Treating opioid addictions with cannabis
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The US is battling an opioid epidemic characterized by a huge increase in the use of prescription and non-prescription opioids. To help lower the growing number of addictions and subsequent deaths caused by drugs like heroin, Vicodin, and more, people are discussing turning to cannabis. Could cannabis help treat opioid addictions?
When we think about opioid addictions, our mind quickly conjures up images of dark alleys filled with people injecting heroin into their veins. And while heroin is a dangerous drug that leads to an ever-increasing number of deaths across the US, it’s not the only opioid we should be worried about.
The use of prescription opiate medication like Vicodin, Oxycontin and other related painkillers is rising extremely quickly across the US; the number of deaths and sales of opioid based painkillers like those mentioned above quadrupled from 1999 to 2008 and only continue to rise.
In 2012, 259 million prescriptions were written for opioids, which is more than enough to
give every American adult their own bottle of pills. Furthermore, statistics show that prescription opiate drugs are the new “gateway drug” to heroin; 4 in 5 heroin users started out misusing prescription painkillers.
In 2015, the Drug Enforcement Agency declared that overdose deaths, particularly from prescription drugs and heroin, had finally “reached epidemic levels.”
Some of the areas most affected by this new epidemic include the states of Connecticut, Delaware, Maine, and Maryland, were the number of overdose deaths caused by opiates between 2015 and 2016 increased by 26%, 35%, 39%, and 62% (respectively).
The groups most at risk of abusing prescriptions opioids are young adults aged 18 to 25. The reasons why young people turn to these drugs are varied and can include simply getting “high” or using ADHD stimulants to improve their focus while studying.
Prescriptions drugs are also the second most commonly used drugs in high school seniors following marijuana, and other high-risk groups include homeless youths and low-income earners.
THE CALL FOR URGENT MEASURES
Given the severity of the opioid epidemic in the US, politicians, medical professionals, and advocates are calling for desperate measures to deal with the problem of opiate abuse. In March 2017, for example, the governor of Maryland declared a State of Emergency to combat the epidemic.
The US government is responding with a wide variety of measures. These include rescheduling certain prescription drugs like hydrocodone combinations. Other measures include the coverage and financing of medications to treat opioid addictions via Medicaid, labeling opioids with new warnings, supporting better treatment options for addicts, and more.
The approach to dealing with opioid addiction is complex and is outlined in further detail in this fact sheet prepared by the US Food and Drug Administration.
CANNABIS: A WAY OUT?
One option that the government is overseeing, according to activists, is the use of cannabis to help treat opiate addiction.
Advocates like Michelle Ham, a 37-year-old mother of two from Maine who claims she ended her years-long addiction to painkillers by using cannabis to deal with her withdrawal symptoms, make a strong case for this argument.
Michelle’s story (and those of others like her) have empowered cannabis advocates around the country and intrigued both lawmakers, medical professionals, and researchers to the point where experiments in using cannabis to treat opiate addictions are already underway in California and Massachusetts
Dr. Gary Witman, for example, is actively treating addicts with cannabis at his offices in Fall River, Stoughton and Worcester, Massachusetts. In 2016 Witman announced he’d already helped 15 patients effectively overcome their opioid addictions using marijuana with an impressive 0% relapse rate.
He claims the treatment has helped his patients stay more focused, have greater respect, and enjoy higher levels of self-esteem. He also mentioned he has helped his patients regain employment.
Meanwhile, advocates in Vermont and Maine are pushing to have heroin and prescription drug addiction listed as qualifying conditions on their respective medical marijuana programs.
To better understand the argument behind the use of cannabis in treating opioid addictions, it’s important to take a closer look at the unique ways in which cannabis affects opiate use.
CANNABIS, PAIN, AND OPIOIDS: AN OVERVIEW
By now we are well aware of the pain-relieving properties of cannabis. The drug gets these properties from compounds known as cannabinoids, especially THC and CBD. When these compounds enter the body, they interact with the body’s endocannabinoid system which plays an important role in pain management.
The first studies exploring cannabis’ unique pain-relieving properties date back to the 20th century. However, most of the significant evidence is drawn from more recent studies. In 2016, for example, a study published in the Clinical Journal of Pain showed cannabis produced significant improvements in pain severity and helped patients become more functional.
More importantly for this discussion, the study also showed that medical cannabis use drove down the use of opiates in participating patients by over 40%.
Another favorite source of evidence among advocates for using cannabis in addiction treatment is a 2014 study by The Journal of the American Medical Association (JAMA). This study found that states with medical marijuana laws had nearly 25% fewer opioid-related overdose deaths than those without.
The fact that cannabis is a proven painkiller with the ability to reduce opiate use in chronic pain patients, coupled with other research that promote cannabis as a well-tolerated, safe, and effective drug with arguably less significant side effects than traditional opiate medications is the basis of the argument to legalize medical marijuana to treat opiate addictions.
CANNABIS AND OPIOID ADDICTION: THE FINAL VERDICT
While the results from the above studies are compelling, some medical professionals argue it’s not enough to warrant that cannabis is an effective form of treating opioid addiction.
Although the results from the JAMA study mentioned above are intriguing, even the study authors claim they are not enough to warrant making the case for cannabis as a treatment option for opioid addictions:
“If the relationship between medical cannabis laws and opioid analgesic overdose mortality is substantiated in further work, enactment of laws to allow for use of medical cannabis may be advocated as part of a comprehensive package of policies to reduce the population risk of opioid analgesics,” wrote the authors.
The Harvard Medical School’s Dr. Kevin Hill also puts the scientific evidence for cannabis into perspective:
"If you are thinking about using cannabis as opposed to using opioids for chronic pain, then I do think the evidence does support it," he said in a previous interview. "However, I think one place where sometimes cannabis advocates go too far is when they talk about using cannabis to treat opioid addiction."
While there are some compelling figures out there about cannabis, it’s ability as a pain reliever, and even its ability to lower opiate usage in some patients, it seems it still isn’t enough to come to clear conclusions about whether the drug can effectively treat addictions.
However, this evidence does at least open the topic up for discussion, and promotes further research into this field in order to find more conclusive evidence.