The U.S. is facing an opioid epidemic that claims 115 lives every day. Addiction and overdose rates have dramatically risen over the past two decades, culminating in the massive public health crisis the United States is facing today. Fortunately, there are promising signs that medical cannabis could offer a treatment option.
Although cannabis has long been lambasted as a gateway drug, evidence is mounting that it is more likely an “exit drug.” When prescribed as medicine and combined with treatment such as drug counseling and group therapy, cannabis may help bring addicts back from the brink and give them a new shot at life.
Opioids are a class of drugs primarily used for pain relief that activate one of three opioid receptors in the brain and throughout the body. These narcotics often induce a morphine-like effect in the user and pose a high risk of dependency. Opioids include prescription painkillers, such as oxycodone, as well as illegal drugs like heroin and the synthetic opioid fentanyl.
According to the CDC, more than 636,000 people died from a drug overdose between 1999 and 2016. More than half of those deaths were related to the use of opioid-based drugs. Worse yet, the rate at which people are becoming addicted and dying are increasing sharply in recent years. In 2016, for example, the number of overdose deaths involving opioids was five times higher than in 1999.
More than 10% of all overdose deaths that took place in the 17-year period occurred in 2016, when 63,600 people died from a drug overdose. Of those who died, 66% overdosed on an opioid.
The CDC breaks up the opioid epidemic into three waves, the first of which began in the late ’90s. At that time, there was a significant rise in fatal prescription opioid overdoses. Roughly 1 in every 100,000 Americans would overdose on a prescription painkiller that year.
The second wave came in 2010, with a sharp increase in fatal heroin overdoses. By 2014, heroin had overshadowed prescription opioids as the leading cause of opioid-related deaths, claiming 4 in every 100,000 American lives. At this time, prescription opioids have reached a similar level.
The third wave, which began in 2013 and outpaced heroin as the leading cause of opioid-related deaths by 2015, is marked by the rise in synthetic opioid overdoses. Deaths related to synthetic opioids have risen so sharply since 2013 that they now claim roughly 6 in every 100,000 American lives annually.
Overdoses on each one of these opioid types – prescription, heroin, and synthetic – continue to rise year-over-year and unabated, with seemingly no end in sight. However, as cannabis legalization spreads to more states, it appears there may be a role for medical marijuana in combating the epidemic.
A growing body of research suggests that cannabis can effectively reduce opioid abuse in states where it is legal and easily accessible.
One study, conducted by researchers at the University of Georgia, Athens, found that the availability of legal medical marijuana significantly reduces the number of opioid prescriptions. Given that the opioid epidemic began first and foremost with prescription drug abuse, finding other methods for treating pain before resorting to narcotics is an effective way of controlling the flow of legally-obtained opioid drugs. Not only does this prevent misuse, but it also keeps prescription painkillers from falling into the wrong hands or entering the black market.
Another study performed by researchers at the University of Kentucky and Emory University confirmed those findings, particularly for Medicaid enrollees who are at a higher risk for chronic pain and substance abuse. States with active medical cannabis programs saw 3.7 million fewer daily doses filled. States that only permitted home cultivation still saw a reduction of nearly 1.8 million daily doses.
Moreover, the researchers noted that legal adult-use had an even greater impact on prescription rates than legal medical programs. States with medical cannabis laws saw a 5.88% lower rate of opioid prescription, while those with adult-use programs saw a 6.38% drop.
But what about patients who are already suffering from addiction? Here, the research is not as clear, but some medical professionals are experimenting with recommending cannabis to wean people off of their opioid addiction. Still, there is a dearth of empirical evidence to support any premature claims about the effectiveness of cannabis as treatment for substance abuse. That topic will likely be the subject of additional research, as legal markets expand and researchers have larger sample sizes to study.
As more states legalize cannabis, there will be more opportunities to study the impact of cannabis on substance abuse. However, nothing would help research efforts more than federal legalization. Because many universities receive federal funding, some are hesitant to meaningfully engage in cannabis research. Lifting the federal prohibition could help put their minds at ease and direct even more academic energy toward understanding what this new industry means for public health.
Whatever new findings crop up as research continues, one thing is already clear: cannabis can help treat pain before doctors prescribe opioid-based painkillers. A reduction in the number of patients ever introduced to opioids and keeping more doses in pharmacies instead of on the streets is already a huge win against an epidemic that has raged unchecked for nearly 20 years. For that, we have medical cannabis and the legal cannabis industry to thank.