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Pain-Pill Use Fell As Medical-Cannabis Use Grew, Report Says

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For years, Elizabeth used prescription pain medicine to relieve her symptoms from her rare and painful gastrointestinal condition, sphincter of Oddi dysfunction, until she smoked cannabis for the first time in November 2018 at her doctor’s recommendation. 

“He had told me at one point in time, ‘You know, if we were in a state that would allow for medical marijuana, I would write a prescription immediately. I am telling you as your doctor and your friend: If you can find it, if you can get it and it helps, go for it,’” she told the Mississippi Free Press in an interview on April 29.

Elizabeth asked to go by a pseudonym instead of her real name because she works in Tennessee, where medical and recreational cannabis are both illegal.

She had taken hydrocodone, had several surgeries and even tried CBD, but nothing was alleviating her pain. Doctors increased her dosages and then prescribed her fentanyl patches because she was hurting all day, every day, for seven days a week. Before her dad passed, Elizabeth made a promise to him that she would find a way to get off the narcotics. So, she listened to her doctor, stopped taking the medicine “cold turkey” and smoked weed for the first time on Nov. 28, 2018.

“And that was the last pain pill I took aside from having some dental work done a few years ago,” she said. She used to take a dozen prescription medications but is now down to just three.

At the time, Elizabeth lived in Tennessee, so she bought marijuana from street dealers. She found out in 2022 that Mississippi had legalized medical cannabis and decided to move to the Magnolia State, where she would also be closer to her family. She moved to Long Beach, Miss., in July 2023 and got her medical-cannabis card in October. 

“I feel more in control on marijuana. I don’t have to worry about overdosing on it, and I don’t have to worry about really any of the side effects—there aren’t any. And this helps with my nausea; I don’t have to take my nausea meds,” she said.

While cannabis does not fully relieve Elizabeth’s pain like opioids did, she said she will smoke and feel relaxed for up to eight hours. Some days, she said she does not need to smoke, but others she smokes as soon as she wakes up to relieve nausea.

She emphasized how she felt like a “functioning zombie” when taking prescription pain medicine and said she missed many important events in her children’s lives.

“I am more alive now than I was 10 years ago,” Elizabeth said.

Study: Opioid Use Dips Whiles Medical-Cannabis Use Rises

As cannabis becomes more available in the U.S. through medical and recreational programs, University of Mississippi researchers are looking to see if an increased use of medical cannabis correlates with a decreased use of prescription pain relievers.

Sujith Ramachandran, an associate professor of pharmacy administration and the assistant director of the Center for Pharmaceutical Marketing and Management, researches chronic pain management using opioids in the context of the opioid epidemic with UM’s School of Pharmacy. 

A study he and other researchers published in December 2023 found that many people may be using cannabis for pain management, so they decided to see if Americans’ decreased use of opioids had a correlation with their increased use of medical cannabis. The researchers asked participants whether they had used cannabis within the past year and if so, whether a health-care professional recommended the patient use cannabis. 

Scientists split the participants into three groups: appropriate pain-reliever usage within the past year; misuse of prescription pain killers in the past year; and no history of opioid use in the past year.

“We were not actually able to tell if they were using one instead of the other or why they were using either of those medications,” he told the Mississippi Free Press on April 11. “What we were able to tell, for example, was that individuals who used medical marijuana are more likely to be patients using pain relievers, either appropriately or even nonmedically.”

University of Mississippi researcher Sujith Ramachandran said the research “speaks to the unmet need for pain management.” Photo by Kevin Bain/Ole Miss Digital Imaging Services

The researchers discovered that medical-cannabis use increased from 1.6% to 2.4% between 2015 and 2019, while prescription-pain-reliever use decreased from 33.4% to 27%. Misuse of prescription pain relievers decreased from 4.7% to 3.7%, they found. Fourteen percent of medical-cannabis users have a serious mental illness according to the study, and 5.3% of cannabis users have a non-cannabis-related substance dependence.

When the study’s dataset started in 2015, 21 states had legalized marijuana in some form. By 2019, 32 states had legalized medical or recreational marijuana, not including Mississippi yet. As of April 2023, 38 states have legalized medical cannabis, including Mississippi, and 24 states have legalized recreational cannabis. Mississippi is one of 13 states that has a medical-cannabis program but not a recreational program. The Mississippi Legislature legalized medical cannabis in 2022 after the state Supreme Court struck down a medical cannabis program that voters adopted in a ballot initiative.

The study found that 15.1% of cannabis users lived in a state that did not have a medical-cannabis program from 2015 to 2019.

“The other thing that we really were not expecting to find when we started the study was how many medicinal-marijuana patients actually live in a state that did not allow for medicinal marijuana,” Ramachandran said. “More than anything else, it speaks to the unmet need for pain management.”

Ramachandran said many medical providers are more hesitant to prescribe opioids to patients, so people are finding other ways to manage their pain.

“There’s a lot of untreated pain in the United States, and when there is untreated pain, we believe patients are turning towards other options like medicinal marijuana,” he said.

The next study the UM researchers will publish examines whether medical cannabis could replace prescription pain relievers.

Mississippi To Research Medical Cannabis

Mississippi will establish a medical-cannabis research program at the University of Mississippi’s National Center for Cannabis Research and Education under a bill Gov. Tate Reeves signed into law on April 8.

The Mississippi Medical Cannabis Research Program will use federal, state and private funds to research the health effects and risks of using cannabis products in various forms such as smoking, vaping, ingesting, applying topically and combustion. Researchers will test medical cannabis from Mississippi cultivators on Mississippi medical-cannabis patients who volunteer for the program.

Sujith Ramachandran said he hopes to be able to work with the program.

The researcher said the demand for medical cannabis in states where it is illegal shows that states should legalize it to reflect citizens’ desires. States that have restrictive medical-cannabis programs, like Mississippi, need to expand their programs to reflect patients’ needs, he added.

“We know that medicinal marijuana has very limited or no side effects. And, in seeing the demand we are seeing based on this paper, maybe that is a good argument for state legislatures to expand programs like this one,” Ramachandran said.





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