In states where medical marijuana is legal, doctors write fewer opioid prescriptions and patients consume lower doses
Legalization opponents call marijuana a “gateway drug” that leads users to more dangerous substances. But could it also be an “exit drug” that helps ease the opioids crisis?
The data is scarce, but the anecdotes are plentiful.
After more than a decade in the US air force, Jennifer Baxter needed foot surgery. It wasn’t successful, and she had to have two more procedures to correct her “severely disfigured, painful and mechanically incorrect foot”.
Baxter had had surgeries before, and had taken opioids to recover. But, as she tells it, this time she connected with a civilian doctor known for his generosity with pain medication.
After receiving a medical retirement, Baxter was prescribed her 600 pills a month, including 480 oxycodone (a generic version of the opioid OxyContin), she said.
Soon the month’s oxycodone lasted only 21 days. She lost her career, gained an unhealthy amount of weight and contemplated suicide. “I was watching the clock all day every day for three and a half years,” she said.
She heard medical marijuana might be helpful and began using it in spring 2016. Balancing it with the slow-release morphine to stave off the symptoms of opioid withdrawal, she quit pills entirely in several months.
Today Baxter, 40, has a new life. She is engaged to be married. She volunteers with rescue animals and is involved in her church. She has lost weight and lives in Arizona, where she can legally obtain medical marijuana for her pain, PTSD and insomnia. She takes it nightly and sometimes during the day.
In 2017, a record 47,600 Americans died of opioid overdoses, according to the Centers for Disease Control and Prevention. The grim tally represents an increase of more than 10% from 2016, the previous record year. More Americans die from opioid overdoses than car crashes or gunshots.
Almost no one considers marijuana to be as ruinous for individuals or society. But legalization activists and the industry have marshalled anecdotal evidence and personal testimonies to support the notion that cannabis can help people wean themselves off opioids.
As with all issues surrounding medical marijuana, there’s not much good data. Despite encouraging stories like Baxter’s – I’ve heard lots of them – there have been no formal clinical trials to determine whether cannabis is an effective treatment for opioid addiction. And cannabis remains unproven as an adequate substitute for opioids in treating chronic pain, which is how many addictions begin, sometimes after car or work-related accidents. Despite public perceptions, the evidence for cannabis as a painkiller “is actually weak and … riddled with limitations”, the psychologist Jonathan M Stea wrote recently in Scientific American.
However, studies have consistently shown that in states where medical marijuana is legal, doctors write fewer opioid prescriptions and patients consume lower doses of opioids. (One study released in 2018 found evidence that states with legal medical marijuana saw fewer prescriptions for weaker “schedule III” opioids but not the more addictive and powerful schedule II drugs.)
Despite the paucity of data, the “exit drug” theory has led to overwhelming support for medical marijuana research among veterans. Several US states allow anyone with an opioid prescription to obtain a medical marijuana card.
The interest in cannabis as a substitute for opioids comes as opioid makers face escalating scrutiny and legal trouble. In March, a group of more 600 US cities, counties and Native American tribes filed a lawsuit alleging that “eight people in a single family made the choices that caused much of the opioid epidemic”. The family, the Sacklers, control Connecticut-based Purdue Pharmaceuticals, which introduced OxyContin in 1996.
The family denied the allegations in a statement.
Last week, Purdue and the Sackler family agreed to pay $275m to settle a lawsuit brought by the state of Oklahoma. (The family was not named as a defendant in the lawsuit.)
Whatever caused the opioid crisis, it is a deeply complex problem, one that few if any credible observers think will be relieved by cannabis alone. And some reject the idea of employing a drug as an appropriate response to a drug crisis.
“When we are dealing with opioids as the single biggest health crisis this state has ever had, you are going to tell me legalizing more drugs is the answer?” New Hampshire’s Republican governor, Chris Sununu, said last fall. “Absolutely not.”
Thank you readers for your interest in the article. Please like and comment so we have more motivation to write articles
0 Comment:
Post a Comment