(Part 3) Practical Strategies for Using Medical Cannabis to Reduce Harms Associated With Long-Term Opioid Use

If you are someone using high doses of opioids and not getting adequate pain relief, or you're experiencing unwanted side effects, speaking to your health care provider about a trial of medical cannabis may be an option. Medical cannabis is not right for everyone, just as other medications may not be right for everyone.

In the last two posts of this blog series we discussed the issues of treating chronic pain with opioids, and how cannabis may be a useful tool to improve pain control while reducing the dose of opioids being used (Find part 1 & 2 here). The third-part of this blog series will cover what to consider when considering if medical cannabis may be right for you.  

It is very important that medical cannabis use is guided by a qualified healthcare professional. If you are someone using high doses of opioids and not getting adequate pain relief, or you're experiencing unwanted side effects, speaking to your health care provider about a trial of medical cannabis may be an option. Patients should not attempt this on their own as it could lead to serious side effects.

Medical cannabis is not right for everyone, just as other medications may not be right for everyone. Your healthcare provider should do a thorough screening to make sure it is safe to use medical cannabis. If you begin medical cannabis, the general approach to make sure patients stay safe is to start at very low doses, and slowly increase by small amounts every few days. The goal is not to experience euphoria or being "high." Instead, the optimal dose is the dose where you get the most amount of symptom control without side effects. Cannabidiol (CBD) should be tried first before THC as it has less side effects.

What this might mean for you:

1. Medical cannabis may be a tool that can help improve pain relief and reduce the dose of opioids needed.

2. You should always seek the guidance of a qualified healthcare provider if they are interested in medical cannabis.

Dr. Caroline MacCallum is a specialist in internal medicine with expertise in complex pain and cannabinoid medicine. In addition to serving as an advisor to EO Care, she is a clinical instructor in the Department of Medicine; Adjunct Professor in the Faculty of Pharmaceutical Sciences program; and associate member of the Dept. of Palliative Care at the University of British Columbia. An avid researcher, Dr. MacCallum is primary author of Primary Considerations for Medical Cannabis Administration and Dosing, and assistant for Cannabinoids and Pain.

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