What topics does this cannabis study cover?

This study covers research on: Pain, Addiction.

Ten-year observational study links cannabis with lower opioid use

Q: Where was this research published?

Published in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society on September 14, 2026.

Ten-year outcomes of medical cannabis for chronic low back pain: opioid reduction, pain relief, and functional improvement in 1,000 patients.

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society • September 14, 2026 • Highly Relevant

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AI Summary

This single-center longitudinal observational study asked whether medical cannabis therapy was associated with changes in opioid use, pain, disability, and medication use among 1,000 cannabis-naive adults with chronic low back pain. Participants were followed for 10 years, with 638 patients (63.8%) completing follow-up. The primary outcome was daily opioid exposure, measured in morphine milligram equivalents. Among completers, opioid use fell by 89.8%, while pain intensity fell by 84.2% and disability scores improved by 16.1 points. These changes exceeded the study’s pre-specified thresholds for clinically meaningful improvement for most participants: 91.2% for opioid reduction, 96.6% for pain, and 62.1% for disability.

The study also reported reductions in several concomitant medications, including tramadol or tapentadol, benzodiazepines, SSRIs, and gabapentinoids. Tolerability adverse events occurred in 11.4% of visits, while serious psychiatric events were reported in 0.02%. However, this was an uncontrolled observational study, so the results show associations rather than proof that cannabis caused the improvements. The authors note that the effects were much larger than those seen in randomized-trial benchmarks and that observational biases may contribute. This abstract-based summary cannot establish medical cannabis efficacy, identify which cannabis products or components were responsible, or determine how the findings would compare with alternative treatments.

💡 Key Findings

Among 638 patients who completed follow-up, daily opioid exposure fell by 89.8% over 10 years during medical cannabis therapy; this was an observational association, not proof of causation.

Good

75%

Pain intensity decreased by 84.2%, and 96.6% of completers met the study’s pre-specified threshold for a clinically meaningful pain reduction.

Good

75%

Functional disability improved by 16.1 points, with 62.1% of completers meeting the study’s minimal clinically important difference threshold.

Good

75%

The study reported medication reductions alongside cannabis use, while tolerability adverse events occurred in 11.4% of visits and serious psychiatric events in 0.02%.

Good

70%

Because the study had no control group and its effects exceeded randomized-trial benchmarks, the authors conclude that observational biases may contribute and that randomized controlled trials are needed.

High

90%

📄 Original Abstract

PURPOSE: To evaluate 10-year outcomes of medical cannabis therapy on opioid use, pain intensity, functional disability, concomitant medication use, and adverse events in cannabis-naïve chronic low back pain (CLBP) patients, with particular attention to clinically meaningful outcomes defined by established minimal clinically important difference (MCID) thresholds. METHODS: Single-center longitudinal observational study of 1,000 consecutive cannabis-naïve CLBP patients from a registry database (2015-2024), reported following STROBE guidelines. PRIMARY OUTCOME: morphine milligram equivalents (MMEQ). SECONDARY OUTCOMES: Numeric Rating Scale (NRS) for pain intensity, Oswestry Disability Index (ODI) for functional disability, cannabis dosing patterns, adverse events, and concomitant medication use. Pre-specified MCID thresholds: ≥50% MMEQ reduction, ≥ 30% NRS reduction, ≥ 10-point ODI improvement. Statistical analyses included paired t-tests for completers and linear mixed-effects models for sensitivity analyses. RESULTS: Of 1,000 enrolled patients, 638 (63.8%) completed 10-year follow-up. Among completers, MMEQ decreased from 62.8 ± 35.7 to 6.4 ± 7.1 mg/day (- 89.8%, p < 0.001); NRS from 8.71 ± 1.23 to 1.37 ± 1.71 (- 84.2%, p < 0.001); ODI from 52.9 ± 11.9% to 36.8 ± 14.9% (16.1-point reduction, - 30.4%, p < 0.001). MCID responders: 91.2% for MMEQ, 96.6% for NRS, 62.1% for ODI. Substantial polypharmacy reductions occurred: tramadol/tapentadol - 84.0% points (pp), benzodiazepines - 73.5 pp, SSRIs - 71.9 pp, gabapentinoids - 30.7 pp. True tolerability adverse events occurred in 11.4% of visits; serious psychiatric events in 0.02%. CONCLUSIONS: In this uncontrolled observational study, medical cannabis therapy was associated with reductions in opioid use, pain intensity, and functional disability over 10 years, accompanied by polypharmacy reduction and acceptable tolerability. Effect sizes substantially exceeded RCT benchmarks (e.g., - 0.6 NRS difference vs. placebo in a recent phase 3 trial), suggesting observational biases contribute to these findings. These hypothesis-generating data warrant validation in randomized controlled trials.

Paper Type

📄 Research

Publication

Journal: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Published: September 14, 2026
PMID: 42734834
DOI: 10.1007/s00586-026-10290-y

Authors (7)

Muhammad Khatib Department of Orthopedics, Rabin Medical Center, Petah Tikva, Israel.
Dror Robinson Department of Orthopedics, Rabin Medical Center, Petah Tikva, Israel. robinson@tauex.tau.ac.il.
Eitan Lavon Management Department, Clalit Health Services, Petah Tikva, Israel.
Feras Qawasmi Department of Orthopedics, Rabin Medical Center, Petah Tikva, Israel.
Waseem Abu Rashed Department of Orthopedics, Rabin Medical Center, Petah Tikva, Israel.
+2 more authors