Date of Award

August 2020

Degree Type


Degree Name

Doctor of Philosophy (PhD)




Joseph W. Ditre


chronic pain, marijuana, medical cannabis, prescription opioids

Subject Categories

Social and Behavioral Sciences


Medical cannabis is increasingly used as a treatment for chronic pain, and there is initial evidence that medical cannabis may lead to a subsequent decrease in prescription opioid use. The objective of the current study was to conduct a retrospective, naturalistic examination of medical cannabis use (i.e., dose, frequency, type) and subsequent changes in prescription opioid use among a sample of treatment-seeking chronic (non-cancer-related) pain patients (N =277). Data from the electronic medical record (EMR) was paired with information from the State Prescription Drug Monitoring Program and collected at time of initial certification and at six months post-certification. Results indicated that 91% of patients used their certification to buy medical cannabis at least once within the first six months. Heterogeneity in purchase patterns was observed (range of total doses purchased = 5 to 417, mean = 64.5, SD = 67). High THC:low CBD and vaporization-based products were the most common formulations purchased. A total of 37% of all patients who purchased medical cannabis at least once evinced a clinically significant reduction (i.e., ≥ 30% MME) in prescription opioid use by six months post-certification.


Open Access