Lack of association of cannabis use with opioid outcomes among opioid-dependent youth.

Cannabis use is common among opioid-dependent patients, but studies of its association with treatment outcome are mixed. In this secondary analysis of National Drug Abuse Treatment Clinical Trials Network protocol CTN-0010 (“Buprenorphine/Naloxone-Facilitated Rehabilitation for Opioid Dependent Adolescents/Young Adults”), the association of cannabis use with opioid treatment outcomes is assessed. In the main study, participants (N=152) aged 15-21 years were randomized to receive psychosocial treatments and either a 12-week course of buprenorphine/naloxone with a dose taper to zero in weeks 9-12, or a 2-week detoxification with buprenorphine/naloxone. Drug use was assessed by self-report and urine drug screen at baseline and during study weeks 1-12. The association between cannabis and opioid use at weeks 4, 8, and 12 was examined using logistic regression models. Participants reported a median of 3 days (range=0-30) cannabis use in the past month; half (50.3%, n=77) reported occasional use; one-third reported no use (33.1%, n=50), and one-sixth reported daily cannabis use (16.6%, n=25). Median lifetime cannabis use was 4.0 years (range=0-11) and median age of initiation of use was 15 years (range 9-21). Neither past cannabis use (age of initiation and use in the month prior to baseline), nor concurrent use, was associated with level of opioid use.

Conclusions: Overall, cannabis use had no association with opioid use over 12 weeks in this sample of opioid-dependent youth. While cannabis use remains potentially harmful, it was not a predictor of poor opioid treatment outcome, as measured by opioid urine drug screens, in this sample.

Related protocols: CTN-0010