A 2024 Augsburg Thesis Finds Cannabis May Complement Opioid Treatment
A 2024 thesis from Augsburg University examines whether cannabis could play a role in reducing opioid-related harm, while emphasizing that the evidence is not strong enough to establish cannabis as a replacement for proven treatments for opioid use disorder (OUD).
In Clark Furlong’s thesis, “The Efficacy of Cannabis as a Substitute Addiction for Opiates,” the author combined a review of existing research with a seven-question online survey of Augsburg students. The thesis concludes that cannabis may have some usefulness in the context of opioid maintenance and harm reduction, but it also calls for substantially more research before cannabis could be considered a viable treatment.
The literature reviewed in the thesis suggests that cannabinoids may affect opioid withdrawal, cravings, pain, and drug-taking behavior. Some observational studies and small experimental trials have reported that cannabis or THC may ease certain withdrawal symptoms. However, the findings are inconsistent, and the available studies differ widely in their methods, patient populations, opioid treatments, and cannabinoid doses.
A 2022 systematic review of human studies reached a similarly cautious conclusion: cannabis and THC showed preliminary potential for reducing opioid-withdrawal symptoms, but the apparent benefits appeared to have a narrow therapeutic window. Higher doses were also associated with adverse effects, including dysphoria, rapid heart rate, and indicators of abuse liability. The review noted that much of the evidence came from observational research rather than large, well-controlled clinical trials.
More recent evidence does not show that cannabis improves the core outcomes of medication treatment for OUD. A 2024 systematic review and meta-analysis of 10 longitudinal studies involving 8,367 people receiving methadone, buprenorphine, or naltrexone found no significant association between cannabis use and nonmedical opioid use. The researchers said the results neither demonstrated that cannabis reduces opioid use nor showed that it undermines treatment with medications for OUD.
That distinction is important. Cannabis may eventually prove useful as an adjunct for particular symptoms, such as pain or withdrawal, but the current evidence does not support presenting it as a substitute for established treatment. According to SAMHSA’s guidance on medications for OUD, methadone, buprenorphine, and naltrexone remain the FDA-approved medications used to treat the disorder. These medications help reduce cravings and withdrawal and can be used over the long term under medical supervision.
Furlong’s survey addressed students’ perceptions of cannabis rather than its clinical effectiveness. The thesis reports generally favorable views of cannabis as a possible alternative to opioids, including recognition that opioids carry greater risks. Respondents were also divided over cannabis’s effects on mental health, with many acknowledging that it can provide benefits for some people while worsening symptoms for others.
Those concerns are clinically relevant. Cannabis can affect mood, cognition, and anxiety, and some users can develop cannabis use disorder. A 2024 review estimated that cannabis use disorder occurs in a substantial minority of people using medicinal cannabis, particularly among people with certain mental-health or substance-use conditions. Any future clinical use of cannabinoids for OUD would therefore require careful screening, monitoring, and individualized treatment plans.
The Augsburg thesis adds to a research discussion that is worth pursuing, particularly around whether specific cannabinoids could help manage withdrawal or pain without increasing opioid-related risks. But its findings should be viewed as exploratory. A student survey and a literature review cannot demonstrate that cannabis treats OUD, prevents overdose, or improves recovery outcomes. Controlled clinical trials will be needed to determine whether cannabis has a safe and effective role alongside—not in place of—evidence-based medications for opioid use disorder.
