Combining marijuana and opioids may help treat pain, without the risk of addiction

In an ideal world, patients in need of pain relief would take pain medication without the inherent fear of opioid addiction. According to a recent study, combining cannabinoids (the active chemicals in the marijuana plant) with morphine could offer a safe way to decrease opioid dosage among those suffering from pain, thereby reducing their risk of becoming addicted to pain medication.

Finding a way to decrease dosage is key - opioid addiction often begins when patients build a tolerance to prescription pain medications. Over time, a higher and higher dose of the drug is required to feel sufficient pain relief. Although prior research has shown that combining cannabinoids with opioids may enhance pain-relieving effects of opioids, both drugs alone are known to slightly impair cognition. This led to a concern that if taken together the drug combination would result in negative cognitive effects, such as behavioral and memory deficits. However, recent research suggests that this is not the case; cannabinoids and opioids together do not impair certain aspects of cognition.

In an animal study, researchers reported that combining cannabis and morphine did not increase the risk of impulsivity nor impair memory. In the study, scientists gave monkeys moderate doses of morphine and CP55940, a synthetic drug that mimics the activity of tetrahydrocannabinol (THC), a natural cannabinoid found in the marijuana plant responsible for the drug's psychoactive effects. After administering both drugs, monkeys were tested on measures of memory and impulsivity using touchscreens and treats. Results showed that each drug hindered performance, but both drugs combined had a lower effect on performance compared to each drug alone.

"The current opioid epidemic underscores the need for safe and effective pharmacotherapies for treating pain," said Dr. Vanessa Minervini, a postdoctoral fellow at the University of Texas Health Science Center at San Antonio, who presented the research at the American Society for Pharmacology and Experimental Therapeutics annual meeting during the 2019 Experimental Biology meeting held April 6-9. "Combining opioid receptor agonists with drugs that relieve pain through actions at non-opioid mechanisms (for example, cannabinoid receptors [in the body and brain]) could be a useful strategy for reducing the dose of opioid needed to achieve pain relief."

Clinical trials still need to commence to confirm how well these findings translate to humans. Nevertheless, by demonstrating that combining cannabinoids and morphine do not impair cognitive staples of addiction these results highlight the potential therapeutic benefits of using both drugs together.

Source: AAAS EurekAlert!, ScienceDaily