Despite growing awareness, opioid use disorder (OUD) remains a problem in the United States. As people continue to seek solutions, novel approaches are emerging, such as the use of cannabis. Although not without risks, cannabis is generally deemed safer than opioids and is thought to help reduce cravings for those trying to stop opioid use.
While marijuana is being explored as a possible complement to traditional treatment plans—or even a full-blown alternative—it is not a perfect solution. Whether you are considering turning to cannabis as an OUD treatment or already receiving treatment and wondering if recreational marijuana use may be harmful, it's important to do your research.
Below, we explain everything you need to know about marijuana and OUD treatment.
Effects of marijuana during OUD treatment
Medications for addiction treatment (MAT) remain the gold standard of care for OUD treatment. With MAT, patients are prescribed medication to help reduce opioid cravings and withdrawal symptoms.
Suboxone®, a combination medication made up of buprenorphine and naloxone, is commonly used in MAT (important safety information). The buprenorphine reduces withdrawal symptoms and cravings, while the naloxone blocks the action of opioids at the brain's opioid receptors.
So, can you take marijuana—or cannabis products of any kind—and Suboxone safely together? Marijuana and Suboxone are both psychoactive substances with a depressive effect on the central nervous system (CNS). As a result, using cannabis while taking Suboxone can increase the impact these substances have on the body, resulting in slowed breathing, coma, and even potential death.
Despite these risks, research suggests that marijuana can be a useful component of a comprehensive OUD treatment plan, helping curb opioid cravings, reduce anxiety and stress, and minimize withdrawal symptoms, like insomnia or loss of appetite.
One study showed that medical cannabis patients reported improved health and reductions in opiate use. Another showed that cannabis helped people manage opioid cravings during a drug toxicity crisis. Informal online OUD treatment forums also show reports of people finding relief from OUD cravings through marijuana or cannabis products.
Given the potential benefits, it appears possible that cannabis can help some patients in OUD treatment. Experts suggest that making total sobriety a requirement of OUD treatment, a condition of some programs, may be detrimental. To avoid the risk of negative repercussions, some states have categorized OUD as a qualifying condition for medical marijuana use.
Overall, the evidence suggests that cannabis use doesn't seem to undermine OUD treatment, and that marijuana is safe during OUD treatment when used in moderation. The issue is that "moderation" looks different for different people. Problematic use may still pose risks, and the "California Sober" trend isn't for everybody. Every patient is different, and care plans need to be formulated to each person's specific needs.
The rise of "California sober"
In recent years, the "California sober" approach to sobriety has become increasingly popular. When a person goes “California sober,” they abstain from hard drugs—like opioids—but still consume other substances, notably marijuana. The approach gained widespread attention in early 2021 when singer Demi Lovato used the phrase to describe their recovery from a 2018 overdose.
While this approach can be a harm reduction method for some, critics suggest it's a risky approach to sobriety and may be a slippery slope to relapse. By the end of 2021, Lovato acknowledged that the California sober lifestyle played a role in a later relapse. Further, a two-decade-long study showed that there is actually no evidence to suggest that cannabis use reduces long-term opioid use. Nonetheless, some mental health professionals view cannabis as a potentially useful component of successful OUD treatment and as an alternative to traditional addiction rehab programs.
While marijuana may be less immediately damaging than hard drugs, it can also come with negative consequences that shouldn't be dismissed. Potential side effects of marijuana use include:
- Short-term memory loss
- Problems concentration
- Temporary impairment of judgment
- Temporarily impaired motor skills
- Short-term psychosis or paranoia
- Sleep problems
- Potential lung damage when smoking marijuana, especially with long-term use
Keep in mind that marijuana is still an illegal substance at the federal level and regulated as a Schedule I controlled substance. While some states have measures to decriminalize the drug or allow it for medical or recreational purposes, others have not. Marijuana may show up in urine analysis (UA) testing, which can be a problem for individuals who must undergo mandated testing in court or at a workplace.
Finally, although it may be helpful to some people, cannabis cannot fully replace a comprehensive OUD treatment. If anything, it may serve as a supplemental aid to more established routes. As more information becomes available, it's important to continue rethinking how we approach OUD treatment.
Comprehensive OUD treatment with Ophelia
Most experts still recognize MAT as the gold standard of care for OUD treatment, as it offers a holistic approach encompassing body and mind. While Suboxone and other buprenorphine medications address the physical side of addiction, mental health support can be a valuable supplement.
Ophelia makes OUD treatment accessible online, providing MAT via telemedicine. If your care team feels that Suboxone is the right treatment for you, they’ll call a prescription into your local pharmacy and set up an online appointment schedule. The virtual sessions allow for more privacy and remove geographic barriers to care, so you can get the support you need in any of the states we serve.
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