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Screening Patients at Community Pharmacies for Cannabis and Opioid Co-Use May Provide Useful Health Risk Information

September 1, 2021
Meg Brunner, MLIS
Bryan MA, et al. Concomitant cannabis misuse and associations with depression, pain and substance misuse among patients prescribed opioids. Pharmacy 2021;9:134.
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Addiction Science Made Easy
for September 2021

CTN Dissemination Library


About 10% of people with pain who are prescribed opioids also use cannabis, and there is substantial evidence to suggest that medicinal cannabis is effective in treating chronic pain in adults. However, frequent non-medical cannabis and opioid co-use may put people at higher risk of problems like substance misuse, anxiety, and depression.

Considering how common this co-use is, it might be helpful to screen and engage with patients when they fill their opioid prescriptions at their community pharmacies. Before a useful intervention can be developed, though, researchers first need to identify the risks associated with non-medical cannabis use among such patients.

ConsultationThis study used data from NIDA Clinical Trials Network study CTN-0093 (Validation of a Community Pharmacy-Based Prescription Drug Monitoring Program Risk Screening Tool) to look at the relationship between non-medical cannabis use and depressive symptoms, pain, overdose, and other substance misuse among people receiving their opioid medications at a community pharmacy.

The data revealed that patients reporting moderate- to high-risk compared to low-risk cannabis use were more likely to report depressive symptoms, history of overdose, and moderate- to high-risk use of alcohol, opioids, sedatives, stimulants, and tobacco.

These findings suggest that cannabis misuse among patients receiving opioids may increase risk for mental health issues, substance use disorder, and overdose.

Conclusions: Cannabis use may be an important health behavior to screen for and target as an indicator of increased health risks. Community pharmacies could be a promising point for such screening and related interventions. Next steps for this research may include replicating these findings in a more diverse sample with additional information on cannabis type (i.e., medicinal versus recreational), operationalizing cannabis use screening, and developing clinical support tools to guide referral and intervention in community pharmacies.

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