Can we use medical cannabis in patients with alcohol or drug addiction?
Kevin P. Hill, MD: Can we use cannabis in patients that have substance use disorders, like alcohol addiction, other drug addiction? I would be very leery of doing that. I think you should be very cautious.
For example, in Massachusetts, where I am from, there are some physicians who talk about using cannabis as an exit drug for those who have opioid use disorder. There is a growing body of evidence to suggest that in the states that have medical cannabis policies, for example, there are fewer opioid overdoses. I think those are data that we cannot ignore; however, I think there is a big difference between a patient who has chronic pain and is prescribed opioids—that is a patient that I would consider for medical cannabis. I would be very cautious about using cannabis for patients who have other substance use disorders, particularly opioid use disorder, because we have treatments that are effective for opioid use disorder. I would certainly suggest that physicians consider evidence-based treatment always.
When you are using a substance that is potentially high risk—you could develop addiction potentially with cannabis—and there are other treatments that are available for alcohol use disorder and opioid use disorder, I would recommend that physicians stick to evidence-based treatments.