[Canniseur: Here’s a reasoned response about opiate addiction and cannabis. Cannabis is not a panacea. We shouldn’t expect it to be a cure-all. That moves things into snake oil territory.]
There is a lot of hype right now over the possibility that medical marijuana can help curb the opioid epidemic, but the leader of the National Institute on Drug Abuse (NIDA), Nora Volkow, says she isn’t holding her breath.
There is so much more research needed, she said earlier this week in an interview with USA Today, before the nation can even begin to entertain the possibility. And she fears that jumping the gun on such a speculative treatment without first taking strides to learn the truth about its effectiveness could have a negative effect and launch addicts further down a rabbit hole.
“If you don’t treat it [addiction] properly, your risk of dying is quite high,” she said. “My main concern is by basically misinforming potential patients about the supposedly beneficial effects of cannabis, they may forgo a treatment that is lifesaving.”
Volkow is not wrong.
Proceeding With Caution
Sure, a few small studies are showing how opioid use is down in states that have legalized medical marijuana programs. There are even a few states that have made it possible for cannabis to be used as an alternative to prescription painkillers, with like Illinois and New York are essentially telling patients: Take your pick!
But the fact remains there is not a lot of substantial evidence showing that giving patients the freedom to use pot rather than opioids is going to make a real dent in the millions of people struggling from addiction issues in this day and age.
Some studies even suggest that putting hardcore opioid addicts on the path of medical marijuana treatment as opposed to traditional options, like methadone, could actually be life-threatening. So, you know, giving someone with an opioid problem an ounce of weed and hoping for the best probably isn’t going to work out.
The state of opioid addiction is such a multi-layered problem that it would be ridiculous to suggest that any single treatment option is a panacea. At best, medical marijuana seems to have the power to perhaps provide chronic pain patients with a way to reduce their pain pill consumption — not get them off entirely, but give them space to take less.
But then again, there are also those people out there who intentionally abuse opioids because it just feels good. These folks are less likely to respond to medical marijuana, because pot just doesn’t provide the same headspace as drugs like Lortab or heroin. It’s one of the reasons why this country is dealing with an opioid epidemic and not one stemming from cannabis abuse.
They are two entirely different drugs.
And while the brain receptors that allow humans to appreciate the feel-good effects of both cannabis and opioid are closely linked, they do not appear close enough to inspire most deep addicts to switch sides. For some, though, there’s a chance that it might.
But Wait, There’s More
There is some preliminary evidence that medical marijuana might be beneficial when it comes to curbing withdrawal symptoms and cravings. There are even some treatment centers on the West Coast that are experimenting with this concept.
“This is exciting,” writes Dr. Jonathan Stea for the Scientific American. “It means that there is much promise for the development and use of cannabis-based medicines in the treatment of opioid addiction.”
Whether it could has yet to be revealed, but NIDA hopes to find out.
The agency is on the verge of conducting several studies intended to determine whether cannabis could be useful in treating opioid addiction. This is needed, Volkow says, because as of now all of the noise on this issue is not supported with science. “I’m not saying it’s not possible,” she told USA Today. “Like anything else, we do science in order to determine and provide the evidence of whether it’s effective or not.”
But no matter what the outcome, opioids are not going anywhere. There are pain patients out there, those dealing with the repercussions of terrible injuries, surgeries and the nasty wrath of cancer, that argue they cannot go without strong painkillers. “Trauma and battlefield injuries could not be managed without the analgesic effects of opioids,” wrote Roger Chriss, a Washington-based technical consultant who suffers from a connective tissue disorder known as Ehlers Danlos syndrome, in a piece for the Pain News Network. “Opioids are an invaluable medical resource,” he added.
Some medical experts even argue that while the claims about medical marijuana being an effective painkiller might be spot-on, the research is flimsy. This is because all of the studies done on the subject thus far have been compared to a placebo, rather than an actual pain reliever. Not even a drug as weak as Ibuprofen has been compared to marijuana, says Dr. Peter Bach, a pulmonary physician at Memorial Sloan Kettering Cancer Center in New York. “That’s not the type of rigorous evaluation we pursue for medications,” he wrote in a recent piece for the Wall Street Journal. “What’s more, every intoxicant would pass that sort of test, because you don’t experience pain as acutely when you are high. If weed is a pain reliever, so is Budweiser.”
Some studies have even shown that medical marijuana makes pain worse in patients that have used opioids.
While marijuana is not likely going to be a salvation’s wing for the opioid problems — a plague that is killing tens of thousands of Americans each year — it could still be found to be part of the solution. Nobody is arguing that. But like we’ve said before at Cannabis Now, it is crucial to spread well-vetted information when it comes to cannabis. And right now, at least in the debate of whether marijuana is a suitable alternative to opioids, the truth is we just don’t know. We shouldn’t be afraid to admit that.