Over the past decade, attitudes toward using opioids and cannabis for pain relief have changed dramatically.
The opioid crisis has made both doctors and the public more cautious about strong prescription painkillers, while new laws have made medical and even recreational cannabis more accepted in many parts of the United States.
These changes have reshaped how pain is treated, but they have also created unexpected challenges for people living with chronic pain.
For many patients, opioids were once a common treatment for severe, long-term pain caused by conditions such as back injuries, arthritis, or nerve damage. Doctors prescribed these medications more freely in the past, believing they were safe when used correctly.
However, rising addiction rates and overdose deaths led to stricter rules and growing concern about their risks. At the same time, cannabis began gaining attention as a possible alternative for pain relief, especially in states where medical use became legal.
A new study from Michigan Medicine, led by Dr. Mark Bicket at the University of Michigan, explored how these changes are affecting patients in real life. The researchers surveyed more than 1,000 primary care doctors across the United States to see how willing they were to accept new patients who already use opioids or medical cannabis for chronic pain.
Of the doctors surveyed, 852 said they were accepting new patients. However, about one in five said they would not take on patients who were already using opioids for pain management.
Around 12 percent were also hesitant to treat patients who use medical cannabis. In contrast, almost all doctors were comfortable treating patients who rely on common over-the-counter pain medicines such as ibuprofen.
This situation creates serious difficulties for people who have used opioids for many years. These individuals are sometimes called “legacy patients” because they began treatment when opioid prescribing was more common.
If their doctor retires, moves away, or stops practicing, they may struggle to find a new doctor willing to continue their care. Without proper medical supervision, these patients risk severe withdrawal symptoms, worsening pain, and declining health.
Patients who use medical cannabis face similar problems. Although many states allow cannabis for medical purposes, federal law still considers it illegal. This conflict between state and federal rules leaves doctors uncertain about how to handle such cases.
Some physicians worry about legal risks, while others feel they lack enough scientific evidence about cannabis safety and effectiveness for chronic pain.
Dr. Bicket noted that the study highlights a growing gap between policy changes and patient care. Doctors are expected to manage complex pain cases but often do not have clear guidelines or strong research to guide their decisions. He described the situation as similar to “flying in the dark,” where doctors must make difficult choices without enough reliable information.
Other researchers involved in the study emphasized the need for better research and clearer medical guidelines. Without these tools, both doctors and patients face uncertainty. Patients may feel abandoned, while doctors may worry about making the wrong decision.
The study also points out that alternative pain treatments are being explored. Some scientists are studying supplements like krill oil to support muscle health in older adults, while others are testing new ways to treat arthritis and back pain without strong medications.
Researchers have even looked at traditional plant-based remedies used by Indigenous communities. While these options may help some people, they are not yet a complete solution.
The central issue remains clear: people living with chronic pain need access to compassionate and consistent medical care. As laws and attitudes continue to change, the healthcare system must adapt to ensure that patients are not left without support.
This research shows that without better evidence, clearer policies, and improved communication, many pain patients may continue to struggle—not only with their condition but also with finding a doctor willing to help them.
If you care about pain, please read studies about vitamin K deficiency linked to hip fractures in old people, and these vitamins could help reduce bone fracture risk.
For more health information, please see recent studies that Krill oil could improve muscle health in older people, and eating yogurt linked to lower frailty in older people.
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