Curbing need for opioids

By Paul Armentano

OtherWords

In the struggle to address rising levels of opioid misuse and mortality, an unlikely ally has emerged: marijuana.

The relationship between cannabis and opioid use is among the best-documented aspects of marijuana policy. In short, the science demonstrates that marijuana is a relatively safe and effective pain reliever – and that patients with legal access use fewer conventional opiates.

Over 35 controlled clinical trials, involving over 2,000 subjects, have been conducted to assess the safety and usefulness of cannabis in treating chronic pain. Many of these trials specifically evaluate the plant’s ability to target hard-to-treat neuropathic pain.

An exhaustive literature review of over 10,000 scientific abstracts by the National Academy of Sciences, Engineering, and Medicine determined: “There is conclusive or substantial evidence that cannabis is effective for the treatment of chronic pain in adults.”

In clinical trial settings, pain patients provided with cannabis as part of their treatment typically reduce their use of opioids.

It’s worth looking at in some detail.

For instance, in one recent study that assessed cannabis use among the elderly, investigators reported over 18 percent of the study’s participants “stopped using opioid analgesics or reduced their dose.” They concluded: “Cannabis can decrease the use of other prescription medicines, including opioids.”

Decline in opioid use

Another clinical trial, which looked at 1,200 cancer patients over a six-month period, concluded that nearly half of respondents reported either decreasing or eliminating their use of opioids when given access to cannabis during their treatment.

In another recent trial, Columbia University scientists documented that using cannabis along with “sub-therapeutic” – that is, lower than usual – doses of opioids resulted in pain relief at a level “comparable to an effective opioid analgesic dose.” These findings point to the “opioid-sparing effects of cannabis,” investigators concluded.

Given this reality, it should hardly come as a surprise that in states where cannabis is legal, rates of opioid-specific abuse, hospitalizations and mortality fall. One particularly notable study reported a 20 percent decrease in opioid-related deaths one year after the enactment of medical marijuana legislation.

Assessments of pain patient cohorts in medical cannabis access states affirm this observational data. For example, the Minnesota Department of Health in 2017 reported that over 60 percent of state-registered patients using cannabis for chronic pain “were able to reduce or eliminate opioid usage after six months.”

Minnesota’s findings are hardly unique. 2016 data gathered from patients enrolled in Michigan’s cannabis access program reported that marijuana treatment “was associated with a 64 percent decrease in opioid use, decreased number and side effects of medications, and an improved quality of life.”

It’s time for lawmakers and health officials to recognize the well-established power of medical marijuana to treat chronic pain – and to acknowledge its emerging role in combating the opioid abuse crisis.

Paul Armentano is deputy director of the National Organization for the Reform of Marijuana Laws. Distributed by OtherWords.org.