Cannabis Use Was Linked to Lower Stimulant Use in a Vancouver Study

A 2023 study of people who use unregulated drugs in Vancouver found that many participants used cannabis to manage stimulant cravings—and most of those participants said they subsequently used fewer stimulants. The findings point to cannabis as a harm-reduction strategy for some people, but they do not establish that cannabis itself caused the reduction.

The study, published in Addictive Behaviors, was a secondary analysis of cross-sectional questionnaire data from three Vancouver research cohorts: the At-Risk Youth Study, the Vancouver Injection Drug Users Study and the AIDS Care Cohort to Evaluate Exposure to Survival Services.

The researchers examined 297 participants who reported using both cannabis and unregulated stimulants during the previous six months. Participants were asked whether they used cannabis to manage stimulant cravings and whether their stimulant use changed during periods when they used cannabis. The researchers then used logistic regression models to assess the relationship between the two measures.

Nearly half of the participants—134 people, or 45.1%—said they used cannabis to manage stimulant cravings. Of those, 104 people, or 77.6%, reported reducing their stimulant use during periods of cannabis use. In the adjusted analysis, cannabis use to manage cravings was associated with self-reported reductions in stimulant use.

The association was strongest among participants who used crystal methamphetamine daily. It was not statistically significant among people who used crack or cocaine daily. That difference suggests that the relationship may vary by substance, pattern of use or individual circumstances.

However, the study was observational and cross-sectional. It relied on participants’ self-reports and measured cannabis use and perceived changes in stimulant use at the same point in time. As a result, it cannot determine whether cannabis reduced cravings or stimulant use. People who chose cannabis as a coping strategy may also have differed from other participants in ways the study did not capture, such as motivation to reduce use, access to services or changes in their drug supply.

The authors described cannabis use to manage stimulant cravings as a common harm-reduction practice and said the results support further investigation. The findings do not show that cannabis is an established treatment for stimulant use disorder, nor that it is appropriate or safe for everyone.

That caution is important because cannabis also carries risks. The Centers for Disease Control and Prevention summarizes potential cannabis-related health effects, including impairment, cardiovascular effects, mental-health concerns and the risk of developing cannabis use disorder. Using cannabis with other substances can also increase impairment and create additional risks.

There are currently no FDA-approved medications specifically for stimulant use disorders, although behavioral approaches—including contingency management—are used in treatment and researchers are studying additional options. The National Institute on Drug Abuse provides information on current treatment approaches.

The Vancouver study therefore offers a useful observation rather than a clinical recommendation. For some people who use stimulants, cannabis may function as a substitute or a way to manage cravings. Determining whether it can reliably reduce stimulant use—and understanding its risks, benefits and effects over time—will require prospective studies and controlled clinical research.