In the last ten years, opinions about using opioids and cannabis to treat pain have changed a lot. The opioid crisis has made people more cautious about using strong painkillers, while changes in laws have made medical and even recreational cannabis more accepted in many parts of the United States.
These changes have affected how both the public and medical professionals think about pain treatment. But while some of these changes are positive, they have also created new problems—especially for people who rely on these drugs and are trying to find help from a new doctor.
A new study from Michigan Medicine, led by Dr. Mark Bicket at the University of Michigan, looked into how these shifts in opinion are affecting real-life care. The research team surveyed more than 1,000 primary care doctors across the country. They wanted to understand how open these doctors were to accepting new patients who suffer from long-term, or chronic, pain.
Out of the 1,000 doctors surveyed, 852 said they were accepting new patients. However, about 20% of them said they would not take on new patients who were already using opioids for their pain. Around 12% were also hesitant to treat patients who use medical cannabis.
In comparison, nearly all doctors were fine with seeing patients who use over-the-counter painkillers like ibuprofen, which belongs to a group of drugs known as NSAIDs. Only one out of a thousand expressed concern about that.
This has become a real issue for people who have been using opioids for a long time. These patients, sometimes called “legacy patients,” may have started opioid treatment years ago when it was more commonly prescribed.
Now, they can face big problems if their doctor retires or they move to a new place. If they can’t find a new doctor willing to continue their treatment, they risk not only losing pain relief but also experiencing serious withdrawal symptoms or worsening health conditions.
Dr. Bicket said the findings raise concern for both these patients and for doctors who are unsure how to treat them. The situation becomes even more complicated for patients who use cannabis.
Although many states allow medical cannabis, federal law still lists it as an illegal drug with no medical use. This conflict between state and federal law creates confusion for doctors, who may be unsure whether they can safely or legally treat patients who use cannabis.
The study didn’t go into great detail about why doctors are hesitant, but Dr. Bicket believes that part of the issue is the lack of strong, clear research about the safety and effectiveness of both opioids and cannabis for chronic pain. He described the current situation as “flying in the dark,” meaning doctors don’t have enough solid information to confidently make decisions.
Other researchers who worked on the study—Elizabeth M. Stone, Kayla Tormohlen, Reekarl Pierre, and Emma E. McGinty—agreed that the healthcare system needs more research and better guidelines. Without these tools, it’s hard for doctors to know how to treat patients in a way that is both safe and helpful.
The study was published in Health Affairs Scholar and adds to growing concerns about the gap between changing drug laws and the reality of patient care. Many patients are turning to opioids or cannabis for relief, but the rules and advice for doctors haven’t caught up.
For those interested in pain relief, there are other options being studied as well. Some research has looked into using krill oil to improve muscle health in older adults, and other studies have explored ways to manage arthritis or back pain without strong medications. Scientists have even studied traditional Native American plants that might reduce pain or diarrhea.
But even with these alternatives, the key issue remains: people in pain need access to care, and doctors need better guidance. This study shows that without more research and clearer policies, patients may continue to struggle—not just with pain, but with simply finding someone willing to help.
If you care about pain, please read studies about why long COVID can cause pain, and common native American plant may help reduce diarrhea and pain.
For more information about pain, please see recent studies about why people with red hair respond differently to pain than others, and results showing this drug may relieve painful ‘long covid’ symptoms.
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