A major new study involving more than 8,300 chronic pain patients has found that individuals receiving medical marijuana for an extended period were approximately twice as likely to discontinue prescription opioid medications compared with patients who received cannabis for a shorter duration. Published October 28, 2026, in the Journal of Addiction Medicine, the findings provide new evidence supporting a possible relationship between medical cannabis treatment and reduced reliance on opioid painkillers. The research adds to a growing body of scientific literature investigating whether cannabis could help certain patients manage persistent pain while reducing their exposure to medications associated with dependence, overdose, and other serious health risks.
Researchers examined medical records from 8,358 New York patients receiving long-term opioid therapy for chronic pain, comparing prescription outcomes among those who continued obtaining medical cannabis with those who received it for a shorter period. During the 90-day observation period, 15.5% of patients in the longer-duration cannabis group discontinued opioid prescriptions, compared with 7.6% in the comparison group. The association was particularly strong among individuals receiving lower or moderate opioid doses, while patients taking the highest doses did not experience a statistically significant difference in discontinuation rates. Although the observational findings cannot establish that marijuana directly caused patients to stop taking opioids, they offer important insight into how medical cannabis may fit into strategies for managing chronic pain and reducing dependence on long-term opioid prescriptions.
New York Study Examines More Than 8,300 Chronic Pain Patients
The study, titled Medical Cannabis and Opioid Prescription Discontinuation Among Chronic Pain Patients on Long-term Opioid Therapy, was conducted by researchers including Trang Nguyen, Yunshu Li, Danielle Greene, Sharon Stancliff, Nicole Rosa, Eli Rosenberg, and Kathleen A. Kelly. The investigators analyzed information from New York State’s Medical Cannabis Program and Prescription Monitoring Program covering 2017 through 2019. By combining these databases, researchers were able to examine documented medical marijuana dispensing alongside prescription opioid records, providing a more objective measurement of treatment patterns than studies relying exclusively on patient surveys or self-reported medication use.
All 8,358 participants had received long-term opioid therapy for chronic pain and had entered the state’s medical cannabis program. Researchers divided them into two groups based on the amount of medical marijuana dispensed during a 90-day follow-up period. The longer-duration group included 4,892 patients who received more than 30 days of medical cannabis, while the comparison group contained 3,466 patients who received 30 days or less. Importantly, this was not a comparison between cannabis users and individuals who had never received marijuana. Instead, the researchers evaluated whether sustained participation in medical cannabis treatment was associated with different opioid prescription outcomes. Opioid discontinuation was defined as a gap of at least 45 consecutive days without a recorded prescription, allowing investigators to identify meaningful interruptions in prescribed opioid therapy.
Medical Cannabis Users Show Twice the Opioid Discontinuation Rate
The study’s central finding was a substantial difference in opioid prescription discontinuation between the two groups. Among patients receiving medical cannabis for more than 30 days, 759 individuals stopped receiving opioid prescriptions during the observation period, representing 15.5% of that group. In comparison, 264 patients receiving cannabis for 30 days or less met the same definition, representing 7.6%. The difference corresponds to a relative likelihood of discontinuation approximately 2.04 times higher among patients with longer medical cannabis exposure. Researchers reported that the difference was statistically significant, indicating that it was unlikely to be explained by random variation alone.
The results were notable because previous research on cannabis and opioid reduction has produced conflicting findings. Some studies have documented reductions in prescribed opioid doses among patients participating in medical marijuana programs, while others have found little evidence of a meaningful relationship. The New York investigation strengthens the evidence by using actual dispensing records rather than relying solely on whether patients possessed medical cannabis authorization. However, receiving a product from a dispensary does not necessarily confirm how frequently it was consumed, and a gap in opioid prescriptions does not establish that a person permanently stopped using opioids. The findings therefore demonstrate an association between sustained medical cannabis dispensing and reduced prescription opioid receipt, rather than definitive proof that marijuana can replace opioid treatment.
Patients Taking Lower Opioid Doses Experience the Greatest Benefits
One of the most important discoveries involved the relationship between a patient’s existing opioid dosage and the likelihood of discontinuing prescriptions. Researchers measured opioid exposure using morphine milligram equivalents, or MME, a standardized method for comparing the potency of different opioid medications. Among participants receiving less than 50 MME per day, 22.1% of longer-duration medical cannabis patients discontinued opioid prescriptions, compared with 10.4% of those in the shorter-duration group. For patients receiving between 50 and 90 MME daily, the difference was even more pronounced: 13.9% discontinued prescriptions in the longer-duration cannabis group, compared with just 4.6% in the comparison group. These findings suggest that the potential relationship between medical cannabis and opioid discontinuation may be particularly meaningful for people receiving low or moderate prescription doses.
Researchers also examined how quickly patients discontinued their medications. Among individuals receiving less than 50 MME daily, the association was strongest during the first 30 days of follow-up, when longer-duration cannabis patients had an adjusted opioid discontinuation rate approximately 2.87 times higher than the comparison group. The association subsequently weakened but remained statistically significant. Among those receiving between 50 and 90 MME, the adjusted discontinuation rate was approximately three times higher throughout the observation period. These differences suggest that baseline opioid dosage may help identify patients most likely to experience changes in prescription use during medical cannabis treatment, although individual responses will depend on medical history, pain severity, treatment goals, and other factors.
Higher-Dose Opioid Patients Show Different Results
The findings were substantially different among patients receiving at least 90 MME daily. In this group, 6.3% of longer-duration medical cannabis patients discontinued opioid prescriptions, compared with 5.4% of patients receiving cannabis for a shorter period. The difference was not statistically significant, meaning researchers could not establish a reliable association between sustained cannabis dispensing and opioid discontinuation among individuals receiving higher baseline doses. This result is especially important because patients taking larger opioid doses often have more complicated treatment histories, greater physiological dependence, and conditions requiring careful long-term management.
However, the absence of a significant discontinuation difference does not necessarily mean medical cannabis had no relationship with opioid prescribing among higher-dose patients. Researchers observed that some individuals receiving cannabis for longer periods reduced their opioid doses without completely discontinuing prescriptions. The investigators suggested that patients beginning at higher doses might require a longer period of gradual reduction before stopping medication becomes feasible. Because the study followed participants for only 90 days, it could not establish whether those reductions continued or ultimately resulted in discontinuation. The findings reinforce the need to distinguish between reducing opioid dosage and stopping opioid therapy entirely, particularly when evaluating treatments intended for people with complex chronic pain conditions.
Findings Support Earlier Research on Cannabis and Opioid Reduction
The New York results are consistent with some earlier investigations exploring whether access to regulated medical cannabis is associated with lower opioid consumption. A separate study published in JAMA Internal Medicine examined 204 adults with chronic pain participating in New York’s medical cannabis program. Researchers monitored participants for 18 months and found that average prescribed opioid doses declined from approximately 73.3 MME per day at baseline to 57.4 MME during follow-up. Greater medical cannabis dispensing was associated with modest additional reductions in prescribed opioid dosage, even after researchers accounted for several factors that could influence medication use.
Other research has produced less favorable results, illustrating why the issue remains scientifically unsettled. A four-year prospective study involving patients prescribed opioids for chronic noncancer pain did not find clear evidence that cannabis improved pain outcomes or reduced opioid use. Research from Alberta, Canada, also reported findings that differed from the latest New York investigation. Differences in participant characteristics, cannabis products, treatment duration, study design, and measurement methods may contribute to these inconsistencies. Observational studies can reveal important treatment patterns, but randomized controlled trials and longer-term research are necessary to determine whether medical cannabis directly improves opioid tapering outcomes and which patients are most likely to benefit.
Why Medical Marijuana Might Influence Opioid Prescriptions
One possible explanation involves the different biological mechanisms through which cannabinoids and opioids affect pain perception. Opioid medications primarily act on opioid receptors in the nervous system, while cannabinoids such as THC interact with the body’s endocannabinoid system, including CB1 and CB2 receptors. These systems participate in regulating pain signaling, inflammation, mood, and other physiological processes. Researchers have investigated whether certain cannabinoids can provide pain relief independently or complement conventional treatments, potentially allowing some patients to manage symptoms with lower opioid doses. However, the biological plausibility of an opioid-sparing effect does not establish that all cannabis products are effective or that combining cannabis with opioids consistently produces better clinical outcomes.
Patients may also seek medical marijuana for reasons beyond direct pain reduction. Chronic pain frequently occurs alongside sleep disturbances, anxiety, reduced mobility, and diminished quality of life, all of which can influence perceptions of treatment effectiveness. Some patients report using cannabis to address several symptoms simultaneously, while others turn to it because of concerns about opioid side effects or a desire to reduce prescription medication use. These motivations may help explain why individuals who continue medical cannabis treatment show different opioid prescribing patterns. However, the latest study did not measure improvements in pain intensity, sleep quality, physical functioning, or withdrawal symptoms. It therefore cannot determine whether patients discontinued prescriptions because cannabis improved their symptoms, because treatment preferences changed, or because other circumstances influenced prescribing decisions.
Medical Experts Warn Against Abrupt Opioid Discontinuation
Although reducing unnecessary opioid exposure can be beneficial, stopping long-term opioid medications is not automatically safer in every situation. Patients taking opioids regularly may develop physical dependence, even when medications are used exactly as prescribed and no opioid use disorder is present. Abrupt discontinuation can cause significant withdrawal symptoms, including anxiety, insomnia, nausea, sweating, abdominal discomfort, and increased pain. In some circumstances, rapid or involuntary tapering has been associated with psychological distress, emergency medical visits, overdose, and other serious complications. The Centers for Disease Control and Prevention recommends individualized treatment decisions and generally advises against abrupt discontinuation or rapid dosage reduction unless an immediate safety threat requires urgent intervention.
Medical cannabis also presents potential risks that should be considered before incorporating it into an opioid treatment plan. THC can cause dizziness, sedation, impaired coordination, anxiety, and cognitive changes, while some products may interact with other medications. Combining cannabis with opioids or additional sedating substances may increase impairment and create safety concerns, particularly for older adults or people with underlying medical conditions. Patients with certain cardiovascular disorders, a history of psychosis, or pregnancy-related concerns may face additional risks. The new research does not establish that combining cannabis with opioids is safe for every patient, nor does it support independently replacing prescribed medications with marijuana. Any reduction in long-term opioid therapy should be coordinated with a qualified healthcare professional and supported by appropriate pain management.
Researchers Identify Important Study Limitations
Despite its large sample size, the investigation has several limitations that affect how the findings should be interpreted. Its observational design means participants were not randomly assigned to receive different durations of medical cannabis treatment. Patients who continued obtaining marijuana may have differed from those who stopped or received it less frequently in ways not fully captured by the available records. Researchers adjusted for age, sex, payment type, and previous opioid treatment duration, but lacked detailed information about underlying pain diagnoses, other medical conditions, and additional factors that might influence treatment decisions. The dataset also did not provide sufficient information to evaluate differences across racial and ethnic groups.
Another limitation involves the absence of detailed cannabis product information. Researchers could not determine whether particular THC concentrations, CBD ratios, formulations, or administration methods were associated with better outcomes. They also could not confirm whether patients consumed every product they obtained or whether some participants accessed cannabis outside the regulated medical system. Most importantly, the study measured prescription records rather than directly observing medication consumption. A 45-day gap does not necessarily establish permanent opioid discontinuation, and researchers could not determine whether patients experienced improved pain control, fewer overdoses, or better long-term health outcomes. The 90-day observation period further limits conclusions about sustained treatment success.
Medical Cannabis Access and Affordability Remain Important Barriers
The study also raises questions about whether patients can consistently access medical cannabis when they wish to explore it as part of chronic pain treatment. Although state medical marijuana programs have expanded considerably, patients may encounter financial, geographic, and regulatory obstacles. Medical cannabis is often purchased out of pocket, making ongoing treatment difficult for individuals with limited incomes. Unlike many conventional prescription medications, state-dispensary cannabis products generally lack routine health insurance coverage. Dispensary availability, qualifying-condition restrictions, product costs, and transportation difficulties can create additional barriers, particularly for patients with disabilities or limited mobility.
These inequalities may be especially relevant for individuals receiving long-term opioid prescriptions through public insurance programs. The researchers observed relatively limited participation by Medicaid-covered patients in the medical cannabis group, suggesting that affordability and access deserve further investigation. Patients who might benefit from additional treatment choices may be unable to obtain cannabis consistently enough to evaluate its effects. At the same time, expanding access without adequate medical oversight could introduce new risks. A balanced approach would involve improving scientific knowledge, strengthening product safety standards, encouraging communication between patients and clinicians, and ensuring that financial circumstances do not determine who can explore potentially beneficial treatment options.
What the New Study Means for Chronic Pain Treatment
The findings arrive amid continuing efforts to develop safer and more effective treatments for chronic pain. Long-term opioid therapy remains appropriate for some patients, but its potential risks have encouraged clinicians and researchers to investigate alternative and complementary approaches. These include physical therapy, behavioral treatments, nonopioid medications, interventional procedures, and emerging therapies targeting different pain pathways. Medical cannabis is increasingly part of that discussion, particularly in states where patients can obtain regulated products through established programs. The latest study contributes meaningful evidence by showing that sustained medical cannabis dispensing was associated with substantially higher opioid prescription discontinuation rates, especially among individuals receiving less than 90 MME daily.
The next challenge is determining whether that association translates into better clinical outcomes. Future research will need to examine specific cannabis formulations, appropriate dosing, longer treatment periods, and the safety of combining cannabinoids with opioid medications. Randomized studies could help establish whether cannabis facilitates gradual opioid tapering while maintaining acceptable pain control and quality of life. Longer follow-up will also be necessary to determine whether patients remain off opioids or eventually resume prescriptions. For now, the study offers an encouraging but carefully qualified conclusion: among more than 8,300 chronic pain patients, those who received medical cannabis for longer periods were approximately twice as likely to stop receiving opioid prescriptions. The results strengthen the case for further investigation into medical marijuana’s potential role in chronic pain management, while reinforcing the importance of individualized treatment and medically supervised decisions about opioid reduction.
