A New 10-Year Study on Medical Cannabis, Pain, and Opioids
At The Post Dispensary in Beaver Dam, we talk with patients every day who are living with long-term pain. Many have already tried physical therapy, anti-inflammatory drugs, and prescription opioids. Some are looking for a different option. That is why a newly published 10-year study has our attention.
Researchers in Israel followed 1,000 adults with chronic low back pain who had never used cannabis before. After a decade of supervised medical cannabis treatment, they reported that “medical cannabis therapy was associated with reductions in opioid use, pain intensity, and functional disability over 10 years, accompanied by polypharmacy reduction and acceptable tolerability.”
That sentence is dense. In everyday language, it means this: over a very long stretch of time, patients in the study used far fewer opioids, said their pain was much lower, were less disabled in daily life, and took fewer other prescription drugs. Side effects were generally mild. This is not a miracle story, and it is not a reason to throw away a treatment plan without talking to a doctor. It is, however, one of the longest looks yet at medical cannabis for chronic back pain. Below, we unpack the findings.
What the Researchers Actually Did
The paper, titled “Ten-year outcomes of medical cannabis for chronic low back pain: opioid reduction, pain relief, and functional improvement in 1,000 patients,” was published September 14, 2026, in the European Spine Journal. The team included physicians from Rabin Medical Center, Tel Aviv University, and Clalit Health Services.
They enrolled 1,000 consecutive patients who:
The average patient was about 49 years old. Pain had lasted nearly 10 years on average. This was not a group of people with a mild, short-term ache. These were people with stubborn, documented back pain.
Treatment was medical cannabis under physician supervision. Patients used licensed products: mostly vaporized dried flower (about 62 percent) and oral oils (about 31 percent). Dosing started low, often around 2.5 to 5 milligrams of THC, then was adjusted over a few weeks. There was no forced opioid taper. Doctors reduced other medicines only when it made clinical sense. Patients were checked at baseline and then yearly for 10 years.
Of the original 1,000 people, 638 completed the full decade of follow-up. That 63.8 percent retention rate is actually quite high for a 10-year real-world study. Still, dropouts matter, and we will come back to that.
The Opioid Numbers
Among people who finished the study, average daily opioid use fell from 62.8 morphine milligram equivalents (MME) to 6.4 MME. That is an 89.8 percent drop. More than 91 percent cut their opioid dose by at least half. About 6.6 percent stopped opioids altogether.
Most of the drop happened early. By year one, average use was already down near 3 MME a day. It stayed low for the rest of the decade.
MME is a way doctors convert different opioids into a common scale so they can compare doses. A fall from the low 60s to the mid-single digits is large. It does not prove cannabis “replaced” opioids for every person, but it is a striking association in a group that had already been on opioids for a year or more.
What Happened to Pain Scores
Patients rated pain on a 0-to-10 numeric scale. Average pain started at 8.71 — severe by any standard. After 10 years it was 1.37. That is an 84.2 percent reduction. Nearly 97 percent had at least a 30 percent drop in pain, which researchers treat as a meaningful improvement. About 89 percent ended the study with mild pain or less (a score of 3 or below).
Again, pain fell quickly and stayed down. That pattern is important. If the improvement had faded after a year or two, it would look more like a short-term experiment. Here, the lower scores held.
Getting Back to Daily Life
Pain scores are only part of the story. The other question is whether people could actually do more.
Researchers used the Oswestry Disability Index, a common questionnaire about how back pain interferes with sitting, standing, lifting, walking, sleeping, and other everyday tasks. Scores dropped from 52.9 percent to 36.8 percent, a 30.4 percent relative reduction and a 16-point improvement on the scale. About 62 percent met the study’s definition of a clinically meaningful gain.
Function improved more slowly than pain. Through year five, disability scores barely budged. The bigger gains showed up between years seven and ten. The authors suggest a simple explanation: once pain is better controlled for a long time, people can slowly rebuild strength, confidence, and habits. Disability in chronic back pain is not only about the spine. It is also about deconditioning, fear of movement, mood, and years of limited activity. Those pieces take time.
Fewer Other Prescriptions
“Polypharmacy” means taking many medicines at once. That can raise the risk of side effects, drug interactions, and foggy thinking.
In this study, use of several common drug classes fell sharply among completers:
Those cuts were not forced by a study protocol. They happened as clinicians and patients adjusted treatment over time. For someone who has been stacking pain pills, sleep medicines, nerve medicines, and mood medicines, fewer bottles on the nightstand can be a quality-of-life change all by itself.
How Much Cannabis Patients Used, and How Safe It Was
Average use settled around 39 to 48 grams of cannabis per month after the first couple of years and stayed fairly stable through year 10. There was no clear pattern of needing more and more product as time went on, which argues against simple tolerance in this group. The typical THC-to-CBD ratio was roughly 4 to 1.Across 8,089 clinic visits, true tolerability side effects showed up at about 11.4 percent of visits. The most common were dry mouth and stomach issues such as nausea or appetite changes. Red eyes, lightheadedness, and a few other mild effects were less frequent.
Serious psychiatric events were recorded at two visits — 0.02 percent. The authors reported no hospitalizations, no deaths linked to cannabis, no dropouts after year two because of side effects, and no diagnosed cases of cannabis use disorder. That is a favorable safety picture for a 10-year observational series, but it is still not the same as a large randomized trial designed to catch rare harms.
What This Study Cannot Prove
This was an observational study, not a randomized controlled trial. There was no placebo group and no comparison arm that stayed on standard care alone. That means we cannot say with certainty that cannabis caused every improvement. Other things can look like treatment effects: people who feel better may be more likely to stay in a study, pain can ebb and flow on its own, expectations can change how people rate symptoms, and other therapies can shift over a decade.
The authors themselves note that the size of the improvements is larger than what recent randomized trials of cannabis for pain have typically shown. They call the results hypothesis-generating and say they need to be tested in proper controlled trials. About 36 percent of the original group did not finish 10 years, and the people who stayed may have been the ones who benefited most. The study also came from a single specialty clinic in Israel, so the products, regulations, and patient mix are not identical to Kentucky’s.
In short: this is encouraging long-term real-world data. It is not a blank check.
Why It Still Matters in Kentucky
Chronic or severe pain is a qualifying condition for a Kentucky medical cannabis card. So are several related conditions that often travel with back and nerve pain, including neuropathies, severe arthritis, and fibromyalgia.
Kentucky, like much of the country, has lived through the opioid crisis. Many patients in Ohio County and the surrounding communities were prescribed opioids in good faith for real pain, then found themselves stuck between inadequate relief and medicines that are hard to stay on safely. A study that follows cannabis-naive, opioid-experienced back-pain patients for 10 years and still finds lower opioid doses, lower pain, better function, and fewer companion drugs is relevant to that reality.
It also lines up with a broader pattern in observational research: some people with chronic pain who add regulated medical cannabis later use fewer opioids. That pattern is not universal, and it should never be sold as a guarantee. But it is one reason patients keep asking about cannabis as part of a wider plan, not as a replacement for medical care.
How We Think About This at The Post
The Post Dispensary is a medical cannabis dispensary, not a doctor’s office. We do not diagnose, certify, or tell anyone to stop a prescribed medicine. What we can do is help cardholding patients understand product types, start low and go slow, and choose formats that match their goals and comfort level.
The Israeli study used vaporized flower and oils under medical supervision, with low starting THC doses. That “start low, adjust carefully” approach is the same principle we emphasize with patients here in Beaver Dam. Flower, oils, and other regulated products each have a different onset and duration. The right choice depends on the person, the time of day, and what their certifying practitioner has recommended.
If you do not have a card yet and think you may qualify because of chronic or severe pain, the first step is a conversation with an authorized practitioner, not a trip to the counter.
A Long Study, a Local Conversation
Ten years is a long time in medicine. Most pain studies last weeks or months. This one followed people from their first cannabis prescription through a full decade of life — work, family, aging, and all the other things that happen while back pain is still in the background. The results are large, consistent inside the study, and paired with a tolerable side-effect profile. They are also uncontrolled. Both of those facts can be true at once.
For patients in Beaver Dam, Hartford, McHenry, Centertown, and the rest of Ohio County, the practical takeaway is simpler than the statistics: medical cannabis is one tool some people with long-standing back pain have used while cutting back on opioids and other prescriptions. Whether it belongs in your plan is a decision for you and your clinician.
This article is educational and is not medical advice.
