Medical Marijuana and Opioid Addiction

TABLE OF CONTENTS

Can medical marijuana help with opioid addiction? So far, research does not show that it does. NIH reports that in a 2017 review of studies that gave cannabinoids with opioids for pain, none of the three high-quality trials showed that cannabinoids led to less opioid use. Opioid addiction treatment belongs with your care team. Our post on marijuana and alcohol use disorder covers a different substance use question.

CDC data count 54,045 opioid-involved overdose deaths in 2024, down from 79,358 in 2023 and from 81,806 in 2022; the 2024 total is still about 1,000 people a week. From 2023 to 2024, the overdose death rate involving synthetic opioids other than methadone, mainly illegally made fentanyl, fell the most, by 35.6 percent, CDC reports.

Cannabis comes up so often in conversations about pain that people still ask whether it can help with opioid addiction. Marijuana has been called a “gateway” drug for decades, and some researchers, doctors and journalists believe it could be a gateway that leads away from harder drug use. The science is mixed, and the early hopeful findings have not held up. Medical marijuana and opioid addiction do have a connection, just not the one people immediately assume, and the research section below shows what studies of cannabis and opioids have found.

What Are Opioids?

Opioids are drugs that act on our nervous system in order to relieve pain.

Many opioids are legal prescription medicines. They include:

oxycodone
hydrocodone
codeine
morphine
fentanyl (which is 50 to 100 times more potent than morphine)

Heroin is a widely known illegal opioid.

How Do Opioids Work?

Opioids bind to opioid receptors in your brain and throughout your body.

Your Limbic System: The limbic system manages your emotions. When opioids affect the limbic system, you feel pleasure, relaxation, and contentment.
Your Brain Stem: Your brain stem controls automatic body functions such as your breathing. Opioids can slow down your breathing rate and suppress coughs.
Your Spinal Cord: By affecting your spinal cord, opioids reduce the pain signals sent to your brain.

What Are the Side Effects of Opioids?

Side effects can include:

drowsiness
dizziness
nausea
vomiting
constipation
sexual dysfunction
respiratory depression

Why Are Opioids Addictive?

Withdrawal

Your body produces its own natural opioids. With repeated use of opioid drugs, nerve cells adapt so they work normally only when the drug is present, NIDA explains.

The body adjusts to the outside supply.

That is why people can have severe withdrawal symptoms when they try to quit. Without the drug, the body needs time to recover, which causes withdrawal, MedlinePlus says.

Withdrawal symptoms include:

muscle pain
anxiety
excessive perspiration
insomnia
diarrhea
stomach cramps
nausea
vomiting
runny nose
dilated pupils

For some, these withdrawal symptoms are enough to drive people back to opioids.

Tolerance

Over time, opioids lose their power. A dose has less effect than it did when you first started taking them.

So you have to take higher doses to get the same effect. As you take more and more, you put yourself at greater risk of overdosing.

Non-Medical Use / Recreational Use

Opioids also cause pleasure, which is part of why they are misused. That’s part of their job: take away the pain and make you feel better.

The pleasure opioids cause is one reason they can become addictive. People might want to keep using them, even if they’re no longer feeling chronic pain.

That is how people end up using them in ways they were never meant to be used.

Some opioids, such as oxycodone, have an “extended release” function. This releases the drug slowly so it works over a long period of time.

Some people who misuse them crush the pills and snort the powder, or dissolve it and inject it into a vein, for an instant, powerful high. Users get a stronger high after doing this, but they’re also putting their lives in danger.

Why Are Opioid Overdoses So Dangerous?

Opioids affect your brain stem, which controls your breathing. If you overdose, you could stop breathing and die from asphyxiation. That risk goes up if you mix opioids with alcohol.

Some opioids can also disturb the heart’s rhythm: the methadone label warns of life-threatening QT prolongation and serious arrhythmia.

What Caused the Opioid Crisis?

CDC and NIDA, the federal agencies that track overdose deaths, publish the record of how the opioid epidemic grew.

Here are some key facts:

In the 1990s, the first wave of the opioid overdose epidemic began with increased prescribing of opioids, CDC says, and overdose deaths involving prescription opioids increased starting around 1999.
FDA’s criminal investigators reported that the Purdue Frederick Company trained its sales representatives to tell health care providers that OxyContin carried a lower risk of addiction than immediate-release opiates.
In 2012, prescribers wrote 82.5 opioid painkiller prescriptions for every 100 people in the United States, according to CDC.
Many people became dependent. In 2014, the opioid overdose death rate rose 14 percent from 2013, to 9.0 per 100,000 people, according to CDC.
The second wave began in 2010, with rapid increases in overdose deaths involving heroin, an illegal opioid, CDC says, and the third began in 2013 with synthetic opioids.
Heroin-involved overdose deaths rose from 3,036 in 2010 to 15,469 in 2016, then fell to 3,984 in 2023; by 2022, 80% of these deaths also involved illegally made fentanyl.
In 2007, the Purdue Frederick Company pleaded guilty to a felony count of misbranding OxyContin and agreed to pay more than $700 million to resolve criminal charges and civil liabilities, FDA reported, and three of its executives pleaded guilty to misdemeanor misbranding.
Federal and state governments now fund opioid prevention and treatment programs, and many people with chronic pain still look for other options.

That gap is why so many people ask about medical marijuana.

Medical Marijuana and Opioid Addiction: What the Research Shows

Reviews find a small benefit for chronic pain: in a 2018 review of 47 studies, 29% of people on cannabinoids had a 30% drop in pain, versus 26% on placebo. The crisis began with pain treatment: people wanted strong pain relief, and opioids were prescribed to give it. Cannabis is not a proven substitute for that.
Pain is where the two topics meet, but their risks are different. Cannabis has risks of its own: CDC estimates about 3 in 10 people who use it have cannabis use disorder, while opioids were involved in 79,358 overdose deaths in 2023.
The NIH summary does not mention opioid withdrawal, and in the high-quality pain trials it summarizes, cannabinoids did not lead to less opioid use.
A 2014 study found 24.8% lower opioid overdose death rates in states with medical marijuana laws from 1999 to 2010, but with data through 2017 the link reversed.

A federal rule effective April 28, 2026 put marijuana in FDA-approved products, or subject to a state medical marijuana license, in Schedule III; it is still a federally controlled substance, and wider rescheduling is still pending.

What This Means for Nevadans

Nevada’s drug overdose death rate was 35.9 per 100,000 people in 2024, age-adjusted, according to CDC.

If you’re a Nevadan struggling with opioid addiction or chronic pain, you’re not alone, and Nevada lists opioid dependence as a qualifying condition for its medical program.

Our team can answer questions about medical marijuana and chronic pain and how Nevada’s program works. Please give us a call during office hours.

If you want to ask about Nevada’s program, you can schedule an appointment. Nevada law requires the application to be signed by a Nevada-licensed provider of health care who is responsible for your care, and opioid addiction treatment should stay with your care team.

Last updated October 16, 2026 by the Dr. Green Relief Editorial Team.

Medical review

Medically reviewed by Achilles Kalnoky, M.D.

Reviewed on October 15, 2026.

He is licensed in Florida as a medical doctor, license ME115088, which you can check on the Florida Department of Health license lookup.

His review covers the medical statements in this post and the sources cited for them.

Medical Marijuana and Opioid Addiction

What Are Opioids?

How Do Opioids Work?

What Are the Side Effects of Opioids?