Opioid abuse was declared an epidemic in the US, so far there is still no solution for this crisis. Many people are starting to believe that the controversial herb, marijuana, may just be the panacea.
In the recent past, cannabis has been a hot topic in different circles. While others are pushing for the decriminalization of marijuana, scientists have been studying its potential therapeutic benefits. Research efforts have been rewarded with some exciting medical breakthroughs such as the use of cannabis in the treatment of intractable childhood seizures as well as chemotherapy-induced nausea and vomiting. Other areas of interest include the use of cannabis for the treatment of pain, inflammation, insomnia, depression, cancer, IBS, glaucoma, cachexia, and migraines among others. Opioids have strong pain-relieving properties, they also have a high potential for abuse. Cannabis can equally be used to relieve severe pain, but can it stem the tide of the opioid epidemic?
Is The Gateway Theory Hogwash?
The ‘Gateway Theory’ was popularized by Robert DuPont in the ’80s during President Reagan’s ‘War on Drugs’ campaign. The Gateway Theory suggests that by smoking cannabis, a person develops a craving for illicit substances, and is more likely to try harder and harder drugs.
The other assumption is that a cannabis dealer would also end up being a peddler for harder drugs. Over time, the peddler would introduce harder drugs to the cannabis user. To this extent, the theory holds some weight. But with the legalization of cannabis, a user can obtain cannabis from a licensed cannabis dispensary.
The other assumption by DuPont was that marijuana could prime the brain for harder drugs. To date, there is no scientific evidence to back this assumption.
From this campaign, it was decided that a person found guilty of using cannabis would be subject to serve a prison term. Obviously, incarceration rates skyrocketed, but the rates of drug abuse did not decline. This definitely points to a weakness in the approach used by the “War on Drugs.” Imprisoning citizens for marijuana use has not led to a decline in the rates of abuse of harder drugs. But that’s not to imply that the issue of drug abuse isn’t critical– in fact, it is at its worst today.
The Opioid Epidemic
About 130 people die daily in the US due to opioid overdose. For a long time, opioids were the go-to solution for many doctors and healthcare providers for a growing number of pain-related ailments, leading to a massive spike in prescriptions. Before they knew it, patients were manipulating the system to obtain opioid prescriptions because they were hooked on opioids. In the blink of an eye, doctors had taken the place of drug peddlers as the key suppliers of drugs of addiction. In 2017, there were 58 opioid prescriptions per 100 Americans, with rates higher in cities with greater unemployment. It also emerged that 80% of people who abuse heroin have abused opioids in the past. Opioids are prescribed for pain but since they cause euphoria the patient goes on using them long after the pain has left. When they can longer have access to opioid prescriptions they turn to the black market for something with a similar, if not stronger, effect. Does this make opioids a “Gateway Drug” as well?
It is clear that opioids are not a long-term solution for severe pain. With so many opioid-overdose related deaths, a safer alternative is definitely needed. Does cannabis fit the tab?
Can Marijuana Solve The Opioid Epidemic?
This is definitely the ultimate rebuff to the “Gateway Theory.” Currently, cannabis is listed as a schedule 1 drug under US federal law. This basically implies two things: it has no medicinal use and it has a high potential for abuse. This alone serves to rule out cannabis as a potential alternative for the treatment of severe pain. However, a few factors can help to argue the case for marijuana:
- Marijuana is legal for medicinal use in 33 states
Medicinal cannabis is legal in 33 states in the US. This means that marijuana’s therapeutic potential has been acknowledged by over 50% of American states. Also, the FDA approved a cannabis-based drug for the treatment of childhood seizures in 2018. This is further proof that marijuana has therapeutic use.
- Marijuana is an effective treatment for pain
In a Meta-analysis of studies published in NCBI, it was concluded that “the findings support positive results from animal and other basic experiments.”The study evaluated the use of cannabis in treating different kinds of pain. It was recommended that further randomized studies be conducted at a clinical level to verify these findings.
- Marijuana can help to tackle opioid addiction
According to a 2017 survey titled “Cannabis as a Substitute for Opioid-Based Pain Medication: Patient Self-Report,” it emerged that 97% of patients who used marijuana were able to reduce their opioid intake over time. The study surveyed 2897 medical cannabis patients who reported that “cannabis is just as effective, if not more, than opioid-based medications for pain.” They also reported that “cannabis provided relief on par with their other medications, but without the unwanted side effects.”
4. There are no marijuana-related overdose fatalities
To date, there have not been any marijuana-related overdose deaths reported. In one controversial report by Stanford University, the researchers agreed that “We don’t think cannabis is killing people, but we don’t think it’s saving people.” The study criticized the theory that marijuana could help reduce opioid deaths.
There is always a lot of back and forth when it comes to marijuana, but there seems to be a consensus on two things: marijuana helps to relieve pain and reduce opioid dose for those already on opioids. Secondly, marijuana has a greater safety profile as compared to opioids, with no reported overdose fatalities.
It will be many years before we get sufficient scientific evidence to support the use of marijuana as a safe and effective treatment for opioid overdose. In the meanwhile, there is enough reason to keep hope alive.
- CDC: Understanding the Epidemic. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html
- NIH (2019): Opioid overdose crisis. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
- NCBI (2017): Cannabis as a Substitute for Opioid-Based Pain Medication: Patient Self-Report. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569620/
- NCBI: Marijuana and Pain. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK224384/
- Science Daly (2019): Medical marijuana does not reduce opioid deaths. Retrieved from https://www.sciencedaily.com/releases/2019/06/190610151933.html