Can medical marijuana help solve the opioid crisis? | The Tylt

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Can medical marijuana help solve the opioid crisis?

As of August 2018, 30 states have legalized marijuana for medicinal purposes, ranging from treatment of chronic pain to Parkinson's disease. In June 2018, New York state moved to add an opioid prescription to the list of qualifying conditions for obtaining medical marijuana in the state. Per the New York Health Department:

The New York State Department of Health today announced it will develop a regulatory amendment to add opioid use as a qualifying condition for medical marijuana.
"The opioid epidemic in New York State is an unprecedented crisis, and it is critical to ensure that providers have as many options as possible to treat patients in the most effective way," said New York State Health Commissioner Dr. Howard Zucker. "As research indicates that marijuana can reduce the use of opioids, adding opioid use as a qualifying condition for medical marijuana has the potential to help save countless lives across the state."
....Marijuana can be an effective treatment for pain, greatly reduces the chances of dependence and eliminates the risk of fatal overdose compared to opioid-based medications. Studies of some states with medical marijuana programs have found notable associations of reductions in opioid deaths and opioid prescribing with the availability of cannabis products. States with medical cannabis programs have been found to have lower rates of opioid overdose deaths than other states, perhaps by as much as 25 percent. Studies on opioid prescribing in some states with medical marijuana laws have noted a 5.88 percent lower rate of opioid prescribing. Adding prescribed opioid use as a qualifying condition for medical marijuana will allow individuals who use opioids to instead use medical marijuana for pain relief.

Doctors across the country are working on studies to determine cannabis' full range of medical applications. While most doctors agree cannabis can help treat chronic pain or anxiety, there are still questions about whether or not the drug can treat acute pain as effectively as opioids. Yasmin Hurd, a Mount Sinai neuroscientist, is currently working to study just such applications. Per The Atlantic:

Marijuana might have a bigger role in curbing this drug abuse than previously thought. Its potential uses are actually threefold: to treat chronic pain, to treat acute pain, and to alleviate the cravings from opioid withdrawal. And it has the advantages of being much less dangerous and addictive than opioids.
...This is especially relevant to Hurd’s work because her interest is not necessarily THC, the psychoactive chemical in marijuana, but cannabidiol, also known as CBD. Cannabidiol doesn’t get you high, but it affects the receptors in your brain more indirectly. In a small pilot study, Hurd has found that cannabidiol can reduce the cravings of people addicted to heroin. “They relapse because they are in conditions that induce craving,” says Hurd. By controlling their anxiety, cannabidiol also seems to be controlling their cravings.
...“They felt a lot better when their pain was being controlled by cannabis rather opioids because opioids have a lot of side effects,” he says. Those side effects include dizziness, constipation, sexual dysfunction and—in the case of overdoses—breathing problems. That’s because opioids receptors are also in the brainstem, the part of the brain that regulates breathing. Marijuana acts on a different set of receptors.

Not all opioid users are looking for a substitute for the painkillers. Opioids are used—and, admittedly, abused—because of the strength of their painkilling qualities. Many who currently use opioids to manage chronic, severe pain worry that legalizing and encouraging doctors to prescribe medical marijuana could discourage doctors from prescribing more effective opioids. According to the Chicago Tribune:

Joe Ruzich, who has a nerve disease that left him sometimes screaming in pain, said he only survives thanks to an electric stimulator and an opioid pump. He worries that doctors are being pressured to cut off opioid medication.
“It helps people like me live a normal life,” said Ruzich, who previously wrote for the Tribune as a freelance reporter but had to stop because of his ailment. “I’m glad people have more choice, but to present it as an alternative to opioids doesn’t seem right to me.”
As with many aspects of marijuana, research has found mixed results. The short answer is, yes, marijuana can help relieve pain, but not for all patients with all conditions. Some states with medical cannabis have also reported reductions in narcotics prescriptions, abuse and overdose deaths — though those associations don’t prove marijuana caused those changes.

Doctors and addiction specialists worry that medicinal marijuana is often difficult to prescribe and requires much more trial-and-error to determine how much someone should ingest to manage their symptoms. They also worry that marijuana could be over-prescribed just as frequently as opioids. According to NPR:

Aaron Weiner, director of addiction services at Linden Oaks Behavioral Health in Naperville, Ill., says the new policy amounts to replacing one addictive substance with another. "People are prescribed opioids inappropriately all the time," he says. "That doesn't mean they should be smoking pot."
Weiner says some scientific research supports the use of marijuana to treat chronic pain, referring to a 2017 report from the National Academy of Sciences, Engineering and Medicine (NASEM). But, he says, the industry puts patients at risk. That's because patients must use trial and error to find what works among a vast range of marijuana products.
Weiner is concerned that cannabis dispensary staff aren't trained adequately, and, he notes, they've been found to make recommendations that can harm patients.

As the opioid crisis worsens, some patients are refusing prescriptions for painkillers, worried about the addictive properties. Allowing medicinal marijuana would offer an alternative for patients wary of opioids side effects. Per NBC News:

Alex Jordan and Robby Pinnamaneni have suffered chronic pain since they were involved in serious car accidents, with broken bones and nerve damage. Morphine and oxycodone were available with the push of a button while they were hospitalized, they told NBC News, but they didn’t want to become opioid statistics.
Pinnamaneni said he refused a prescription for opioids, knowing that they are highly addictive. “I turned to cannabis in lieu of pills and I've never turned back,” he said. Jordan said she stopped taking opioid pain relievers while on bed rest at her family’s home because her hair and skin were becoming dry.
Both now work at Triple Seven, a marijuana dispensary in Los Angeles. Pinnamaneni said the average age of customers at some of their stores is 40 to 45. “I see families that come in together and shop for pain relief,” he said. “I think people are opening their eyes to the fact that this isn’t some evil drug.”

Some doctors worry treating opioid addiction and pain with cannabis is merely swapping one dangerous drug for another. 

Can medical marijuana help solve the opioid crisis?
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