Countering the Opioid Crisis with Cannabis
I remember once standing in a parking lot, in the Fremont neighborhood of Seattle, on a cold, wet, drizzly day. I think it was winter 2016 or 2017. I looked up and saw the following billboard:
A valuable PSA.
I will always remember the immediate feeling I got when I saw this billboard. I experienced a sharp chill, one that rattled me a little more than the weather already had, but also a wave of optimism.
The topic of the opioid epidemic is a very personal one for me. At the end of 2015, my best friend passed away due to an opioid overdose. This event rocked me.
So, you can imagine the cocktail of emotions I felt when I saw this ad. I remember thinking, “bless the person that put up this billboard, and also screw it because it was too late”. According to the CDC, 33,000 Americans died in 2015 due to the opioid crisis, and my bestie was one of them.
However, my bitterness has waned over time and I have realized that for many others, it is not too late. Additionally, now that cannabis is becoming more and more accessible to the American public, the time is now for us to properly leverage cannabis as a means for countering the opioid crisis.
According to this infographic, sourced from the US Department of Health & Human Services, there are approximately 2.1 million people with opioid misuse disorder (based on 2016-7 data).
The company who puts out the cannabis PSA billboards is called Weedmaps, and I am so inspired by this company’s mission to educate and inform our community about how cannabis can actually contribute to society. They launched the weed statistic billboard campaign for the sole purpose to trigger more constructive conversation about weed legalization. Sure, they probably gained some brand awareness through the campaign, as well, but hey - brownie points were still earned. Check out Weedmap’s most recent “weed facts” here. Their site also contains a lot of educational resources on various weed topics, including how cannabis interacts with the human body as well as cannabis history. I can guarantee that I will be nerd-ing out on the historical content this evening.
How Can Cannabis Help Opioid Addicts?
Pain Management
As discussed in this article from Nursing Outlook, one of the most prevalent reasons that people initiate misuse of opioids is to deal with extreme or chronic pain. Therefore, “an integrative approach to pain management, involving safer, nonaddictive, alternatives to POMs [prescription opioid medications], are essential to continue to treat patients in pain.”
It is estimated that 100 million Americans live with chronic pain, which is awful to think about given the strenuous workweek that is the norm for most Americans. It is very important that as a society, we acknowledge that chronic pain is one of the root causes behind the current opioid epidemic. When researchers, politicians, and involved citizens can share a common understanding of why something is happening, then we are better poised to work together to overcome the original problem. And work toward reasonable solutions to pain management that can mitigate opioid misuse.
So, one of the key problems we have to solve is one of chronic physical pain. How can we provide cost-effective solutions that will address day-to-day discomfort but not risk the lives of those patients? Hmm… mindfulness-based-stress-reduction and cannabis, anyone?
The US government is not yet convinced that cannabis is the answer to dealing with chronic pain for millions of Americans.
Per the Periodic Effects Podcast, market research has shown that individual cannabis consumers use recreational cannabis products for three main reasons, 1) pain management, 2) anxiety, and 3) sleep. If the average cannabis user can cite that they use cannabis for pain reduction, then I think we can start to draw some connections to how cannabis can replace more dangerous forms of pain management, including opioids.
In fact, patients who have access to medical marijuana have provided insights into the fact that cannabis is actually the preferable approach to seeking relief from chronic pain. With cannabis, patients have reported less severe side effects, reduced withdrawal potential, ease of access, and better symptom management for their conditions.
Treatment and Recovery
There is data suggesting that cannabis use can provide value during the opioid treatment process.
According to a study released in 2018, cannabinoid therapy in mice has been correlated with reduced opioid withdrawal. Cannabinoid and opioid receptors are located in a similar section of the brain, and so researchers drawing correlations between how cannabis and opioids interact with the opioidergic system.
There are also studies that suggest that certain cannabinoid molecules can create an aversion to opioids/morphine by impacting the “reward” or dopamine hit that would normally be associated with opioid use. Although these mechanisms have not been well studied in humans, the data so far makes researchers optimistic that the science backs up the assertion that cannabis can be used to combat opioid addiction.
Certain clinical researchers are also recommending the co-administration of cannabis and small-doses of opioids. When administered together, cannabis and opioid analgesics have a “synergistic” effect. It’s possible that during rehabilitation, treatment professionals could direct patients to take a very small dose of opioids combined with cannabis to achieve the same relief they would normally achieve through a much larger dose of opioids, ultimately helping over time to reduce tolerance and dependence.
A 2016 report by the NCIA also highlights the benefit of this synergistic effect. The NCIA spoke with a medical marijuana doctor in Maine who had this to say, “Usually if a patient is taking opioids, you expect them to come back and ask for more, because their effectiveness diminishes over time,” he says. “But we saw patients using cannabis decreasing and stopping their use of opioids without even being asked to. None of us had seen anything like it in any area of medicine.”
So, why isn’t everyone on board with this solution?
More cannabis research is required before cannabis will become a mainstream response to opioids. But, research is often stalled due to the federal Schedule 1 classification of cannabis.
More Research is Needed
For us to truly understand the potential of cannabis to counter the opioid epidemic, providing patients with a safer, alternate route to reduced pain, we need to first have more research about the correlation between marijuana and opioid misuse.
Although cannabis for opioid addiction has been studied, the federal Schedule 1 classification has so far prevented human studies. At this point, cannabis researchers do not receive federal grant money and they could risk their practice by studying the plant. Sheila Vakharia of the Drug Policy Alliance shared that, “The longer marijuana remains a Schedule I drug, the longer we will have to wait for these answers, and the longer it will be until we can understand its potential as a therapeutic drug.”
Despite the many researchers and medical doctors that have been vocal about the efficacy of cannabis for opioid addiction, there is work to be done to convince our leaders within the state and federal government.
And time is of the essence, as approximately 130 people are dying every day. Those are people’s siblings, sons and daughters, and best friends.
Alas, it looks like I’ll be getting into weed activism faster than I had originally anticipated.
While the US government hums and haws over what to do, maybe we can learn something from our kind neighbors to the north. Canada has recently legalized recreational cannabis use at the federal level. Yay, Canada!
Canadian health researchers are starting to look into how cannabis can provide value in the face of the opioid epidemic. I hadn’t even realized this, but Canadian citizens have also been hit hard by the opioid crisis (this is the most devastating epidemic in Canada since the AIDS crisis).
I plan to keep my eyes open for the research studies that start to come from the Canadian government. Will cannabis-based forms of relief be available for opioid addicts in Canada? Let’s watch closely - perhaps an effective model will emerge that we can adopt here in the States.