Material hardship moderates the association between cannabis use frequency and opioid withdrawal frequency among people who inject drugs.

INTRODUCTION

Previous literature identified cannabis as a potential opioid withdrawal management tool. We conducted an exploratory analysis on cannabis and opioid use among a community sample of people who inject drugs (PWID) and use opioids. We also considered the role that material hardship (inaccessibility of food, shelter, clothing, water, housing) plays in the relation between cannabis use and opioid withdrawal.

METHODS

We surveyed 472 PWID in Los Angeles, CA and Denver, CO between 2021 and 2022 on cannabis use frequency, material hardship, and opioid withdrawal frequency. We used Poisson and zero-inflation regression to examine associations between cannabis use and opioid withdrawal with material hardship as a moderator.

RESULTS

Material hardship significantly moderated the association between cannabis use and opioid withdrawal. At low levels of material hardship, higher cannabis use was significantly associated with lower opioid withdrawal frequency. Conversely, at high levels of material hardship, higher cannabis use was significantly associated with higher opioid withdrawal frequency.

DISCUSSION: Material hardship may influence if and how cannabis may be used for opioid withdrawal management. Interventions should aim to address gaps in basic needs access among PWID.