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Impact of Prescription Opioid Dose Changes on Cannabis Use and Clinical Outcomes

Award Number: R01DA048817
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2019
PERIOD OF PERFORMANCE END DATE: 05/31/2026

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Impact of Prescription Opioid Dose Changes on Cannabis Use and Clinical Outcomes - Project Summary With the ongoing opioid epidemic in the United States, alternative options for pain management are urgently needed. Data from recent ecological and open-label studies suggest that the introduction of medical cannabis laws are associated with decreased opioid prescribing and fewer overdose deaths, and that new initiations of cannabis are associated with prescription opioid discontinuations. With the rapid changes in the legal status of cannabis for medical and recreational purposes, more patients may be seeking cannabis for chronic pain management and its use as an analgesic is increasing in all age groups. However, the clinical outcomes of increased cannabis use for pain are unclear and there are calls for prospective empirical data. This proposal is for a prospective cohort study in a national sample of VA patients. The overall goal of this research is to improve our understanding of the extent to which cannabis use changes following prescription opioid discontinuation, and identify clinical outcomes associated with changes in cannabis use for pain. We will recruit 650 patients who are currently prescribed LTOT and have a past-month urine drug test result that is positive for cannabis/THC. Participants will complete a battery of self-report measures at baseline and every six months for two years. They will also complete monthly web-based assessments of cannabis use status and prescription opioid dose. A subset of participants who discontinue prescription opioids will complete qualitative interviews to better understand how cannabis use fluctuates following opioid discontinuation. The Specific Aims of this proposal are to characterize changes in cannabis use and symptoms of cannabis use disorder following prescription opioid dose discontinuation; evaluate associations between changes in opioid dose, cannabis use, and pain over time; and qualitatively explore patient-reported factors that lead to changes in cannabis use following prescription opioid discontinuation. The proposed research has broad implications for clinical care, providing novel data to examine how cannabis use changes following opioid dose modification, and the clinical impact of these changes. The overarching goal of this research is to generate empirical data to guide pain management approaches that optimize functional gains and decrease risk of adverse events.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2027 ( Subtotal = -$1 )
2027	2023	OREGON HEALTH & SCIENCE UNIVERSITY	3181 SW SAM JACKSON PARK RD	PORTLAND	OR	97239	MULTNOMAH	USA	Drug Use and Addiction Research Programs	000	5	10/16/2026	NON-COMPETING CONTINUATION	-$1
														Subtotal = -$1

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2023	OREGON HEALTH & SCIENCE UNIVERSITY	3181 SW SAM JACKSON PARK RD	PORTLAND	OR	97239	MULTNOMAH	USA	Drug Use and Addiction Research Programs	000	5	3/28/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $541,509 )
2023	2023	OREGON HEALTH & SCIENCE UNIVERSITY	3181 SW SAM JACKSON PARK RD	PORTLAND	OR	97239	MULTNOMAH	USA	Drug Use and Addiction Research Programs	000	5	5/12/2023	NON-COMPETING CONTINUATION	$541,509
														Subtotal = $541,509

Issue Date FY: 2022 ( Subtotal = $561,365 )
2022	2022	OREGON HEALTH & SCIENCE UNIVERSITY	3181 SW SAM JACKSON PARK RD	PORTLAND	OR	97239	MULTNOMAH	USA	Drug Use and Addiction Research Programs	000	4	5/3/2022	NON-COMPETING CONTINUATION	$561,365
														Subtotal = $561,365

Issue Date FY: 2021 ( Subtotal = $564,053 )
2021	2021	OREGON HEALTH & SCIENCE UNIVERSITY	3181 SW SAM JACKSON PARK RD	PORTLAND	OR	97239	MULTNOMAH	USA	Drug Use and Addiction Research Programs	000	3	5/12/2021	NON-COMPETING CONTINUATION	$564,053
														Subtotal = $564,053

Issue Date FY: 2020 ( Subtotal = $547,764 )
2020	2020	OREGON HEALTH & SCIENCE UNIVERSITY	3181 SW SAM JACKSON PARK RD	PORTLAND	OR	97239	MULTNOMAH	USA	Drug Use and Addiction Research Programs	000	2	5/14/2020	NON-COMPETING CONTINUATION	$547,764
														Subtotal = $547,764

Issue Date FY: 2019 ( Subtotal = $537,390 )
2019	2019	OREGON HEALTH & SCIENCE UNIVERSITY	3181 SW SAM JACKSON PARK RD	PORTLAND	OR	97239	MULTNOMAH	USA	Drug Use and Addiction Research Programs	000	1	7/19/2019	NEW	$537,390
														Subtotal = $537,390

Grand Total All Awards = $2,752,080

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Impact of Prescription Opioid Dose Changes on Cannabis Use and Clinical Outcomes

Award Number: R01DA048817

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/01/2019

PERIOD OF PERFORMANCE END DATE: 05/31/2026

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