in patients undergoing cardiac surgery, who often times have more severe post-operative pain.
Our goal in this study was to determine how many patients after cardiac surgery and are opioid naive are continuing to take opioids within 90-180 days after their surgery. 
