Can Using Opioids With Cannabis Increase Depression, Anxiety Risks?

By Kelly Burch 08/14/19

A recent study explored the idea that using cannabis and opioids together can have unintended consequences. 

opioids and cannabis

People with chronic pain often turn to opioids and cannabis for pain relief, but a new study suggests that using both substances can increase the risk of depression and anxiety. 

The study, published in the Journal of Addiction Medicine, explored the idea that using cannabis and opioids together can have unintended consequences. 

“Results suggest that, compared to opioid use alone, opioid and cannabis co-use was associated with elevated anxiety and depression symptoms, as well as tobacco, alcohol, cocaine, and sedative use problems, but not pain experience,” the study authors wrote. “These findings highlight a vulnerable population of polysubstance users with chronic pain, and indicates the need for more comprehensive assessment and treatment of chronic pain.”

Study author Andrew Rogers, who works in the University of Houston’s Anxiety and Health Research Laboratory and the university’s Substance Use Treatment Clinic, said that the work is important since more people are using both opioids and cannabis to relieve pain. 

"Given the fact that cannabis potentially has analgesic properties, some people are turning to it to potentially manage their pain,” he told Medical Express. "There's been a lot of buzz that maybe cannabis is the new or safer alternative to opioids, so that's something we wanted to investigate.”

Co-Use Issues

The researchers found that people who used both cannabis and opioids didn’t get greater pain relief. However, in addition to being more at risk for depression and anxiety, they were more likely to use other substance including alcohol, cocaine and sedatives, that can have complicated interactions with opioids. 

With prescription opioids coming under increased scrutiny, more states are making it easier for people to use medical cannabis instead of opioids to manage their pain. For example, in February, Illinois launched The Opioid Alternative Pilot Program, which lets people who have been prescribed opioids get access to legal cannabis instead, without going through the state’s complex medical marijuana registry system. 

“I think it’s going to make a difference to the people that don’t want to be on opioids and haven’t been able to break away. It’s going to give them some relief and they’re going to realize I don’t have to have this heavy prescription with all these side effects,” Christine Karhliker, who worked at a Chicago-area dispensary, said at the time. 

More recently, Colorado passed a law that lets doctors recommend cannabis for conditions that they otherwise would have recommended opioids for. 

However, some people oppose the measure, calling for more research into cannabis and pain relief. 

“Our real concern is that a patient would go to a physician with a condition that has a medical treatment with evidence behind it, and then instead of that treatment, they would be recommended marijuana instead,” said Stephanie Stewart, a physician in Colorado. “This will substitute marijuana for an FDA-approved medication—something that’s unregulated for something that’s highly regulated.”

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.