Medical Marijuana and Opioid Addiction

TABLE OF CONTENTS

CDC data count 54,045 opioid-involved overdose deaths in 2024, down from 79,358 in 2023.

That is still about 1,000 people a week. Can medical marijuana help with opioid addiction? So far, the research does not show that it does.

The decline began a year earlier: CDC counted 81,806 opioid-involved overdose deaths in 2022, so the 2023 total was already lower.

Most of those deaths involved synthetic opioids such as fentanyl, according to the same CDC data. Pain treatment is part of the same debate.

People still ask, because cannabis comes up so often in conversations about pain.

Marijuana has been called a “gateway” drug for decades. Some researchers, doctors, and journalists believe it could be a gateway that leads away from harder drug use.

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.

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.

If you’re struggling with opioid addiction, keep reading to see what the research on cannabis and opioids actually shows.

What are Opioids?

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

Remember: many of the opioids responsible for this epidemic are perfectly legal and can be prescribed by doctors. This includes drugs such as:

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

The most commonly-known illegal opioid is heroin.

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 pain sensations that are 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. When people take high dosages of opioids, their bodies don’t produce as much of their own natural opioids.

The body adjusts to the outside supply.

And that’s why people can experience severe withdrawal symptoms when they try to quit. Their bodies don’t make enough natural opioids to pick up the slack.

Withdrawal symptoms include:

muscle pain
anxiety
excessive perspiration
insomnia
diarrhea
stomach cramps
nausea
vomiting
high blood pressure
rapid heartbeat

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

Tolerance

Over time, opioids lose their power. A single dose doesn’t pack the same punch as 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.

In fact, opioids make us feel so good, they can become addictive for that reason alone. People might want to keep using them, even if they’re no longer feeling chronic pain.

And that’s how people wind up using them in ways they were never intended to be used.

Some opioids, such as oxycodone, have an “extended release” function. This allows the drug to work over a long period of time and prevents you from being overwhelmed by euphoria and intoxication.

But some opioid users want an instant, powerful high, so they crush and snort their pills. Or they inject them directly into their bloodstream. 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 opioid users experience irregular heartbeats, which also have the potential to be fatal.

What Caused the Opioid Crisis?

This Vox video offers a great breakdown of how the opioid epidemic got to where we are today:

Here are the most important facts:

During the 90s, the federal government and advocacy groups pressured doctors to treat pain as a “serious medical issue.” A 2011 Institute of Medicine report later estimated that about 100 million U.S. adults live with chronic pain.
Drug companies like Purdue Pharma claimed that opioid painkillers were safer, more powerful, and less addictive than other types of painkillers.
In 2012, prescribers wrote 82.5 opioid painkiller prescriptions for every 100 people in the United States, according to CDC.
Millions became dependent. In 2014, 28,647 overdose deaths involved an opioid, according to CDC.
Doctors tried to pull back on these prescriptions but the damage was already done. Patients had already become addicted, and when they were unable to get more opioids from their physicians, they turned to an illegal opioid: heroin.
Heroin-involved overdose deaths rose from 3,036 in 2010 to 15,469 in 2016, then fell to 3,984 in 2023 as fentanyl took over.
In 2007, the Purdue Frederick Company pleaded guilty to misbranding OxyContin by misrepresenting its risk of addiction and abuse, and the company and three executives paid $634.5 million.
Federal and state governments are finally responding. They’re funding opioid prevention and treatment programs, but we still need an alternative treatment for chronic pain.

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