Should Cannabis Use Keep Someone Out of Opioid Treatment? An Op-Ed Makes the Case

A look at a Scientific American opinion piece — and the evidence around it.

A 2025 opinion piece in Scientific American raises a pointed question about how the U.S. treats opioid use disorder (OUD). Written by physicians Joao P. De Aquino and Gabriel P. A. Costa, the article argues that OUD treatment programs need to rethink their approach to cannabis as cannabis policy evolves. It's worth being clear from the outset about what this is: an opinion and analysis article, not a research study. The summary below describes the authors' argument.

The Argument

The authors start from a grim backdrop. The U.S. overdose crisis, driven largely by opioids, has been staggering — the article cites CDC data of more than 81,000 opioid-related overdose deaths in a single recent year. And yet, they note, as of 2021 roughly four out of five adults with opioid use disorder were not receiving treatment for it. Closing that treatment gap, they argue, should be the overriding priority.

Against that backdrop, the authors point to what they see as a counterproductive barrier: many OUD treatment programs require patients to abstain from cannabis in order to qualify for or remain in treatment. They argue these zero-tolerance rules often rest on outdated assumptions that cannabis use derails recovery — and that the rules can have the perverse effect of pushing people away from the very treatment that could save their lives. Instead, they advocate for a more individualized approach: revisiting blanket cannabis bans, and encouraging honest, judgment-free conversations between providers and patients about how cannabis use fits into a person's recovery.

Important Context

The op-ed's central point — that people shouldn't be denied lifesaving treatment simply for using cannabis — is a humane and reasonable one. But a few things are essential to keep in view alongside it.

First, the authors themselves are careful: they note that while some evidence hints cannabis might help with things like opioid cravings or pain, the science is far from settled, and they call for more research. That caution is well placed. Independent reviews of the evidence are blunt on this point — the use of cannabis or cannabinoids as a treatment for OUD is not confirmed by rigorous research, and its effects on opioid overdose and treatment outcomes are not yet clear. “Rethinking cannabis exclusion rules” is not the same as “cannabis treats opioid addiction,” and the op-ed does not claim the latter.

Second, and most important: the treatments that are genuinely proven to save lives in opioid use disorder are the FDA-approved medications — primarily buprenorphine and methadone. The op-ed's argument is about not letting cannabis use block access to those medications; it is emphatically not an argument for using cannabis in place of them. This distinction is not academic. Research has found that when some states made OUD a qualifying condition for medical cannabis, cannabis dispensaries became more likely to make unsupported claims — including suggesting patients replace FDA-approved OUD medications with cannabis. Substituting cannabis for proven medication would be dangerous.

The Takeaway

Read carefully, the op-ed makes a measured case: adopt evidence-based policies that keep proven, approved medications at the center of OUD treatment, stop using cannabis use as a reason to exclude people from that treatment, and study the role of cannabinoids properly rather than assuming the worst. It's a call for compassion paired with scientific rigor — and a reminder that the deeper crisis is the vast number of people who never get treatment at all.

Source: De Aquino JP, Costa GPA. “Cannabis Needs Rethinking As a Strategy in the Overdose Crisis.” Scientific American, 2025 (opinion and analysis article).

This article is for general information only and is not medical advice. Cannabis is not an approved treatment for opioid use disorder, and approved medications should not be replaced without medical guidance. If you or someone you know is struggling with opioid use, please consult a qualified healthcare professional.