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We investigated the relationship between cannabis use and cessation of unregulated opioid use among people who use drugs (PWUD) living with chronic pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Data for analyses were collected from three prospective cohort studies in Vancouver, Canada. All cohort participants who completed at least two study visits and reported both pain and unregulated opioid use in the past 6\u2009months were included in the present study. We analysed the association between cannabis use frequency and opioid cessation rates using extended Cox regression models with time\u2010updated covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between June 2014 and May 2022, 2340 PWUD were initially recruited and of those 1242 PWUD reported chronic pain, use of unregulated opioids and completed at least two follow\u2010up visits. Of these 1242 participants, 764 experienced a cessation event over 1038.2 person\u2010years resulting in a cessation rate of 28.5 per 100 person\u2010years (95% confidence interval [CI] 25.4\u201331.9). Daily cannabis use was positively associated with opioid cessation (adjusted hazard ratio\u20091.40, 95% CI\u20091.08\u20131.81; <jats:italic>p<\/jats:italic>\u2009=\u20090.011). In the sex\u2010stratified sub\u2010analyses, daily cannabis use was significantly associated with increased rates of opioid cessation among males (adjusted hazard ratio\u20091.50, 95% CI\u20091.09\u20132.08; <jats:italic>p<\/jats:italic>\u2009=\u20090.014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>Participants reporting daily cannabis use exhibited higher rates of cessation compared to less frequent users or non\u2010users. Observed sex\u2010specific differences in cannabis use and opioid cessation suggest potential differences in cannabis use behaviours and effects. Our findings add to the growing evidence supporting the potential benefits of cannabis use among PWUD, underlining the need for further research.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.14014","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:54:13Z","timestamp":1741740853000},"page":"799-810","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cannabis use and illicit opioid cessation among people who use drugs living with chronic pain"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3026-1581","authenticated-orcid":false,"given":"Chenai","family":"Kitchen","sequence":"first","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver Canada"},{"name":"Department of Medicine University of British Columbia, St. Paul's Hospital  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenia","family":"Socias","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver Canada"},{"name":"Department of Medicine University of British Columbia, St. Paul's Hospital  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric C.","family":"Sayre","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3843-2928","authenticated-orcid":false,"given":"Kanna","family":"Hayashi","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver Canada"},{"name":"Faculty of Health Sciences Simon Fraser University  Burnaby Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kora","family":"DeBeck","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver Canada"},{"name":"School of Population and Public Health University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3821-6221","authenticated-orcid":false,"given":"M.\u2010J.","family":"Milloy","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver Canada"},{"name":"Department of Medicine University of British Columbia, St. Paul's Hospital  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0870-7153","authenticated-orcid":false,"given":"Thomas","family":"Kerr","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver Canada"},{"name":"Department of Medicine University of British Columbia, St. Paul's Hospital  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8775-7142","authenticated-orcid":false,"given":"Hudson","family":"Reddon","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver Canada"},{"name":"Department of Medicine University of British Columbia, St. Paul's Hospital  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2020.101939"},{"key":"e_1_2_10_3_1","volume-title":"Responding to the oppression of addiction: Canadian Social Work perspectives","author":"Csiernik R","year":"2023"},{"key":"e_1_2_10_4_1","unstructured":"Health Canada.Opioid\u2010 and stimulant\u2010related harms.2024[cited 23 Dec 2024]. 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