Five Years, 241 Patients: The Cannabis Back-Pain Study That Cut Opioid Use by 95% (2026)| Workmans Relief

A new five-year study followed 241 chronic lower back pain patients who had already failed everything else. The results were large, durable, and hard to ignore, including a drop in opioid use from 100 percent of patients to under 5 percent. Here’s what the research actually found.

Chronic lower back pain is one of the most democratic afflictions in America. It doesn’t care what you do for a living, though it shows up early and stays late for the people who work with their bodies. It doesn’t care how tough you are. It doesn’t care how many times you’ve been told to stretch more, lift with your legs, or lose a few pounds. Roughly one in five adults on the planet is dealing with it at any given moment, and it remains the single leading cause of years lived with disability worldwide. If you’ve got it, you already know all of this. If you don’t, count yourself lucky and knock on something wooden.

The standard menu of treatments for serious chronic back pain has never been great. Opioids, which come with a dependency risk that has fueled a national crisis. Anti-inflammatories, which chew up your stomach and kidneys over years of use. Antidepressants and nerve medications, which come with their own long lists of side effects. Physical therapy, which helps but rarely solves it. For the people whose back pain doesn’t respond to any of that, the options get thin and the outlook gets bleak. These are the patients who have tried everything and are still in pain, still taking pills that aren’t working well enough, and still looking for something that does.

That’s exactly the population a new study zeroed in on, and the results are significant enough to warrant a careful, honest look.

What the Study Actually Did

Researchers at Rabin Medical Center in Israel followed 241 adults with treatment-refractory chronic lower back pain over a full five years, from 2020 to 2025. The word refractory matters here. Every single patient in the study had already documented failure of at least a year of conventional treatment, including opioids, anti-inflammatories, and physical therapy, with the majority having also failed antidepressants and nerve medications. These were not first-timers looking for an easy fix. These were people the existing medical system had run out of answers for. The study, published in the peer-reviewed journal Biomedicines, used each patient as their own historical control, comparing their documented pain and medication use during the failed conventional-treatment period against their outcomes over the following five years. You can read the full study on the publisher’s website if you want the complete methodology and data.

The scale of the improvement is what makes this study stand out from the usual noise. On the standard 0-to-10 pain scale, the average patient went from a severe 8.1 down to a mild 2.7 by year five. That’s not a marginal improvement. That’s a transformation of daily life. Disability scores, pain severity, and pain interference all improved by large, statistically robust margins, and critically, those improvements held steady across all five years rather than fading over time. The study authors summarized it directly: cannabis was associated with “large, sustained, and statistically robust improvements in pain, disability, and pain interference.”

The Opioid Number That Stops You Cold

Here’s the finding that made this study news. At the start, 100 percent of these patients were on opioids. That was part of the entry criteria. By year five, opioid use had fallen to 4.6 percent. Read that again. A group of chronic pain patients who all started on opioids ended up almost entirely off them. The study describes this as a within-patient absolute risk reduction of 95.4 percent, which in plain terms means the overwhelming majority of these patients stopped needing the opioids they had been dependent on for years.

The same pattern held across the other drug categories. Anti-inflammatory use fell from 100 percent to about 7 percent. Antidepressant use dropped from around 80 percent to 5 percent. Nerve medication use fell from about 39 percent to 2.5 percent. This near-total displacement of an entire pharmacy’s worth of daily medications is, from a public-health standpoint, the most important thing in the study. In a country still fighting an opioid epidemic that has caused staggering loss, a finding that a group of refractory pain patients almost entirely stopped needing opioids is not a small thing.

The safety profile held up over the five years, too. Across more than a thousand patient-years of tracked use, 99.8 percent of the recorded side effects were mild, and there was no evidence that patients developed tolerance requiring ever-higher doses to get the same relief. The effect that showed up in year one was still there in year five. That durability is the part short-term studies simply cannot measure, and it’s the reason a five-year window like this one is genuinely valuable.

This isn’t a lone finding hanging out on a limb, either. It lands in the middle of a steadily growing pile of research pointing in the same direction. A separate study of more than 3,500 patients found that medical cannabis helped people reduce their use of opioids, sleeping aids, and antidepressants, with fewer side effects after switching. A federally funded study found that about one in three Americans who use CBD take it as an alternative or supplement to at least one medication, particularly painkillers. Multiple studies published by the American Medical Association have found cannabis serving as an effective substitute for opioids in chronic pain treatment. Research on states that legalized cannabis has repeatedly found reductions in opioid prescriptions and, in several cases, reductions in fatal opioid overdoses. The Israeli back-pain study is one more careful brick in a wall that keeps getting taller.

The Honest Caveats, Because the Researchers Led With Them

Here’s what makes this study trustworthy rather than hype. The researchers were relentlessly honest about what their data can and cannot prove. This was an observational study, not a randomized controlled trial. There was no separate control group taking a placebo. That means the researchers were careful to say, repeatedly, that their findings show an association, not a proven cause-and-effect relationship. They openly acknowledged that some of the improvement could reflect things like regression to the mean, patient expectancy from a treatment they actively chose, and the general benefit of being in structured, supportive medical care for five years.

Their conclusion reflected that restraint. The data, they wrote, “support consideration of cannabis as a potentially clinically meaningful, opioid-sparing option in patients who have failed multimodal conventional therapy, pending confirmation in randomized comparative trials.” That’s a scientist’s sentence. It says this is promising and worth serious attention, and it says the definitive proof still requires more rigorous trials. Both halves of that are true, and the researchers deserve credit for stating both plainly instead of overselling a genuinely striking result.

One point the researchers made carries extra weight. The binary fact of stopped opioid prescriptions is much harder to fake than a self-reported pain score. A patient might unconsciously rate their pain lower because they want the treatment to work. But a patient either is or is not still filling opioid prescriptions, and that’s a hard, objective data point. The 95 percent reduction in opioid use is the finding least vulnerable to wishful thinking, and it’s the one that held up most strongly.

Why Cannabinoids Work on Pain in the First Place

The study looked specifically at one delivery method, but the reason cannabis affects pain at all has nothing to do with how it gets into the body. It has to do with the endocannabinoid system, the internal signaling network that runs throughout your body and helps regulate pain, inflammation, mood, and stress. THC and CBD interact with that system through what are called CB1 and CB2 receptors, influencing how pain signals get processed, how inflammation gets managed, and how the body handles the emotional weight of chronic discomfort. That underlying mechanism is the same regardless of whether the cannabinoids arrive through a topical, a tincture, a gummy, or anything else.

This is the important part for everyday consumers, because most people managing back pain are not looking to smoke anything. They want something that fits into a normal working life. And the cannabinoid science that makes the Israeli study interesting applies across the whole range of product formats. The receptors don’t care about the delivery method. They respond to the cannabinoids. What changes between formats is the onset time, the duration, and whether the effect is localized to one area or spread throughout the body. Those differences are exactly what let you match the right product to the right kind of back pain.

A topical, for instance, works locally. Applied directly to a sore lower back, it delivers cannabinoids right to the tissue that hurts, interacting with the receptors concentrated in that area without putting anything systemic into your bloodstream and without any high whatsoever. A tincture or an edible works differently, distributing cannabinoids throughout the body for a longer, broader effect that can be useful for pain that’s harder to pin to one spot, or for the sleep disruption that chronic pain so often drags along with it. Neither is universally better. They’re different tools for different versions of the same underlying problem.

Where Workman’s Relief Fits, Honestly

Let’s be straight about what we do and don’t sell. Workman’s Relief does not sell smokable products, and the study above looked specifically at inhaled cannabis in a supervised medical program. We’re not going to pretend our products are the same thing the researchers studied, because they aren’t. What we will say is that the science underneath that study, cannabinoids interacting with the body’s receptors to influence pain and inflammation, is the exact same science our products are built on. The delivery method is different. The biology is shared.

For the working American dealing with a chronically sore lower back, our Elbow Grease CBD topical line was built for exactly that job. The 1500mg CBD cream and the roll-on stick, available in cooling and warming variants, are formulated to be worked directly into the lower back, the shoulders, and the joints that a hard day leaves aching. It’s a localized tool for localized wear, no high, no impairment, no systemic effect, just cannabinoids delivered to the tissue that’s asking for attention. This is the same kind of muscle and joint wear that sends so many working people looking for relief in the first place.

For pain that comes paired with poor sleep, which chronic back pain almost always does, our USDA Certified Organic CBD tinctures and CBD gummies are built for the longer, broader kind of wind-down that helps the body rest despite the discomfort. We covered the growing sleep research in detail in our look at how two out of three Americans report cannabis helps them sleep better, and the overlap between pain and sleep is one of the most common reasons people build a cannabinoid routine in the first place.

Here’s the honest bottom line on the medical side. If you’re dealing with serious, treatment-refractory chronic pain, the right move is to talk to your doctor about your options, including the kind of supervised medical cannabis program the study describes. We are not a substitute for that conversation, and we would never claim to be. What we are is a clean, lab-tested, federally compliant option for the everyday muscle and joint wear that a working life produces, made for people who want a trustworthy product without a prescription or a doctor’s visit. That’s the lane we’re in, and we’re honest about its boundaries.

The Bigger Picture: What Opioid-Sparing Actually Means for Working America

Step back from the single study and look at the pattern. The opioid crisis has hit working America harder than almost any other group. The people who do physically demanding jobs are the people most likely to develop chronic pain, most likely to be prescribed opioids for it, and most likely to get caught in the long, brutal cycle of dependency that follows. Construction workers, warehouse workers, tradespeople, truckers, veterans, first responders. The demographics of chronic back pain and the demographics of the opioid epidemic overlap almost perfectly, and that overlap is not a coincidence.

So when a study finds that a group of refractory pain patients almost entirely stopped needing opioids, the significance goes beyond the 241 people in the study. It points at a possible path out of the cycle for exactly the population that has been hurt worst by it. The research on legalization backs this up at the population level. Studies have consistently found that states with legal cannabis see reductions in opioid prescriptions, and several have found reductions in fatal opioid overdoses, with one analysis estimating a meaningful drop in overdose deaths in states that legalized earlier in the crisis. The signal keeps showing up across different study designs, different populations, and different states. That consistency is what makes it credible.

None of this is a call to throw out conventional medicine. Opioids have a real, appropriate place in acute pain management and end-of-life care. The point is narrower and more honest. For the specific population of people whose chronic pain has not responded to conventional treatment, and who are stuck on long-term opioids that carry serious risk, the growing body of research suggests cannabinoids deserve to be part of the conversation. That’s not a radical position anymore. It’s increasingly the mainstream one.

Why Quality Is the Whole Game

Here’s the thing the research keeps underlining, directly or indirectly. The results depend entirely on the quality of the product. The Israeli study used pharmaceutical-grade, government-regulated cannabis with known, verified cannabinoid content. That precision is part of why the results were so consistent. When you know exactly what’s in the product, you can dose it reliably and get reliable results. When you don’t, all bets are off.

This is the single most important lesson for a consumer shopping the federally legal hemp market. A cannabinoid product is only as good as its formulation and its testing. A cream that claims 1500mg of CBD but actually contains a fraction of that will not deliver what the science promises. A tincture cut with mystery ingredients is a gamble every time you use it. The way to protect yourself is simple: buy from brands that publish their lab results. We went deep on this quality question in our look at what a scientific review found about CBD and skin inflammation, and the lesson there is the same as the lesson here. The compound can be genuinely useful. Whether the product actually delivers it is a completely separate question that comes down to quality control.

Every Workman’s Relief product carries a publicly available Certificate of Analysis showing the actual cannabinoid content and screening for contaminants. The CBD is USDA Certified Organic, grown on Wisconsin soil, and manufactured in our own GMP-certified facility. When the research says results depend on verified, standardized formulation, that’s the exact standard we’ve operated under since day one. Not because a study told us to, but because it’s the only honest way to make a product people rely on for real relief.

The Long View: An Old Remedy, Finally Measured

There’s a longer arc under all of this. Humans have been turning to this plant for pain relief across an enormous span of recorded history. The documented relationship between people and cannabis goes back many thousands of years, and its use for aches, injuries, and inflammation appears across countless traditions long before anyone could run a five-year clinical study on it. The plant was doing this work for our ancestors. Modern science is now, slowly, catching up to measure exactly how well.

That’s the recurring theme in nearly all the good cannabinoid research. The findings aren’t discoveries of some brand-new property. They’re rigorous confirmations of things people figured out empirically over centuries, now backed by the kind of measurement that lets us understand the mechanism and, crucially, formulate products that deliver it reliably. The five-year pain reduction is a number no ancient healer could have measured. The underlying relief is one they were almost certainly already putting to use.

What makes this era genuinely better is the combination of that old knowledge with modern quality control and honest science. A working American with a bad back today can access a lab-verified, precisely dosed, contaminant-screened product made under controlled conditions and backed by a public Certificate of Analysis. The plant is ancient. The reliability is new. And for the person who just wants their back to stop screaming at the end of a long day, the reliability is the entire point.

For the People Who Carry the Load

If your back has been part of the price you pay for doing honest work, this research is worth your attention. Not because any product is a miracle, and not because you should make any major medical decision based on a single study or a single blog post. But because the evidence that cannabinoids have a real, measurable role in managing pain keeps getting stronger, and the stigma that kept a lot of working people from even considering it is finally starting to fade.

Talk to your doctor about the serious stuff. For the everyday muscle and joint wear that comes with a working life, our lineup is built to help, lab-tested, transparently dosed, and made in America. The 15% discount for veterans and first responders is standing policy, because so many of the people carrying chronic pain earned it in service. The Subscribe & Save program is there for the routine that builds over time. The lab reports are public. The standard doesn’t change.

Your body has carried you through a lot. It’s worth taking care of, with tools you can actually trust.

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