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FARGO--With mounting attention focused on the nationwide abuse of prescription painkillers, a new report seems to come at an opportune time for those supporting a proposed medical marijuana measure in North Dakota.

However, a Sanford Health physician who specializes in pain management said there's a selection bias to the information, and it won't change how medicine is practiced.

The survey, published in The Journal of Pain, shows medical cannabis use is associated with 64 percent lower opioid use in chronic pain patients. Opioid use has come under increased scrutiny in part due to an associated surge in heroin abuse. There have already been several fatal heroin overdoses in Fargo-Moorhead this year.

Rilie Ray Morgan, chairman of the North Dakota effort to get medical marijuana on the November ballot, welcomes the survey news.

"If we can provide those patients with some relief that has very little chance of addiction, I think it just benefits patients and society as a whole," Morgan said.

As part of the survey, 244 chronic pain patients who patronized a medical cannabis dispensary in Michigan between November 2013 and February 2015 were asked about changes in their opioid use before and after starting medical cannabis.

In addition to a decrease in opioid use among participants, cannabis use was associated with a 45 percent increase in quality of life, fewer medication side effects and fewer medications used.

Dr. Manuel Colón, Sanford pain specialist and anesthesiologist, cautions that it's merely a survey, not a scientific study. It lacks a control group and a study group.

"The group has already been pre-selected," Colón said.

He said there's not enough data to suggest that medical cannabis would help more than it hurts, and much more study is needed.

"I would warn that substituting one addictive drug for another is not necessarily going to be the answer here," Colón said.

Morgan maintains that the cannabidiol, or CBD, in medical marijuana is different than tetrahydrocannabinol, or THC, in marijuana used recreationally.

"The CBD's don't have the addictive qualities that THC's do," he said.

Morgan said doctors should take a hard look at the practice of prescribing opioids, and medical marijuana should at least be an option for physicians and patients to explore.

Supporters are circulating petitions in hopes of putting the legalization of medical marijuana to a statewide vote in North Dakota this fall. They need 13,452 signatures by July 11 to get the measure on the ballot.

Medical marijuana was legalized last year in Minnesota. A dispensary is expected to open in Moorhead this summer.

The U.S. Centers for Disease Control and Prevention issued new recommendations in March aimed at reducing the number of pain pills being prescribed nationwide. Colón said Sanford Health is reviewing them.