Medical marijuana could prove to be an effective combatant against opioid epidemic, says expert
In the late 1990s, pharmaceutical companies maneuvered the medical community into believing that patients would not become addicted to opioid pain relievers in a bid to drive up profits. The net result of that move is that the US is now suffering from an epidemic that has prompted the United States Department of Health and Human Services (HHS) to declare a national emergency and announce a 5-point strategy to combat the crisis.
So, what is an opioid exactly? It is a group of chemically similar drugs that include the likes of commercially and socially-approved ones like hydrocodone (Vicodin®), oxycodone (OxyContin®), methadone, and morphine, as well as illegal ones like heroin.
The numbers relating to the crisis are startling. More than 130 people died each day from opioid-related drug overdoses in 2018 and over a year, that's more than 47,000 deaths. Besides the deaths, 10.3 million people misused prescription opioids that year with more than two million found to have an opioid-use disorder.
Also, 2018 was a year were at least over two million people misused prescription opioids for the first time and 81,000 people used heroin for the first time. The latter was found to be responsible for 15,349 deaths.
It's not that there aren't resources that are being dedicated to combating this crisis.
In 2017, the HHS issued over $800 million in grants to support access to opioid-related treatment, prevention, and recovery, while simultaneously making it easier for states to receive waivers to cover treatment through their Medicaid programs. The HHS has also awarded the $1 billion Opioid State Targeted Response (STR) grant funding allocation to states and territories to help combat opioid addiction. The same year, the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded $144 million in grants to support opioid and other efforts to combat substance abuse across the country.
But despite this investment, which began with the Obama administration in 2011 and has seen the Trump administration order US mail carriers to block shipments of the most powerful and dangerous opioid, fentanyl, the crisis continues to rage, almost unchecked.
One of the reasons the death toll is still so high is because methadone and buprenorphine — both used to treat overdoses — are not widely available despite their effectiveness as they are both opioids themselves and their prescription is highly regulated. Concerns about diversion and addiction to these drugs remain as well.
Here, medical marijuana seems to offer an effective alternative to prescription opioids, at least when it comes to pain management. Topical Cannabinoids, one of the chemicals found in cannabis, has been shown to reduce pain, inflammation, discomfort, and a variety of other health conditions.
In 2017, it was found that chronic pain was the most common qualification amongst patients who are licensed to use marijuana medically, accounting for almost 62% of nearly 1 million medical cannabis patients.
A study conducted by Dwight K Blake, the Founder & Editor of AmericanMarijuana.org, a trusted medical marijuana resource online, has shown that opioid prescription rates have fallen in all but four of the 19 states where medical marijuana has been legalized after just one year. Of those states, Ohio and Pennsylvania have shown the highest fall of opioid prescription rates, with 19.2% and 17.8% decrease, respectively.
But how does that explain New Jersey, New Mexico, Michigan, and Arizona, where the rates of prescription have increased after legalization? Blake told MEA WorldWide (MEAWW) this had to do with how the legalization was carried out in these states.
"Patients [in these states] are only allowed to possess up to 2.5 ounces of cannabis for treating certain qualifying conditions (with a doctor’s recommendation)," he explained. "Furthermore, cannabis dispensaries were also limited in numbers, on top of specifying that only patients living within 25 miles from a dispensary could cultivate their own cannabis, which makes it more difficult for patients to get access to medical marijuana."
"In New Mexico and New Jersey, patients aren’t limited to possessing a specific amount of cannabis for treating but is limited to each state’s respective approved qualifying medical conditions, and by saying 'limited', I do mean it's limited: 10 in NJ and 6 in NM," he added.
It's not just Blake who is espousing medical marijuana as a solution to the epidemic either.
A study conducted by Hefei Wen, PhD and Jason M Hockenberry, PhD showed that from 2011 to 2016, adult-use marijuana laws and medical marijuana laws were associated with lower opioid prescribing rates for Medicaid enrollees: 6.38% and 5.88% lower, respectively, compared with states without medical cannabis laws.
Similarly, an October 2014 study Marcus A Bachhuber, Brendan Saloner, PhD, Chinazo O Cunningham, MD, MS, and Colleen L Barry, PhD, MPP to determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality found that between 1999 and 2010, states with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate compared to the states without.
But, as one can imagine, pharmaceutical companies aren't too pleased with these recent developments and findings.
"Big pharma companies could potentially lose billions of dollars with the legalization of medical marijuana so it’s likely that they’ll see medical marijuana as a threat instead," Blake said. "Due to this, it’s likely that they’ll do everything to stop the legalization of medical marijuana."
He brought up the example of Insys, a pharmaceutical company in Arizona that won the prize for the biggest personal campaign donation, made to oppose the state's recreational marijuana initiative in 2016. They had spent $500,000 to block legalization. When the cannabis-derived medical drug was still approved, they went ahead and received approval from the US Drug Enforcement Administration (DEA) to develop its own synthetic marijuana to battle small cannabis growers.
Big pharma aside, there are other hurdles too, including the fact that commercially available drugs in the US are subject to rigorous clinical tests and evaluations to ensure safety and efficacy, and that the remaining 31 states don't have laws pertaining to driving under the influence of marijuana.
The biggest hurdle, however, is rescheduling, Blake explained.
"Marijuana was classified before as a Schedule I substance," he said. "This meant it had no accepted medical use and has a high potential for abuse. But since it’s been used for medicinal purposes — and even recreational uses in some states, having to reschedule the drug could to a completely controlled substance could take a long time."