Frequent cannabis users enrolled in a Medication-Assisted Treatment for opioid addiction exhibit greater associations between pain and negative affects (anxiety and depression) compared with less-frequent users, according to findings from a study published in Addictive Behaviors.

Investigators sought to determine whether frequency of cannabis use had an effect on the relationship between pain and depression and/or anxiety in 150 participants treated for opioid use disorder with Medication-Assisted Treatment. The most frequent mental health diagnoses in the patient cohort were major depression (36.7%), bipolar disease (20.0%), and generalized anxiety (17.3%).

Levels of anxiety, depression, and pain were similar in study participants who had used cannabis in the last month and in nonusers. A positive relationship between depression and pain intensity was established in individuals reporting cannabis use for a period of 1 to 2 days (P =.01; 95% CI, 0.04-0.28), 20 to 29 days (P <.001; 95% CI, 0.24-0.60), and 30 days (P <.001; 95% CI, 0.26-0.70) in the last month.

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The frequency of cannabis use was found to moderate the relationship between anxiety and pain intensity in participants using cannabis in the last month for 1 to 2 days (P =.003; 95% CI, 0.11-0.35), 20 to 29 days (P <.001; 95% CI, 0.28-0.66), and 30 days (P <.001; 95% CI, 0.29-0.76). The relationship between anxiety and pain intensity was found to increase with the frequency of cannabis use.

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Because this cross-sectional study relied on self-reported data for cannabis use frequency, the investigators note it does not establish a causal relationship between the frequency of cannabis use and the association between pain and negative affect.

This study shows that frequent cannabis use among patients receiving Medication-Assisted Treatment “may be interfering with patients’ ability to disentangle symptoms of pain and emotional distress,” underscoring “an important discrepancy between patients’ positive beliefs about the role of cannabis in symptom management and the more complicated detrimental influence cannabis may have on symptom entanglement.”


Wilson M, Gogulski HY, Cuttler C, et al. Cannabis use moderates the relationship between pain and negative affect in adults with opioid use disorder. Addict Behav 2017;77:225-231.

This article originally appeared on Clinical Pain Advisor