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Cannabis and Chronic Pain

Key points

  • There is limited evidence that cannabis works to treat most types of acute or chronic pain.
  • More research is needed to know whether cannabis works better than other options to manage pain.

Cannabis and pain

Even though pain management is one of the most common reasons people report for using medical cannabis in the United States,1 there is limited evidence that cannabis works to treat most type of acute or chronic pain.

A few studies have found that cannabis can be helpful in treating neuropathic pain (a specific type of chronic pain caused by damaged nerves).2 However, more research is needed to know whether cannabis works better than other options to manage pain.

Opioids and Cannabis‎

Opioids are a class of drugs used to reduce pain and include prescription opioids, heroin, and synthetic opioids (like fentanyl). More than 106,000 people died from drug overdoses in 2021 in the United States, and three in four of these overdose deaths involved an opioid.3 Learn more about opioids and the drug overdose epidemic.

Although some research suggests that states that legalize cannabis use for medical purposes experience a reduction in opioid prescribing and opioid-related deaths,4567 other research that examines the impact of medical cannabis policies over a longer period of time indicates cannabis legalization is not associated with decreases in opioid overdose deaths and that prior research findings could be coincidental.89

Importantly, using cannabis either alone or in combination with opioids has been shown to increase risk for opioid misuse.1011 There is no evidence that cannabis works to treat opioid use disorder. FDA-approved medications are available to treat opioid use disorder.

If you or someone close to you needs help for a substance use disorder, talk to your doctor or call SAMHSA's National Helpline at 1-800-662-HELP or go to SAMHSA's Behavioral Health Treatment Services.

  1. Boehnke KF, Dean O, Haffajee RL, et al. US trends in registration for medical cannabis and reasons for use from 2016 to 2020: an observational study. Ann Intern Med. 2022;175(7):945-951. doi: 10.7326/M22-0217.
  2. National Academies of Sciences, Engineering, and Medicine. The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research. Washington, DC: The National Academies Press; 2017. Accessed February 8, 2024.
  3. Centers for Disease Control and Prevention. "U.S. Overdose Deaths In 2021 Increased Half as Much as in 2020 – But Are Still Up 15%," Accessed February 9, 2024.
  4. Raji MA, Abara NO, Salameh H, et al. Association between cannabis laws and opioid prescriptions among privately insured adults in the US. Prev Med. 2019;125:62-68. doi: 10.1016/j.ypmed.2019.05.012.
  5. Liang D, Bao Y, Wallace M, et al. Medical cannabis legalization and opioid prescriptions: evidence on US Medicaid enrollees during 1993–2014. Addiction. 2018;113(11):2060-2070. doi: 10.1111/add.14382.
  6. Bachhuber MA, Saloner B, Cunningham CO, et al. Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010. JAMA Intern Med. 2014;174(10):1668-1673. doi: 10.1001/jamainternmed.2014.4005.
  7. Pardo B. Do more robust prescription drug monitoring programs reduce prescription opioid overdose? Addiction. 2017;112(10):1773-1783. doi: 10.1111/add.13741.
  8. Chihuri S, Li G. State marijuana laws and opioid overdose mortality. Inj Epidemiol. 2019;6:38. doi: 10.1186/s40621-019-0213-z.
  9. Shover CL, Davis CS, Gordon SC, et al. Association between medical cannabis laws and opioid overdose mortality has reversed over time. Proc Natl Acad Sci USA. 2019;116(26):12624-12626. doi: 10.1073/pnas.1903434116.
  10. Cooper ZD, Bedi G, Ramesh D, et al. Impact of co-administration of oxycodone and smoked cannabis on analgesia and abuse liability. Neuropsychopharmacology. 2018;43(10):2046-2055. doi: 10.1038/s41386-018-0011-2.
  11. Fiellin LE, Tetrault JM, Becker WC, et al. Previous use of alcohol, cigarettes, and marijuana and subsequent abuse of prescription opioids in young adults. J Adolesc Health. 2013;52(2):158-163. doi: 10.1016/j.jadohealth.2012.06.010.