Marijuana Moment: Millions Of Americans Use CBD As A Substitute For Painkillers And Other Medications, Federally Funded Study Shows

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About one in three Americans who use CBD say they take it as an alternative or supplement to at least one medication—particularly painkillers—according to a new federally funded study.

Researchers at the University of California, San Diego set out to better understand cannabidiol use trends, analyzing nationally representative survey data for the study, which was partially funded by the National Institute on Drug Abuse (NIDA) and published in the journal Frontiers in Public Health.

Overall, about 35 percent of U.S. adults reported lifetime use of CBD, a non-intoxicating cannabinoid that’s grown in popularity since the federal legalization of hemp and its derivatives in 2018. The 1,008 CBD consumers who participated in the survey were asked about their frequency and methods of use, as well as whether they took the cannabis compound as a substitute or supplement to other traditional drugs.

Among lifetime CBD consumers, 32 percent uses it as a substitute or adjunct for at least one medication, with adjunct usage being more common.

“Millions of US adults use CBD as a substitute and adjunct for a wide range of health conditions.”

For those who reported taking cannabidiol for therapeutic purposes, the “conditions most frequently targeted” were musculoskeletal and connective tissue disorders such as joint pain (10.1 percent), psychiatric disorders such as anxiety (7.4 percent) and general disorders or administration site conditions (6.8 percent.

“Frequently replaced or co-administered medications included ibuprofen, Tylenol, and other over-the-counter analgesics,” the study authors said. “Only a small proportion of CBD ever users reported ever having a health problem they believed resulted from CBD use (2.4 percent).”

“CBD use as a substitute or adjunct to medications was common among US adults particularly for pain medications,” they said. “These patterns underscore the need for better evidence and clearer guidance on dosing, product quality, and co-use with other treatments.”

“A key finding is the widespread use of CBD in combination with prescription or over-the-counter medications, highlighting a potential for adverse drug–drug interactions,” the researchers noted.

However, while questions remain as to the risk-benefit analysis of concurrent use of CBD with different drugs, “it needs also to be acknowledged that commonly prescribed medicines, e.g., psychotropics for anxiety or opioids for pain, also have potentially severe adverse effects and risk for forming,” the study says.

“To the extent that CBD, which has very few side effects and likely very low risk of dependence at low to moderate doses, helps a consumer reduce anxiety and decrease or discontinue a medication with more side effects or risk for forming dependence, this might be viewed as a benefit,” it says.

Currently, the Food and Drug Administration (FDA) has only approved a synthetic CBD drug for the treatment of severe epilepsy, “which should not be interpreted as proof of no therapeutic potential for other endpoints, but rather as reflecting in part the difficulty of generating regulatory-grade evidence in a landscape where cannabis has long been federally controlled and clinical research has faced substantial structural barriers,” the authors said.

“Recent federal actions underscore this point,” they said, pointing out that, in December, President Donald Trump signed an executive order directing the federal reclassification of marijuana and laying out plans to incorporate CBD coverage under certain federal health insurance programs.

The order “explicitly framed the gap between widespread medical use and limited clinical evidence as leaving patients and clinicians without adequate guidance, and directed agencies to reduce barriers and expand medical marijuana and CBD research, which hopefully will allow for rigorous clinical evaluation of CBD and medical cannabis for promising endpoints,” the study says.

Meanwhile, although CBD was federally legalized during Trump’s first term under the 2018 Farm Bill, the availability of products could be jeopardized under separate legislation the president signed into law last year that included provisions that stakeholders say would effectively eradicate the cannabinoid market by severely restricting THC content.

CBD isolates wouldn’t necessarily be impacted by the law that takes effect in November, but it’s relatively rare to find CBD such trace amounts of THC so as to meet the new federal definition of legal hemp.

With respect to the latest cannabidiol study, it’s far from the only piece of research establishing that people are using marijuana and its constituents as an alternative to other drugs.

To that point, another recent federally funded study, published by the American Medical Association (AMA), added more evidence that marijuana can serve as an effective substitute for opioids in chronic pain treatment.

Other AMA-published research has found that legalizing marijuana for medical or recreational purposes is “significantly associated with reduced opioid use among patients diagnosed with cancer.”

A separate paper published in October similarly found that medical marijuana legalization is “associated with significant reductions in opioid prescribing.”

In August, meanwhile, Australian researchers published a study showing that marijuana can serve as an effective substitute for opioids in pain management treatment.

Another study published earlier this year in the journal Drug and Alcohol Review found that, among drug users who experience chronic pain, daily cannabis use was linked to a higher likelihood of quitting the use of opioids—especially among men.

Research published late last year also found that legalizing medical cannabis appeared to significantly reduce monetary payments from opioid manufacturers to doctors who specialize in pain, with authors finding “evidence that this decrease is due to medical marijuana becoming available as a substitute” for prescription painkillers.

Other recent research also showed a decline in fatal opioid overdoses in jurisdictions where marijuana was legalized for adults. That study found a “consistent negative relationship” between legalization and fatal overdoses, with more significant effects in states that legalized cannabis earlier in the opioid crisis. Authors estimated that recreational marijuana legalization “is associated with a decrease of approximately 3.5 deaths per 100,000 individuals.”

“Our findings suggest that broadening recreational marijuana access could help address the opioid epidemic,” that report said. “Previous research largely indicates that marijuana (primarily for medical use) can reduce opioid prescriptions, and we find it may also successfully reduce overdose deaths.”

Another recently published report into prescription opioid use in Utah following the state’s legalization of medical marijuana found that the availability of legal cannabis both reduced opioid use by patients with chronic pain and helped drive down prescription overdose deaths statewide. Overall, results of the study indicated that “cannabis has a substantial role to play in pain management and the reduction of opioid use,” it said.

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