Prescription opioid use and opioid related deaths continue to increase nationwide. Several states have adopted legislation allowing for recreational use of cannabis. Little is known about how recreational cannabis law impacts compliance in chronic pain patients prescribed opioid therapy. The goals of this study were to: 1) Retrospectively assess the effect of cannabis use on compliance with opioid therapy in a high-risk patient population and 2) Determine the impact that legalization of recreational cannabis had on patients prescribed therapeutic opioids.