A Finnish Survey Found Broader Self-Reported Benefits With Medical Cannabis Than Opioids for Chronic Pain
A 2023 Finnish study found that patients using medical cannabis and those using opioids reported similar reductions in pain intensity. However, medical-cannabis users more often described improvements in mood, relaxation, sleep, daily functioning and overall well-being.
The findings come from the original study published in the Journal of Cannabis Research by researchers affiliated with Åbo Akademi University and other Finnish institutions. The researchers were investigating whether cannabis affects pain in ways that extend beyond simply making it feel less intense.
Rather than testing the treatments in a randomized clinical trial, the researchers conducted a retrospective internet survey of 201 Finnish adults with chronic pain. Forty participants evaluated their experiences with medical cannabis, while 161 evaluated their experiences with opioids. Eighteen people in the medical-cannabis group also reported using opioids, and seven people in the opioid group reported using medical cannabis.
Participants rated statements about the perceived effects of their medication, including whether it reduced pain, improved mood, helped them relax, supported everyday activities, improved sleep or enabled them to experience pain without reacting to it as strongly. The researchers used propensity-score matching to create more comparable groups; the main comparison included 39 medical-cannabis users and 39 opioid users.
The analysis identified three broad categories of experience: negative side effects, positive holistic effects and positive emotional effects. Medical-cannabis users scored higher than opioid users on both positive categories. The groups did not differ significantly in their overall ratings of negative side effects.
Both groups also rated their medication as similarly effective at reducing pain intensity. The study therefore did not show that cannabis was a stronger painkiller than opioids. Instead, it suggested that patients perceived medical cannabis as affecting a wider range of pain-related experiences, including emotional state, functionality and quality of life.
In exploratory analyses of individual questions, medical-cannabis users more frequently reported relaxation, better sleep, improved mood, a greater sense of control and an ability to feel pain without reacting to it. The study also examined psychoactive effects as a possible part of cannabis’s perceived therapeutic value. In this context, the authors used the term to describe changes in consciousness or subjective experience—not necessarily confusion or a loss of cognitive control.
Those observations should not be interpreted as evidence that cannabis improves memory or concentration in general. They were self-reported responses from a small, nonrandomized sample, and the individual-item analyses were exploratory. The study also did not establish that cannabis caused the reported benefits, prove that it is safer than opioids, or determine whether the results apply to patients with different diagnoses, cannabis products or treatment patterns.
The design has other important limitations. Participants selected which medication to evaluate, the groups were substantially different in size before matching, and medical-cannabis users were less likely than opioid users to have an active prescription. Differences in treatment access, prior experience, expectations, illness severity and other unmeasured factors could have influenced the results.
Broader evidence remains mixed. The National Center for Complementary and Integrative Health describes the evidence for cannabis and cannabinoids in chronic pain as suggesting modest benefits, while also noting frequent side effects and limited information about long-term use. The International Association for the Study of Pain has said that high-quality evidence is still insufficient to endorse the general use of cannabis or cannabinoids for pain.
Opioids also require individualized risk–benefit assessment. In its 2022 clinical practice guideline, the U.S. Centers for Disease Control and Prevention says nonopioid therapies are generally preferred for subacute and chronic pain, while emphasizing that treatment decisions should be patient-centered and should not involve abrupt discontinuation of established opioid therapy.
The Finnish study’s main contribution is its focus on pain as more than a numerical intensity score. Sleep, mood, function and the ability to cope with pain are meaningful treatment outcomes, but larger prospective studies and randomized trials are needed to determine whether medical cannabis produces these effects, which patients might benefit, and how its benefits and risks compare with established pain treatments.
