Can Medical Marijuana Replace Opioid Use?

Can Medical Marijuana Replace Opioid Use?

Using medical marijuana to safely reduce opiate use and ease withdrawal symptoms.

  • Studies show that medical marijuana can help reduce symptoms associated with opiate withdrawal.
  • Medical marijuana is also now widely used for pain reduction.
  • Statistics suggest there is a drop in opiate use and opiate-related deaths in states with medical and recreational marijuana programs.
  • A number of states including Pennsylvania, New Jersey, New York, and New Mexico list opioid addiction among the qualifying conditions for medical marijuana use. Others are expected to follow.

Is medical marijuana an effective substitute for opiates? Can it help ease withdrawal symptoms associated with opiate addiction? Anecdotal evidence, scientific study, and real-world statistics stand in agreement on this. Yes, medical marijuana and high-CBD hemp strains produce compounds that relieve pain, improve mood, reduce anxiety, and directly modulate the brain’s reward circuits to reduce cravings.

An ocean of information and evidence exists for marijuana’s anti-inflammatory, anti-anxiolytic (anti-anxiety), antidepressant, and anti-seizure properties all of which have proven to be beneficial both for reducing the need for opiates and kicking an opiate habit.

In this article, we’ll focus on some of the evidence for these claims. We’ll also explain the ways that patients are using medical marijuana to escape the grips of opiate addiction.

Can medical marijuana replace opioid use?

There is ample scientific evidence that medical marijuana is effective at reducing pain. And the data being gathered in states in which medical marijuana — and even more so, recreational marijuana — are suggesting that opioid prescribing, use, and addiction are falling in those states.

Two reports on this topic were recently published in the Journal of American Medicine.

In a report out of the University of Georgia, Athens, authors of a study on the effects of medical marijuana on opioid statistics concluded:

“Medical cannabis laws are associated with significant reductions in opioid prescribing in the Medicare Part D population. This finding was particularly strong in states that permit dispensaries, and for reductions in hydrocodone and morphine prescriptions.”

And the second report out of the University of Kentucky and Emory University noted:

“Marijuana is one of the potential nonopioid alternatives that can relieve pain at a relatively lower risk of addiction and virtually no risk of overdose…and have the potential to lower opioid prescribing for Medicaid enrollees, a high-risk population for chronic pain, opioid use disorder, and opioid overdose…Marijuana liberalization may serve as a component of a comprehensive package to tackle the opioid epidemic.”

Statistics presented in the reports showed that in states with medical marijuana dispensaries the number of daily doses filled was reduced by 3.742 million. And in states where there are no dispensaries, but residents are permitted to grow marijuana at home, there were 1.792 million fewer daily doses.

And the effect is even greater in states that permit the recreational use of marijuana. Medical-only states have a 5.88% lower rate of opioid prescriptions while states with recreational programs enjoyed a 6.38% lower rate of opioid use.

This isn’t the first-time researchers have come to these conclusions. Back in 2014, a study published in JAMA showed that states with medical cannabis laws have roughly 25 percent lower opioid overdose rates.1

Another paper, by Kentucky and Emory researchers published in JAMA in May 2018 found that doctors in states with medical cannabis programs wrote 39.41 percent fewer opioid prescriptions per 1,000 enrollees annually.2 And, once again, the data showed that recreational legalization had an even greater effect. The report states:

“Furthermore, the implementation of adult-use marijuana laws was associated with a 9.78% lower Medicaid spending on prescription opioids, equivalent to an annual saving of $1,815 Medicaid spending per 1,000 enrollees. The implementation of medical and adult-use marijuana laws was also associated with a lower rate of Medicaid-covered prescriptions for nonopioid pain medications of 8.36% and 8.69%, respectively.”

That same year, the Minnesota Department of Health published the results of a study on the use of marijuana for treating chronic or intractable pain.3 Out of 353 patients who said they were using opioids prior to using medical marijuana, 63 percent reduced or eliminated opioids after six months.

The conclusion is inescapable. In states where marijuana is accessible, a significant percentage of patients opt for a safer alternative to addictive and deadly opioids. Additionally, a significant percentage of patients already addicted to opioids are substituting medical marijuana.

Lawmakers in several US states who have looked at the data have decided that the evidence is strong enough to warrant the drafting of medical marijuana laws specifically designed to reduce opioid use and overdose.

The state of New York, for example, has instituted rules that permit the use of medical marijuana by patients enrolled in certified opioid use disorder (aka opioid addiction) treatment programs. New York State Health Commissioner Howard Zucker, M.D., said in the announcement, “Adding opioid replacement as a qualifying condition for medical marijuana offers providers another treatment option, which is a critical step in combating the deadly opioid epidemic.”

A number of other states have come to the same conclusion. Pennsylvania, New Jersey, Colorado, and recently New Mexico, list opioid use or addiction as a qualifying condition. And other states such as Delaware are considering adding opioid use disorder to their list of qualifying conditions for medical marijuana use.

Is medical marijuana safe?

To answer the question of whether or not medical marijuana is safe, the National Academy of Sciences’ examined 10,000 scientific abstracts on the health effects of cannabis. Their 395-page report includes not one single mention of death by marijuana overdose in adults.4

Compare marijuana’s perfect safety record with more than 30,000 opioid-related deaths reported in 2015. That number ballooned to more than 70,000 in 2017. Case closed.

How is medical marijuana used to treat opioid addiction?

How does medical marijuana help to reduce the cravings associated with opioid withdrawal? Without getting into a highly technical discussion, the answer lies in the brain’s reward circuitry.

In both drug and alcohol addiction, compounds such as opioids attach to receptors in the brain, triggering the reward centers of the brain flooding the brain with dopamine. Dopamine is a neurotransmitter that modulates feelings of pleasure. When used repeatedly, opioids begin to overstimulate reward circuits.

The result is a set of potential withdrawal symptoms include strong cravings, high anxiety, depression, fatigue and lethargy, sweating, shaking, and vomiting, and, in worst cases, seizures and hallucinations.

Both of the two most common cannabinoids produced in marijuana, THC, and CBD, have been shown in studies to have the potential to treat all of these symptoms. CBD, in particular, has been shown to override reward centers in the brain to reduce cravings and anxiety. And THC is known to reduce pain and nausea and improve moods. And both THC and CBD have been shown to reduce seizures.

A number of addiction treatment centers around the country currently allow patients to use cannabis as an alternative to traditional medications. However, the effects of cannabinoids vary from person to person. For this reason, treatment programs involving marijuana are highly individualized.

There is, as of yet, no tried, tested, proven method for using marijuana to wean a patient off of opioids. In most cases, it’s not an instantaneous or “cold turkey” proposition. As with all drug addictions, treatment and rehabilitation take time.

Even though all states that permit recreational use also have medical marijuana programs, many pain patients and even some addicts choose to self-medicate and have no particular treatment plan. In most cases, self-medication draws out the process of rehabilitation or fails altogether.

For this reason and considering the gravity of illnesses involving severe chronic pain and the imminent dangers of opioid addiction, patients are best served by consulting with health care and rehabilitation professionals who can offer a solid treatment plan and monitor progress.

Moreover, self-treatment often involves illicit black-market products which are generally not produced using organic practices and are not subject to lab testing. These products can contain toxins such as pesticides, molds, metals, and other contaminants that might make matters worse or cause additional health problems.

Research continues in the quest to determine the effectiveness of medical marijuana in treating pain and addiction. In fact, the US federal government has set aside a budget of $238,000 to follow more than 10,000 medical marijuana patients in New York over the next two years to see if their opioid use drops. The National Institute on Drug Abuse funded study and others like it, in combination with the growing collection of real-world data, will continue to shed light on the benefits of medical marijuana for both patients with chronic pain and those addicted to opioids.5

Sources

  1. JAMA – Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010
  2. JAMA – Association of Medical and Adult-Use Marijuana Laws With Opioid Prescribing for Medicaid Enrollees
  3. MN DOH – Medical cannabis study shows significant number of patients saw pain reduction of 30 percent or more
  4. National Academy of Sciences – The Health Effects of Cannabis and Cannabinoids
  5. Buzzfeed – Could Pot Help Solve The Opioid Crisis?