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Published: 08 May 2026

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Millions of people with chronic knee pain have hoped that cannabis and opioids for pain might work better together. A new clinical trial published in Anesthesiology has challenged that idea. The research found no meaningful benefit from combining the two drugs. In some cases, the combination made things worse.

What the Study Found About Cannabis and Opioids for Pain

Researchers at Johns Hopkins University School of Medicine ran a rigorous, double-blind, randomised, placebo-controlled trial. They enrolled 21 adults with diagnosed knee osteoarthritis. Each participant attended four sessions, at least seven days apart. Every session involved a different drug combination: placebo only, the opioid hydromorphone (2mg) alone, the synthetic cannabinoid dronabinol (10mg) alone, or hydromorphone and dronabinol together.

The team measured a wide range of outcomes. These included sensitivity to pressure, heat and cold, self-reported pain scores, walking and stair-climbing ability, cognitive function, and side effects.

The results were straightforward. Neither the cannabinoid and opioid combination nor either drug alone produced meaningful pain relief. Hydromorphone raised the pressure pain threshold above dronabinol’s level. It also reduced mechanical pain sensitisation compared with placebo. But participants’ own knee pain ratings did not improve significantly under any condition.

Side Effects Increased Without Pain Relief

The combined condition raised real concerns about tolerability. Participants who took cannabis and opioids for pain together reported higher nausea, stronger feelings of being “high,” and slower working memory reaction times. None of this came with added pain relief.

“Our study suggests that isn’t the case and patients may experience more side effects when the drugs are combined,” said lead author Dr Katrina R. Hamilton of Ohio University and Johns Hopkins School of Medicine.

Growing numbers of people now combine cannabis with prescription painkillers. Many believe the approach is safer or more effective. This trial found no evidence to support that belief.

Why Preclinical Findings Did Not Translate to Humans

Animal studies long suggested that cannabinoids could boost the pain-relieving power of opioids. The theory was that patients might need lower opioid doses, which would reduce addiction risk. Interest in cannabis and opioids for pain grew steadily, driven by shifting legal landscapes and an ongoing opioid crisis. In the United States alone, opioid overdoses contributed to more than 80,000 deaths in a single recent year.

Yet human trials have consistently failed to replicate those animal findings. The Johns Hopkins team ran a similar trial earlier using a 4mg dose of hydromorphone. That study also found minimal added benefit from combining the two drugs. In that version, researchers recorded adverse events in 35.1% of all sessions. The highest rates occurred when participants took hydromorphone alone or alongside dronabinol. The current study dropped the dose to 2mg to test whether tolerability improved. Adverse events fell to 28.6% of sessions. Still, no significant differences emerged between the four drug conditions.

Cognition: A Mixed Picture for the Cannabinoid and Opioid Combination

Researchers flagged one unexpected finding worth watching. Hydromorphone alone impaired working memory accuracy more than every other condition. The cannabinoid and opioid combination slowed reaction times but did not hurt accuracy as much. The authors speculate that dronabinol might partially protect cognitive function when taken with an opioid. They stressed this remains highly preliminary and needs further study.

Researchers found no significant differences across conditions for fine motor movement, physical functioning, or measures of extramedical drug use risk.

Key Limitations to Consider

The trial was small. Only 21 participants completed all four sessions. The study used a single oral dose of synthetic THC rather than inhaled or full-spectrum cannabis. Most real-world users do not take cannabis this way. Inhaled cannabis reaches peak concentration in 3 to 10 minutes. The oral route used here takes one to two hours. Natural cannabis also contains more than 500 compounds. The synthetic version used in the study contains only pure THC, which may affect outcomes in ways not yet understood.

An editorial published alongside the study noted that participants had never used cannabis before. They also received a relatively high single dose. Both factors may limit how broadly these findings apply to everyday users.

What This Means for Using Cannabis and Opioids for Pain

The study adds to a body of controlled trial evidence. It consistently shows that the cannabinoid and opioid combination does not perform as hoped when tested in real patients with chronic pain. The preclinical promise simply has not carried through to clinical settings.

Patients and clinicians in areas where medical cannabis is legal should weigh this evidence carefully. Combining cannabis and opioids for pain in knee osteoarthritis currently lacks strong clinical justification. The side effect burden is real, and the benefits are not.

Future research should test different cannabis formulations, varied routes of administration, dose-ranging designs, and longer follow-up periods. Until that work arrives, the combination remains more risk than reward for most knee arthritis patients.

(Source: WRD News)

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Published: 08 May 2026

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The Road Danger Nobody Is Talking About

For decades, the conversation around drink driving has dominated road safety campaigns. But a quieter, equally deadly threat has taken root in the background, one that nobody can afford to ignore any longer. Drug impaired driving now claims hundreds of lives each year across the United States, and the data suggests most communities have barely begun to reckon with the scale of it.

As attitudes towards cannabis shift and access expands across many parts of the country, a growing number of drivers carry the assumption that it is a “safer” intoxicant. That assumption is costing lives.

What the Numbers Say About Cannabis Behind the Wheel

The statistics coming out of Texas tell a sobering story. According to the Texas Department of Transportation’s Crash Records Information System, cannabis crashes kill an average of 120 people every year in the state. Between 2020 and 2024, that figure reached 602 fatalities. Even more striking, 78% of cannabis-related crashes produce injury or death rather than minor incidents.

These are not abstract numbers. They represent real people on real roads.

The Governors Highway Safety Association (GHSA) found that 25% of seriously injured drivers tested positive for cannabis, edging ahead of alcohol at 23%. A further 20% tested positive for both substances simultaneously, a combination that dramatically compounds impairment and raises crash risk far beyond either substance alone.

Young Drivers and the Growing Toll of Marijuana Impaired Driving

No group faces greater exposure to the consequences of marijuana impaired driving than young people. Among drivers aged 25 and under, 26% of crash fatalities involved both alcohol and cannabis. This is not coincidence. It reflects a generation for whom cannabis use has become normalised, often without any real understanding of what it does to reaction time, spatial judgement, and decision-making at speed.

School survey data from Texas reveals how widespread use has become. Nearly 8% of students in grades 7 through 12 reported using cannabis in the past month, while 13.3% said they had tried it at least once. Among high school seniors specifically, more than one in four reported lifetime use. The numbers on college campuses are higher still, with nearly 33% of Texas college students having tried marijuana and close to 13% reporting use in the past month.

The adolescent and young adult brain is still developing, particularly in areas that govern judgement, impulse control, and risk assessment. Cannabis use during these years carries consequences that extend well beyond the hours after consumption. It can alter cognitive function in ways that persist, including behind the wheel.

Why Drug impaired Driving Is Harder to Catch Than Drink Driving

Part of what makes drug impaired driving so difficult to address is the absence of clear detection tools. Unlike alcohol, there is no breathalyser equivalent for cannabis. No universally agreed threshold for impairment exists in law, and crucially, many users genuinely believe they drive just as well, or even better, after consuming cannabis.

The science does not support that belief. Cannabis disrupts the parts of the brain responsible for tracking moving objects, processing multiple stimuli at once, and responding to sudden hazards. A driver who feels calm and in control may still sit behind the wheel with a significantly reduced ability to avoid a crash.

This perception gap sits at the centre of the challenge facing road safety advocates. Unlike alcohol, where the public widely understands the link between intoxication and danger, drug impaired driving has not attracted the same level of cultural scrutiny, despite producing comparable harm on the road.

Prevention Must Be Central to Tackling Drug Impaired Driving

Nicole Holt, Chief Executive of Texans for Safe and Drug Free Youth, put the stakes plainly. Adolescent and young adult brains are especially vulnerable to the effects of cannabis, particularly in relation to thinking, judgement, and behaviour. When that vulnerability meets driving, the consequences can be fatal.

Tackling drug impaired driving effectively demands action on multiple fronts. Tighter regulation and consistent enforcement form the foundation. Targeted public education campaigns that speak honestly about the risks of marijuana impaired driving, without minimising or overstating, play an equally important role. Youth prevention programmes that reach young people before habits form are among the most valuable investments any community can make, with research consistently showing that early intervention reduces both substance use and related risk behaviours.

Safeguards that limit access to cannabis, particularly for those under the legal age, are not peripheral concerns. They are central to keeping impaired drivers off the road.

A Crisis That Can No Longer Wait

The road safety community, public health advocates, policymakers, and educators all carry a share of responsibility here. drug impaired driving is not a future risk sitting somewhere on the horizon. It is happening now, on roads in every state, and the gap between public awareness and actual danger continues to widen.

The data is clear. The trends point in one direction. What the moment calls for is the collective will to act before more lives are lost to a risk that, unlike so many others, communities have the tools to address.

(Source: WRD News)

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Published: 18 April 2026

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Therapy, Not Tablets: The Real Picture of Cannabis Addiction Treatment

The most comprehensive scientific review of its kind has found that no medication works for cannabis addiction treatment, while certain talking therapies offer more meaningful promise. The findings come from the journal Addiction, published in 2026, at a time when cannabis use disorder is rising worldwide and treatment demand is outpacing the evidence to support it.

Global incidence of cannabis use disorder grew by 32.3% between 1990 and 2019. Prevalence rose by 38.6% over the same period. Yet clinicians still have no approved pharmacological option to offer patients.

What the Researchers Found When Treating Cannabis Use Disorder

A team at the University of Bristol conducted a network meta-analysis (NMA), pooling data from 57 randomised controlled trials with more than 6,200 participants. Unlike a standard review, an NMA lets scientists compare multiple treatments at the same time, including those never directly tested against one another.

The team looked at both psychological (psychosocial) and pharmacological (drug-based) treatments across four key outcomes: cannabis use levels, abstinence, treatment completion, and adverse effects.

Researchers compared psychosocial and pharmacological approaches within one unified analysis for the first time. That makes this the most wide-ranging review of cannabis addiction treatment published to date.

Medications Disappoint

Results for medications were, in a word, disappointing. Across all pharmacological interventions tested, including antidepressants, anticonvulsants, anxiolytics, THC-based preparations and experimental compounds, the evidence for reducing cannabis use or improving abstinence was “highly uncertain.”

Some medications attracted cautious interest. Low-certainty evidence suggested that cannabidiol, N-acetylcysteine and varenicline may increase abstinence compared to placebo. But the confidence intervals in all three cases spanned both meaningful benefit and meaningful harm. No firm conclusions hold.

The safety picture raised further concern. Several medications, including mixed-action antidepressants, benzodiazepines, bupropion and buspirone, produced more adverse events than placebo with no corresponding benefit. The authors stated plainly that pharmacotherapies should still be considered experimental when treating cannabis use disorder.

Therapy Offers More Hope for Cannabis Addiction Treatment

Psychological interventions told a more encouraging story, though still far from definitive. Two approaches stood out.

Dialectical behavioural therapy and acceptance and commitment therapy (DBT/ACT) produced low-certainty evidence of a meaningful reduction in cannabis use frequency. DBT/ACT also showed better treatment completion rates and significantly increased point abstinence in a separate analysis.

Cognitive behavioural therapy combined with contingency management (MET-CBT with CM) also showed reduced use and supported abstinence. Contingency management, where patients receive small financial rewards or vouchers for cannabis-free urine samples, appeared to be the key active ingredient across several effective combinations.

Standalone MET-CBT, long regarded as standard care in many countries, showed little effectiveness and poor treatment completion compared to more structured alternatives. That raises real questions about its current position in clinical pathways.

Why the Evidence Remains Weak

The researchers were candid about gaps in the evidence. Of all findings assessed, 76% carried very low certainty ratings and only 24% reached low certainty. None reached moderate or high certainty.

Several factors drove this. Studies tended to be small, with participant numbers ranging from 10 to 450. Researchers tested many interventions in just a single trial. Missing outcome data, often because participants relapsed and dropped out, created persistent problems. Most psychosocial studies lacked blinding too, meaning participants often knew which treatment they received. That can inflate apparent benefits.

Safety reporting also had notable gaps. Not one psychosocial intervention study recorded adverse events in a way suitable for the safety analysis. That is a significant oversight, particularly since some therapies appeared to lower treatment completion rates.

Who Bears the Biggest Burden

The consequences of cannabis use disorder reach further than many people realise. Young people and adolescents carry a disproportionate burden. Cannabis use links to slower psychomotor speed and poorer attention and memory. Heavy, sustained use associates with lasting neurocognitive deficits into adulthood.

Beyond the individual, cannabis use disorder raises the risk of cardiovascular and respiratory disease and connects to higher all-cause mortality. During adolescence and young adulthood, use correlates with lower educational attainment, reduced income, unemployment, greater economic dependence and higher rates of juvenile offending.

The study participants were predominantly white, male and without significant psychiatric conditions. The researchers pointed out that this limits how far findings apply to the broader population seeking treatment for cannabis use disorder, many of whom live with co-occurring mental health conditions.

What Better Research on Cannabis Addiction Treatment Should Look Like

The authors set out clear recommendations for future work. Trials need larger sample sizes. Researchers and clinicians should agree a core outcome set with input from people with lived experience. Diagnostic criteria need consistency. And psychosocial intervention studies must begin collecting safety data properly.

The authors also called for trials directly comparing psychosocial and pharmacological approaches. Remarkably, that has never happened. Every drug trial in this review ran alongside some form of background psychological support. But no trial has placed both approaches head to head.

Future studies also need to include populations most likely to seek help, particularly people with anxiety, depression, ADHD and other conditions that frequently accompany cannabis use disorder. Since several of the pharmacotherapies reviewed already treat these conditions, integrated trial designs are both feasible and long overdue.

The Bottom Line

This review makes one thing clear. No quick pharmacological fix exists for cannabis addiction treatment right now. Current evidence does not support prescribing any medication for this purpose outside a research setting.

What the evidence does suggest, with low certainty, is that structured psychological approaches, particularly those involving contingency management, DBT or ACT, are more likely to help than harm. They are not a cure. But they are the best tools available today.

Cannabis is becoming more widely used, more potent and more socially accepted across much of the world. The need for robust, evidence-based approaches to treating cannabis use disorder has never been more pressing. This review shows how far the science has come, and how much further it still needs to go.

Source: (WRD News)

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Published: 15 April 2026

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A sweeping new study published in The Lancet Psychiatry has reignited a long-running debate about medical cannabis for mental health conditions. The findings make for uncomfortable reading for a fast-growing private prescribing sector that has largely outpaced the science behind it.

Researchers described this as the largest and most comprehensive review of its kind. They analysed 54 randomised controlled trials involving 2,477 participants across a range of mental health and substance use disorders. The central conclusion is stark: for the vast majority of psychiatric conditions where doctors currently prescribe medical cannabis, no reliable evidence exists that it works.

A Booming Market With a Thin Evidence Base

Medical cannabis has been legal on prescription in the United Kingdom since November 2018. High-profile campaigns on behalf of children with treatment-resistant epilepsy initially drove that change. Since then, the market has expanded dramatically. More than 30 specialist cannabis clinics are now registered with the Care Quality Commission in England, serving an estimated 80,000 patients.

The numbers are striking. Between 2023 and 2024, private prescriptions more than doubled, rising from around 283,000 to 659,000. Yet that figure needs context. Patients typically receive repeat prescriptions every four to eight weeks, so those 659,000 prescriptions likely represent roughly 82,000 individuals rather than a surge of entirely new cases.

What is harder to contextualise, however, is the mismatch between who receives medical cannabis prescriptions and what clinical trials actually support. According to available data, approximately 42 per cent of UK medical cannabis patients receive it for psychiatric conditions such as anxiety, depression, post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD). Notably, the new Lancet Psychiatry review found no significant benefit for any of these conditions.

What the Research Found on Cannabinoids for Mental Disorders

Researchers at the University of Sydney and several partner institutions conducted this systematic review. They examined RCT evidence published between 1980 and May 2025, and what they found was sobering.

For anxiety disorders, including social anxiety, the data showed no significant reduction in symptoms. For PTSD, results were equally discouraging. Furthermore, for psychotic disorders, OCD, bipolar disorder, ADHD and anorexia nervosa, researchers identified no meaningful benefit. Most strikingly, not a single randomised controlled trial has examined cannabinoids for depression.

Cannabinoids did show promise in a few areas. A combination of cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) reduced withdrawal symptoms and cannabis use in people with cannabis use disorder. Additionally, insomnia patients showed improved sleep time, and those with Tourette’s syndrome experienced a reduction in tic severity. Researchers also recorded a reduction in autistic traits in autism spectrum disorder studies, though they rated this evidence as very low certainty.

Overall, people taking cannabinoids were significantly more likely to experience an adverse event than those on placebo. Specifically, roughly one in every seven patients was affected. The most commonly reported side effects included dry mouth, nausea, diarrhoea and dizziness.

The Prescribing Paradox

The disconnect here is considerable. Sleep problems, anxiety, depression and PTSD rank among the most common reasons people seek medical cannabis in the UK, the US and Australia. Yet the evidence base for these very indications is, at best, weak.

Professor Owen Bowden-Jones, former chair of the Advisory Council for the Misuse of Drugs (ACMD), said the findings give the “clearest indication yet” that benefits of medical cannabis may have been overstated for many conditions.

Defenders of the practice argue the picture is more complicated than clinical trials alone can capture. Dr Niraj Singh, a consultant psychiatrist with over six years of prescribing experience, points to what he describes as outstanding outcomes in patients who had exhausted every other option.

“Tens of thousands of patients would testify that it benefits them across an array of symptoms,” he said. “In my experience, it has had some incredible outcomes.”

The Lancet Psychiatry review deliberately excluded this real-world evidence, drawn from patient registries and observational studies. Authors justified this on methodological grounds: observational data cannot establish causation and is more prone to bias. Nevertheless, critics including Professor David Nutt, founder of the charity Drug Science, have pushed back on the idea that RCTs should hold a monopoly on clinical decision-making.

Medical Cannabis for Mental Health: Safety Is Not Efficacy

Proponents of medical cannabis prescribing often argue that a relatively benign safety profile justifies its use even where efficacy evidence is limited. The review offers some support for this position. While cannabinoid users experienced more adverse events overall, serious adverse events and study withdrawals did not increase significantly.

However, researchers flag a critical caveat. Most clinical trials involved registered, pharmaceutical-grade cannabinoid products. These differ markedly from the high-THC preparations increasingly common in Australian, American and Canadian markets, and becoming more available privately in the UK. Products with high THC content carry well-documented risks of increased anxiety, paranoia and, in vulnerable individuals, psychosis.

Dr Marta Di Forti, professor of drug use, genetics and psychosis at King’s College London, has raised concerns about patients with pre-existing mental health conditions receiving high-THC prescriptions. In her view, those with a history of anxiety, depression or paranoia face a greater risk of worsening symptoms and dependency if exposed to products with THC content of 10 per cent or above.

In response to these concerns, the Medical Cannabis Clinicians Society recommends that prescriptions exceeding 60 grammes per month, or those containing more than 25 per cent THC, go through peer panel review.

The Research Gap Nobody Is Filling

Perhaps the most troubling part of this debate is not what the evidence shows, but what it does not yet examine. Back in 2018, the Department of Health committed to conducting efficacy trials in children with epilepsy. According to Professor Nutt, nothing has been done. Meanwhile, pharmaceutical companies show little interest in a botanical product that cannot be patented.

The Lancet Psychiatry review authors identified 14 ongoing trials through clinical registries that could not yet contribute to the analysis. They call urgently for trials with larger and more representative samples. Importantly, many of the included studies were small, with a median sample size of just 31 participants, which significantly limits what conclusions researchers can draw.

Professor Mike Barnes, chair of the Medical Cannabis Clinicians Society, has been candid that the industry itself bears responsibility here. “The industry has not been rigorous enough in collecting and analysing patient outcomes,” he said. “Clinics have a moral obligation to collect their own data.”

What This Means for Patients Using Medical Cannabis for Mental Health

For the tens of thousands of people in the UK (alone) currently using prescribed medical cannabis for mental health conditions, these findings present a genuine dilemma. Many have tried multiple treatments without success. Others describe the relief they found as life-changing. The United Patients Alliance has warned that dismissing medical cannabis on the basis of incomplete evidence risks pushing patients back to the unregulated illegal market, where product quality, THC content and medical oversight are entirely absent.

That concern deserves to be taken seriously. Even so, it cannot substitute for a proper evidence base. The Lancet Psychiatry review does not claim that medical cannabis never helps any individual. Rather, it argues, carefully and on the available data, that routine prescribing across these indications lacks the clinical trial support we would expect for any other controlled medicine.

Consider the scale of the problem. An estimated 8.7 million people in England received antidepressants in 2023/24. Over 1.5 million adults were in contact with NHS mental health services as of January 2026. The pressure to find better options is entirely understandable. Yet the answer to a struggling mental health system is to invest properly in research that could one day tell us, with confidence, which patients might genuinely benefit and under what conditions.

(Source: WRD News)

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• Cannabis as ‘Medicine?’: Pot Propaganda, Emotive Anecdote, Marketing Manipulation, and the Side Stepping of Science
• Regulation of Cannabis as Medicinal: Playing the Game of ‘Licensed Credibility’ in a State and Federal Legislation Disconnect.
• Failing Mental Health and ‘Vote for Medicine’ Models: Cannabis Conundrum Grows