The Role of Medical Cannabis in the Opioid Epidemic
The opioid epidemic has ravaged the United States of America. “In Maryland, nearly 90% of drug overdose deaths involved opioids in 2018; a total of 2,087 deaths (a rate of 33.7).” While opioid medications can provide much-needed relief from pain, they can be highly addictive. Those addictions have wreaked havoc across America as patients and their families struggle to manage pain and break the cycle of addiction.
Our home, Harford County, has been acutely affected by the opioid crisis. There was a “173 percent increase in opioid-related deaths from 2013 to 2017” in Harford County. At Four Green Fields, we are committed to helping patients who desperately need pain relief and want to find alternative ways to manage their pain. Thankfully, there are many ways that medical cannabis can be used to manage pain and wean oneself off of opioid medications.
Dr. Dustin Sulak, the co-founder of Healer, is a medical cannabis expert who has written a Medical Cannabis Opioid Guide to teach patients how to use cannabis to reduce and replace opioid medications. In this guide, he highlights the advantages of using cannabis to treat chronic pain.
Cannabis enhances pain relief and other medical effects of opioids.
Taking cannabis with opioids can make the opioids safer by widening their therapeutic window (the window between the effective dose and the lethal dose). An ineffective dose of an opioid drug can become effective when it’s combined with cannabis.
In addition to reducing pain, cannabis conveys holistic benefits, such as improving sleep, reducing anxiety, relaxing muscles, giving perspective on life’s challenges, etc.
Cannabis relieves the symptoms of opioid withdrawal.
In dealing with opioid addiction, cannabis can be safer than other harm reduction options like methadone and Suboxone. It does not have the risk of a fatal overdose and has a lower risk of dependence and problematic use than other psychoactive substances. Cannabis can be used in combination with methadone or Suboxone to enhance the benefits and support a taper of these drugs.
Some studies have shown that cannabis users are more successful adhering to other forms of opioid addiction treatment, such as long-acting naltrexone.
Sulak, Dustin. “Healer Medical Cannabis Opioid Guide.” Healer, 2018, www.healer.com.
Be sure to consult with your health care provider before using cannabis to wean off opioids.
Do not adjust the dosage of prescribed opioid medications without discussing it with your provider. If your health care provider is uncomfortable with a THC-positive urine drug screen, please note that the Centers for Disease Control and Prevention (CDC) recommends against urine testing for THC in patients prescribed opioids for chronic pain. Work with an experienced cannabis clinician who can monitor and provide feedback on your use of cannabis.
Dr. Dustin Sulak
There are plenty of scientific studies analyzing the effectiveness of cannabis in combating opioid use disorder. In June 2017, Cannabis and Cannabinoid Research published the results of a study examining “the use of cannabis as a substitute for opioid-based pain medication by collecting survey data from 2897 medical cannabis patients. Thirty-four percent of the sample reported using opioid-based pain medication in the past 6 months. Respondents overwhelmingly reported that cannabis provided relief on par with their other medications, but without the unwanted side effects. Ninety-seven percent of the sample “strongly agreed/agreed” that they are able to decrease the amount of opiates they consume when they also use cannabis, and 81% “strongly agreed/agreed” that taking cannabis by itself was more effective at treating their condition than taking cannabis with opioids. Results were similar for those using cannabis with non-opioid-based pain medications.”
In September 2018, Cannabis and Cannabinoid Research published an article “highlight[ing] knowledge gaps and discuss[ing] cannabis' potential to prevent opioid misuse (as an analgesic alternative), alleviate opioid withdrawal symptoms, and decrease the likelihood of relapse.” More recently, in April 2020, the Journal of Psychopharmacology published the results of a study “evaluating the co-use of opioids and cannabis for pain among current users using hypothetical purchase tasks.” The data provided evidence that cannabis access may reduce demand for opioids in patients experiencing pain.
There is also evidence that the implementation of state medical cannabis laws can help lower the number of opioid prescriptions in that state. In May 2018, JAMA: The Journal of the American Medical Association: Internal Medicine published an analysis of the “association between US state medical cannabis laws and opioid prescribing.”
This longitudinal analysis of Medicare Part D found that prescriptions filled for all opioids decreased by 2.11 million daily doses per year from an average of 23.08 million daily doses per year when a state instituted any medical cannabis law. Prescriptions for all opioids decreased by 3.742 million daily doses per year when medical cannabis dispensaries opened.
When given an option other than opioid medications, patients are ready to try medical cannabis!
If you are curious about how medical cannabis and how it can help you wean off of opioid medications, please stop by Four Green Fields! Any one of our Patient Advocates would be more than happy to help you. We are also offering virtual consultations during the pandemic. And be sure to check out our Research Library to read more about the science behind medical cannabis and its relationship with opioids.
