Utah Patient Data Link Medical Cannabis Use With Lower Opioid Prescribing
A preliminary Utah analysis found that most chronic-pain patients in a small observational cohort received fewer opioid prescriptions after beginning medical cannabis. The findings suggest a possible opioid-sparing effect, but they do not establish that cannabis access caused the reduction or that medical cannabis lowered overdose deaths statewide.
The 2024 report from Management Science Associates (MSA) examined 186 patients whose medical records were linked with cannabis purchase data from a Utah dispensary. Researchers compared opioid prescriptions before and after each patient’s first recorded cannabis purchase, converting different medications into morphine milligram equivalents (MME) per month.
Across the cohort, 157 patients—84.4%—had a decrease in monthly opioid use after starting cannabis. The report calculated that mean monthly MME fell from 3,832 before the first purchase to 1,798 afterward, a reduction of 53.1%.
What the study examined
The patients ranged in age from 23 to 89, with a mean age of 49. About 54% were women and 45% were men; 87% of participants were identified as White. Chronic musculoskeletal pain was the most common diagnosis, affecting about 57% of the cohort, followed by chronic visceral pain at 19% and chronic headache or orofacial pain at 13%. Many patients had more than one type of pain, and the study included no cancer patients taking opioids.
The analysis used cannabis transaction records from Dragonfly Wellness medical cannabis dispensaries and linked them to electronic health records through an MSA de-identification system. Most participants used vape products, gummies or flower, while products with a THC-to-CBD ratio of 1:0 were the most commonly recorded.
Results varied by pain category. Patients with neuropathic pain showed the largest reported reduction in opioid MME—73.5%—while patients with chronic primary pain showed a reduction of about 68%. By contrast, the headache and orofacial-pain group recorded a 20.6% increase in opioid MME after cannabis use began. The report says that finding requires further study rather than supporting a conclusion about cannabis’s effectiveness for headaches.
An association, not proof of cause
The headline reduction should be interpreted cautiously. This was a retrospective, self-controlled cohort study, not a randomized clinical trial. It relied on data from a single dispensary, included a relatively small and demographically narrow group, and had no separate control group of comparable patients who did not begin using cannabis.
Patients may have changed their opioid use for reasons unrelated to cannabis, including changes in pain severity, treatment plans, prescribing practices, access to care or personal decisions. The report’s adjusted linear mixed-effects model estimated a decrease of about 343 MME per month, but the result was reported as marginally significant, with a p-value of 0.077. That falls short of the conventional threshold commonly used to identify statistical significance.
For those reasons, the findings show a pattern that is consistent with reduced opioid prescribing after cannabis initiation, but they cannot demonstrate that cannabis caused the change. Nor can the study show that medical cannabis reduced opioid dependence, prevented overdose or produced a statewide decline in opioid-related deaths.
Utah’s official overdose dashboard tracks opioid prescribing, MME and overdose fatalities separately. Those statewide trends cannot be attributed to the MSA patient-level analysis without a broader study that accounts for other changes over time.
How the findings fit the broader evidence
Research on cannabis and chronic pain remains mixed. The National Academies of Sciences, Engineering, and Medicine concluded in 2017 that there was substantial evidence that cannabis or cannabinoids can help treat chronic pain in adults, while also noting important gaps involving dosage, product types, delivery methods and long-term effects.
More recent public-health guidance is more cautious about translating pain findings into opioid or overdose conclusions. The Centers for Disease Control and Prevention says evidence remains limited for many forms of chronic pain and notes that studies of cannabis laws and opioid-related deaths have produced conflicting results. The agency also warns that cannabis use—alone or alongside opioids—may be associated with risks including misuse and sedation.
Utah’s medical cannabis program provides regulated access for eligible patients, but the MSA report does not establish which patients are most likely to benefit, what doses are appropriate or whether particular THC-CBD combinations are safer or more effective. Larger, more diverse studies with control groups and longer follow-up will be needed to determine whether cannabis can reliably reduce opioid use while maintaining or improving pain control.
For now, the Utah analysis is best understood as preliminary real-world evidence of an association—not as proof that medical cannabis is a universally effective or safer substitute for opioid treatment. Patients should not change or stop opioid therapy without guidance from a qualified medical professional. Information about Utah’s program and patient requirements is available from the state’s Center for Medical Cannabis.
