Opioids, like fentanyl, morphine, and oxycodone, are commonly taken to treat pain. But, opioids can be addictive and lead to a fatal overdose when taken in toxic amounts or combined with other substances such as alcohol, cocaine and methamphetamines.
Between 2018 and 2020, construction workers accounted for 1 in 13 opioid toxicity deaths. Unregulated opioids (mainly fentanyl) and unregulated stimulants (cocaine and methamphetamines) directly contributed to the majority of these. Alcohol also contributed to 1 in 5 opioid toxicity deaths among construction workers.
Given the risk of opioid toxicity, a common goal for many people is to lower the amount they take or eliminate them altogether. This goal can be difficult to achieve due to ongoing chronic pain, work and life demands, and symptoms of opioid withdrawal. Support and ongoing follow-up with a medical provider can help.
What is opioid withdrawal?
Opioid withdrawal can happen when a person whose body is physiologically dependent on opioids slowly or suddenly lowers the amount taken leading to uncomfortable or distressing symptoms. Without an alternative treatment, this may lead to relapse – returning to opioids to find relief.
What are the symptoms of opioid withdrawal?
Symptoms of opioid withdrawal can include:
· Drug craving
· Nausea and vomiting
· Increased heart rate
How to manage opioid withdrawal?
Rather than managing withdrawal alone, appropriate clinical management of opioid withdrawal with a medical professional is important to prevent overdose and relapse. The goal of medical withdrawal management includes relieving sufferings associated with withdrawal, providing appropriate diagnosis and screening, engaging in Opioid Use Disorder treatment and using harm reduction strategies. Medically supervised withdrawal, or detoxification, involves giving medications such as methadone or suboxone to manage the side effects of stopping opioids. Transitioning to follow-up treatment is important to prevent relapse and returning to opioids.
Can cannabis help to manage opioid withdrawal?
Cannabis is commonly used to treat pain, anxiety, nausea and insomnia. Unlike opioids, it does not depress respiratory function and there have been no documented cases of death due to overdose. As part of harm reduction strategy, cannabis may help in three ways:
1. Cannabis has the potential to prevent opioid misuse as an analgesic alternative
2. Cannabis may alleviate opioid withdrawal symptoms
3. Cannabis may decrease the likelihood of relapse or returning to opioids
A 2021 Ontario study with a group of 2315 individuals receiving pharmacological treatment for Opioid Use Disorder found that taking cannabis daily in the past month was associated with lower odds of opioid use compared to occasional use. Further research is needed to understand the impact of cannabis and cannabis use patterns on opioid withdrawal and opioid use disorder treatment to inform tailored recommendations.
For more information and resources contact your primary care provider or your local helpline. In Ontario call Connex Ontario at 1-866-531-2600.
How should I take cannabis to help manage opioid withdrawal?
Book an appointment with a medical cannabis prescriber for personalized recommendations.