Medical Cannabis as a Substitute for Prescription Agents: A Systematic Review and Meta-analysis

Abstract

ABSTRACT Background The present study examines the prevalence of medical cannabis as a substitute for prescription agents, and how medical cannabis use impacts the use of other prescription drugs. Methodology Four main databases were searched including Medline, Embase, PsychINFO, and Global Health to identify studies that evaluate medical cannabis use as a substitute for prescription agents in adult participants using cannabis for medicinal purposes. Results Of 493 studies identified, 27 relevant studies were included in the final analysis. The pooled percentage of the prevalence of substituting medical cannabis for one or more prescription drugs was 60.0% (95% CI; 50%–70%). Chronic pain and mental health conditions were prominent among the leading reasons for medical cannabis use. The most common substituted drug classes were narcotics/opioids, anxiolytics, and antidepressants. A majority supported that medical cannabis decreased prescription drug uses. Conclusions People use medical cannabis as a substitute for prescription drugs. Yet, despite rigorous self-reporting from patients who attribute their reduction or cessation of prescribed medication to the use of medicinal cannabis, most results are mainly drawn from observational studies. Few good-quality randomized controlled trials (RCT) explore cannabis substitution effects.