Written by: Katie King
The United States is in the throes of the worst drug epidemic we’ve ever seen. This is a national healthcare crisis, created in part by the industry itself: over 650,000 prescriptions for opioids are written in the U.S. every day by healthcare professionals. These drugs are extremely addictive and overwhelmingly dangerous, not only to the individuals who use them but to their families and communities. But there is a light at the end of the tunnel; medical marijuana is emerging as a solution to this crisis, as studies show cannabis access and use can lead to decreased opioid use. Right now, the esoteric political debate of cannabis vs opioids rages on in Washington, while real world application begins to turn the tables for opioid users in states with legalized medical marijuana.
The Opioid Crisis in America Today
The odds are tragically high that you know someone who has struggled with opioid addiction, whether a family member, friend, or classmate. Usually, doctors prescribe opioids for pain management; most of us have probably taken opioids at some point in our lives, maybe due to a car accident, surgery, sports injury, or any sort of random and unforeseen event that ends up causing us physical pain. In spite of the growing opioid epidemic, doctors in America still seem to prescribe these painkillers with wild abandon to anyone with a pain complaint. And while opioids certainly have their use (none of us want to recover from major surgery without morphine, let’s be honest), your uncle probably doesn’t still need those Vicodin for his sprained ankle from 1996.
Unfortunately, opioids have an extremely high rate of addiction. Even a short-term dose of these painkilling drugs can lead to long-term addiction, and people unable to obtain opioids legally often find ways to get them illegally, sometimes by buying pills, or even resorting to using street heroin to satisfy their cravings. These drugs are not only addictive, they are super dangerous, especially when unregulated by a medical professional; an estimated 91 Americans die every day from opiate overdoses, with 500,000 reported overdose deaths occurring in the U.S. since the year 2000. That’s more Americans killed by opiates in the last 18 years than were killed in World War II. Recent studies show opiate drug overdose is the leading cause of accidental death in America, killing more people annually than car or gun accidents, to the tune of 42,000 Americans each year.
This crisis doesn’t just affect the individuals who suffer from addiction; it also impacts families and communities, and carries an economic cost of nearly $500 billion a year in health care costs, criminal justice expenses, and lost productivity and wages.
Could Medical Marijuana Replace Prescription Opioids?
One thing that may be able to curb this trend is medical marijuana. Once considered a “gateway drug” into harder substances such as opiates and heroin, marijuana is now being reconsidered as a gateway away from these drugs, as it clears a path to decreased opiate use in individuals struggling with addiction.
Cannabis and Opioid Addiction
Currently, 30 states and the District of Columbia have provisions for legal access to medical marijuana, and the majority of these list chronic pain among the qualifying conditions. Both opioids and cannabis have analgesic, or pain-managing properties. According to a report published by the U.S. National Library of Medicine, prescription opioid users reported medical marijuana provides pain relief equal to that of their other medications, but without the negative side effects of opioids. In a study of nearly 3,000 patients, 97% confirmed that using cannabis allowed them to significantly decrease the number of opioids they were using. Additionally, more than 80% of the patients agreed that cannabis alone was sufficient to treat their chronic pain, and were able to forgo opioid use entirely.
States with medical marijuana programs have also reported a significant decrease in the number of opioid-related overdose deaths reported each year. This is correlative to the decrease in opioids being prescribed in these states as well- nearly 2,000 fewer prescriptions were for opioids were filled per year in states with medical marijuana in the years following the introduction of their medical marijuana programs.
Can Cannabis Really Curb Opioid Use?
Because cannabis and opioids are both analgesics, it seems natural that using these two substances together would have its benefits; and this appears to be true. When used together, cannabis can boost the positive, pain-relieving effects, while helping to limit the negative side effects of opioids. Using cannabis in conjunction with opioids also lessens cravings and alleviates withdrawal symptoms.
Cannabis use enhances the effects of opioids. Prescribing cannabis for opioid addiction allows physicians to prescribe lower and less harmful doses of opioids, while still providing their patients with the relief they need. In fact, many medical marijuana patients prefer to substitute cannabis for their prescription pain relief drugs altogether.
Cannabis alleviates the symptoms of withdrawal, which can include chills, nausea, physical pain, and depression; relieving these symptoms makes opioid detox manageable and increases the likelihood that opioid users will stay sober and not return to using. There are many anecdotal reports of people addicted to opiate and heroin using cannabis to wean themselves off of the drugs entirely.
CBD-rich marijuana products are quickly gaining popularity among the medical marijuana community. These products are generally low in THC, the psychoactive element in marijuana; instead, they have a higher percentage of CBD, the non-psychoactive element of medical marijuana. CBD acts as an anti-anxiety medication and a natural mood enhancer, and can help inhibit drug cravings and discourage relapse among opioid addicts.
Treating Chronic Pain With Medical Cannabis
In 2017, the National Academies of Science and Medicine reviewed studies of more that 10,000 human subjects, and concluded cannabis is a safe and effective treatment for chronic pain.
Because of its natural analgesic properties, cannabis is a viable, long-term solution for people looking to manage their chronic pain. Cannabis has very little potential for chemical addiction (though any substance can be habit-forming), and there are no life-threatening physical side effects of cannabis addiction or withdrawal if it does occur. Because the toxic threshold of cannabis is so high, the danger of accidental overdose or death is basically zero; an individual would have to consume nearly 200 pounds of marijuana before they would be in any real danger, and that is just physically impossible. An overdose of marijuana essentially constitutes extreme sleepiness, excessive munchies, and maybe some paranoia or a headache. All of these will pass once the marijuana leaves the system.
States with medical marijuana programs, especially those that allow dispensaries to provide cannabis to patients, provide safe and easy access to cannabis. This ease of access is crucial to ensuring that patients continue to choose cannabis over opiates. Studies show that states with easily accessible medical marijuana have lower rates of opioid prescriptions being filled; states that have legalized recreational marijuana see even lower rates of opioid use, which suggests that some individuals who use opioids illegally (and are probably at the highest risk of overdose) also prefer safe, accessible cannabis.
Moving Forward: Cannabis Takes on a New Role in the War on Drugs
Attitudes towards cannabis are rapidly shifting in the U.S. As more states move to legalize medical and recreational marijuana, the federal government will have to decide where its priorities truly lie.
States that have already legalized medicinal (and recreational) marijuana are unlikely to willingly give up these programs. Resident health aside, states with provisions for recreational marijuana are seeing huge economic booms as the cannabis industry grows, creating thousands of jobs and millions of dollars in tax revenue.
Medical programs have a slew of benefits all their own, especially in regards to combating the opioid crisis. States with medical marijuana programs report a decrease in opioid-related deaths by as much as 25%, and non-fatal opioid-related hospitalizations decrease by around 23% as well. This means communities, as well as individuals, are safer and healthier. Easy access to a safe alternative pain medication is the trigger and medical marijuana is the smoking gun.
Because of cannabis’ status as a Schedule 1 drug, studies regarding its medical properties and potentials have been limited in the past. As that continues to change in coming years, it is likely cannabis will emerge as a true solution to the opioid crisis. We’ll continue to follow the debate over cannabis vs opioids in coming years, as more clinical studies and trials will definitively show this plant is one key to ending the opioid epidemic in America.