Cannabis as a substitute for prescription drugs – a cross-sectional study



The use of medical cannabis is increasing, most commonly for pain, anxiety and depression. Emerging data suggest that use and abuse of prescription drugs may be decreasing in states where medical cannabis is legal. The aim of this study was to survey cannabis users to determine whether they had intentionally substituted cannabis for prescription drugs.


A total of 2,774 individuals were a self-selected convenience sample who reported having used cannabis at least once in the previous 90 days. Subjects were surveyed via an online anonymous questionnaire on cannabis substitution effects. Participants were recruited through social media and cannabis dispensaries in Washington State.


A total of 1,248 (46%) respondents reported using cannabis as a substitute for prescription drugs. The most common classes of drugs substituted were narcotics/opioids (35.8%), anxiolytics/benzodiazepines (13.6%) and antidepressants (12.7%). A total of 2,473 substitutions were reported or approximately two drug substitutions per affirmative respondent. The odds of reporting substituting were 4.59 (95% confidence interval [CI], 3.87-5.43) greater among medical cannabis users compared with non-medical users and 1.66 (95% CI, 1.27-2.16) greater among those reporting use for managing the comorbidities of pain, anxiety and depression. A slightly higher percentage of those who reported substituting resided in states where medical cannabis was legal at the time of the survey (47% vs. 45%, p=0.58), but this difference was not statistically significant.


These patient-reported outcomes support prior research that individuals are using cannabis as a substitute for prescription drugs, particularly, narcotics/opioids, and independent of whether they identify themselves as medical or non-medical users. This is especially true if they suffer from pain, anxiety and depression. Additionally, this study suggests that state laws allowing access to, and use of, medical cannabis may not be influencing individual decision-making in this area.

Authors: Coroon JM, Mischley LK, Sexton M

Clinical Trials, Studies and Publications (click to access):

Journal of Pain Research 2017:10 989-998

Medical Cannabis Decreases Use of Pharmaceutical Agents for Pain, Anxiety and Sleep


A prior epidemiological study identified a reduction in opioid overdose deaths in US states that legalized medical cannabis (MC). One theory to explain this phenomenon is a potential substitution effect of MC for opioids. This study evaluated whether this substitution effect of MC for opioids also applies to other psychoactive medications. New England dispensary members ( n = 1,513) completed an online survey about their medical history and MC experiences. Among respondents that regularly used opioids, over three-quarters (76.7%) indicated that they reduced their use since they started MC. This was significantly ( p < 0.0001) greater than the patients that reduced their use of antidepressants (37.6%) or alcohol (42.0%). Approximately two-thirds of patients decreased their use of anti-anxiety (71.8%), migraine (66.7%), and sleep (65.2%) medications following MC which significantly ( p < 0.0001) exceeded the reduction in antidepressants or alcohol use. The patient’s spouse, family, and other friends were more likely to know about their MC use than was their primary care provider. In conclusion, a majority of patients reported using less opioids as well as fewer medications to treat anxiety, migraines, and sleep after initiating MC. A smaller portion used less antidepressants or alcohol. Additional research is needed to corroborate these self-reported, retrospective, cross-sectional findings using other data sources.

Clinical Trials, Studies and Publications (click to access):

Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep.

Authors: BJ Piper, RM DeKeuster, ML Beals, CM Cobb, CA Burchman, L Perkinson, ST Lynn, SD Nichols, AT Abess

J Psycopharmacology 2017 Mar 1 (Epub ahead of print)

Cannabis and Cannabinoids (PDQ®) National Cancer Institute – Questions and Answers About Cannabis

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Combating Anxiety with Marijuana

Stress Meter Showing  Panic Attack From Stress Or WorryAnxiety disorders are quickly becoming one of the largest causes of disability in the United States. Disorders like generalized anxiety disorder, obsessive compulsive disorder and panic disorders afflict as many as 15 million Americans. New treatments and medications hit the market every day for these disorders, but many of these medications and treatments can have severe and adverse side effects. Marijuana therapy has been proven to help a large number of those with anxiety disorders and those numbers continue to grow as the effectiveness of medicinal marijuana is recognized.

What Are Anxiety Disorders?

Anxiety disorder is a generalized term that is used to encompass a large range of specific diagnoses. Commonly diagnosed anxiety disorders include panic disorders, post traumatic stress disorder, social anxiety disorder, obsessive compulsive disorder and generalized anxiety disorder. The initial symptoms of any of these conditions are largely the same. Those suffering from these disorders will suffer extreme tension and worry, frequently when there is no reason for serious concern. They may suffer from sleep disturbances, depression, irritability and restlessness. In addition, physical symptoms like gastrointestinal upset and muscle tension are frequently found. Those who suffer from these disorders may have highs and lows, but their symptoms will adversely affect their activities of daily living for a long period of time.

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Traditional Treatments v. Alternative Treatments

Most anxiety disorders are treated with a combination of therapy and medications. While therapy is a necessary part of any mental health treatment program, the prescription drugs given can sometimes cause more harm than good. The most commonly reported side effects of anxiety medications are headaches, nausea, and difficulty sleeping. These medications need to be adjusted and changed frequently and long term use can cause dependence. In addition, antidepressants, which are sometimes used to treat these conditions, have an increased risk of suicide. Medicinal marijuana use has none of these side effects. Medicinal marijuana is not physically addictive nor has it ever been related to a drug overdose. There are very few side effects of marijuana and it is a medication that can be used as needed, rather than on a consistent scheduled basis. This helps decrease the likelihood of dependence on marijuana for anxiety disorders.

Marijuana Offers a Safe Alternative for Those with Anxiety

Marijuana use can help with mood elevation and relaxation for those who suffer from anxiety, either on a long or short term basis. Marijuana has proven to be a less toxic, less addicting and more effective treatment for a large range of mental disorders. Alternative treatments like medicinal marijuana therapy are gaining ground as patients become frustrated with the side effects and long term need for prescription medications.

Nervousness and Anxiety

Picture2Nervousness and anxiety are often interchangeable as they both display the same sort of symptoms. Most everyone will experience some nervousness or anxiety in their life. It could be due to a public speaking event or trying something new. This is considered normal if the person no longer feels anxiety or nervousness afterwards. However for those who experience nervousness or anxiety on a daily basis may need medical treatment to help alleviate these feelings. Those who have an ongoing medical issue with nervousness and anxiety will note that there is not a specific daily event or idea that sets off these feelings. Instead, anxiety and nervousness becomes their new normal feeling in their day-to-day life.

Symptoms of nervousness and anxiety are broad. They can manifest both mentally and physically. Mentally one may feel a sense of dread, fear, trouble concentrating, worries of dying, irritability, nightmares and depression. Physically one may have trouble with sleep, nausea, headaches, sweating, tense muscles, chest pains, stomach aches, blood pressure and heart rate. Some may even experience panic attacks in which the person feels that they are going to die or lose consciousness.

Many patients suffering from anxiety and nervousness have been treated with over-the-counter medication and therapy. Many doctors are now seeing the bad side effects of these treatments. Many are highly addictive and even worse, some do not make the patient’s condition better. Instead the patient continues to experience anxiety which will over time break down the body. Instead of getting better, patients are becoming worse and needing to take even more medication. This can lead to a quick downward spiral.

Recent studies have shown that supervised medical marijuana treatment is promising in helping those who suffer anxiety or nervousness. Marijuana has been shown to elevate moods and positive outlook among patients. This leads to patients becoming more involved in their recovery and becoming more engaged with life. Together with a therapy program, the patient can feel relief from anxiety and nervousness. Marijuana is a natural plant with little side effects, it is not toxic to the body and is not addictive.