Marijuana legalization could help offset opioid epidemic, studies find
Experts have proposed using medical marijuana to help Americans struggling with opioid addiction. Now, two studies suggest that there is merit to that strategy.
The studies, published Monday in the journal JAMA Internal Medicine [open, DOI: 10.1001/jamainternmed.2018.0266] [DX], compared opioid prescription patterns in states that have enacted medical cannabis laws with those that have not. One of the studies looked at opioid prescriptions covered by Medicare Part D between 2010 and 2015, while the other looked at opioid prescriptions covered by Medicaid between 2011 and 2016.
The researchers found that states that allow the use of cannabis for medical purposes had 2.21 million fewer daily doses of opioids prescribed per year under Medicare Part D, compared with those states without medical cannabis laws. Opioid prescriptions under Medicaid also dropped by 5.88% in states with medical cannabis laws compared with states without such laws, according to the studies.
"This study adds one more brick in the wall in the argument that cannabis clearly has medical applications," said David Bradford, professor of public administration and policy at the University of Georgia and a lead author of the Medicare study. "And for pain patients in particular, our work adds to the argument that cannabis can be effective."
Also at the Washington Post.
Association of Medical and Adult-Use Marijuana Laws With Opioid Prescribing for Medicaid Enrollees (open, DOI: 10.1001/jamainternmed.2018.1007) (DX)
Previously:
Study: Legal Weed Far Better Than Drug War at Stopping Opioid Overdose Epidemic
Opioid Commission Drops the Ball, Demonizes Cannabis
Related Stories
The Free Thought Project reports via AlterNet
There's one thing that appears to be saving more lives during the opioid epidemic than anything else--medical cannabis. While government touts meaningless attempts at addressing the problem--paying lip service to the people while protecting Big Pharma's profits and filling jails--people are saving themselves by turning to an ancient plant.
Yet another scientific study has confirmed that medical cannabis access reduces harm from opioid abuse among the population. A recent study published in the Drug and Alcohol Dependency journal found that states with legal medical cannabis experience fewer hospitalizations related to opioids.
"Medical marijuana legalization was associated with 23% and 13% reductions in hospitalizations related to opioid dependence or abuse and [opioid pain reliever] OPR overdose, respectively; lagged effects were observed after policy implementation."
Researchers from the University of California analyzed hospital administrative records for the period of 1997 to 2014. The author reported:
"This study demonstrated significant reductions on OPR- (opioid pain reliever) related hospitalizations associated with the implementation of medical marijuana policies. ... We found reductions in OPR-related hospitalizations immediately after the year of policy implementation as well as delayed reductions in the third post-policy year."
The data also show that cannabis-related hospitalizations did not increase after legalization, contrary to what prohibitionists would have you believe.
Opioid commission's anti-marijuana argument stirs anger
New Jersey Gov. Chris Christie, head of the presidential commission on opioids, warned of the dangers of marijuana in a letter to President Donald Trump earlier this month about the panel's findings, saying the current push for marijuana legalization could further fuel the opioid epidemic.
"There is a lack of sophisticated outcome data on dose, potency, and abuse potential for marijuana. This mirrors the lack of data in the 1990s and early 2000s when opioid prescribing multiplied across health care settings and led to the current epidemic of abuse, misuse and addiction," Christie wrote in the letter, which was released with the commission's final report.
"The Commission urges that the same mistake is not made with the uninformed rush to put another drug legally on the market in the midst of an overdose epidemic."
[...] But some experts say the commission's fixation on marijuana was bizarre and troubling, lending credence to outdated views of marijuana as a gateway drug. And these experts want to nip such thinking in the bud.
They emphasized that they support efforts to curb the nation's opioid epidemic, but not the demonization of marijuana in the process.
"I was surprised to see negative language about marijuana in the opioid report," said Dr. Chinazo Cunningham, a professor of medicine at the Albert Einstein College of Medicine. "Research that examines pain and marijuana shows that marijuana use significantly reduces pain. In addition, the majority of studies examining marijuana and opioids show that marijuana use is associated with less opioid use and less opioid-related deaths."
You had one job.
Previously:
Study Finds That Legalized Medical Cannabis Led to a Decline in Medicare Prescriptions
New Attorney General Claims Legal Weed Drives Violent Crime; Statistics be Damned
4/20: The Third Time's Not the Charm
Jeff Sessions Reboots the Drug War
President Trump Declares the Opioid Crisis a National Emergency
According to Gallup, American Support for Cannabis Legalization is at an All-Time High
Opioid Crisis Official; Insys Therapeutics Billionaire Founder Charged; Walgreens Stocks Narcan
FDA Blocks More Imports of Kratom, Warns Against Use as a Treatment for Opioid Withdrawal
Past articles: 2015 • 2016 • 2017 👀
U.S. Senate Minority Leader Chuck Schumer (D-NY) has come out in support of federal cannabis decriminalization, just in time for 4/20:
The Minority Leader of the Senate is making it official the day before 4/20: He's down with legal weed. In an exclusive interview with VICE News, Sen. Chuck Schumer (D-NY) confirmed he is putting his name on legislation that he said is aimed at "decriminalizing" marijuana at the federal level. For Schumer, this is a shift. While he has backed medical marijuana and the rights of states to experiment with legal sales of pot, what he is proposing is a seismic shift in federal drug policy.
"Ultimately, it's the right thing to do. Freedom. If smoking marijuana doesn't hurt anybody else, why shouldn't we allow people to do it and not make it criminal?" Schumer said.
The legislation should be available within a week or so, and would remove cannabis (still listed as "Marihuana") from the Drug Enforcement Administration's list of Schedule I substances. States would then be free to regulate or continue to prohibit the plant. Cannabis advertising would be regulated as are alcohol and tobacco advertising. (Also at NPR, CNN, The Washington Post, and CNBC, as well as Reason taking a shot at Schumer for not doing it sooner.)
A majority of Americans support the legalization of cannabis, including, for the first time, a majority (51%) of Republicans, according to Gallup. Nine states and the District of Columbia have legalized cannabis for recreational use. 29 states, D.C., Guam, and Puerto Rico have legalized medical use of cannabis, and another 17 states have legalized the use of cannabidiol (CBD). Cannabis became available for recreational purposes in California on January 1.
Synthetics now killing more people than prescription opioids, report says
Synthetic opioids such as fentanyl have overtaken prescription opioids as the No. 1 killer in the opioid epidemic, according to a new report.
The report, published Tuesday in the journal JAMA [DOI: 10.1001/jama.2018.2844] [DX], calculated the number and percentage of synthetic opioid-related overdose deaths in the United States between 2010 and 2016 using death certificates from the National Vital Statistics System. The researchers found that about 46% of the 42,249 opioid-related overdose deaths in 2016 involved synthetic opioids such as fentanyl, while 40% involved prescription drugs.
That's more than a three-fold increase in the presence of synthetic opioids from 2010, when synthetic drugs were involved in approximately 14% of opioid-overdose deaths.
Related: Heroin, Fentanyl? Meh: Carfentanil is the Latest Killer Opioid
Study Finds Stark Increase in Opioid-Related Admissions, Deaths in Nation's ICUs
U.S. Life Expectancy Continues to Decline Due to Opioid Crisis
Purdue Pharma to Cut Sales Force, Stop Marketing Opioids to Doctors
The More Opioids Doctors Prescribe, the More Money They Make
Two More Studies Link Access to Cannabis to Lower Use of Opioids
FDA approves powerful new opioid in 'terrible' decision
The Food and Drug Administration approved a powerful new opioid Friday, despite strong criticism and accusations that it bypassed its own advisory process to do it.
The new drug, Dsuvia, is a tablet that goes under the tongue. It is designed for use in the battlefield and in other emergency situations to treat intense, acute pain.
Known generically as sufentanil, it's a new formulation of a drug currently given intravenously. Critics say it will be incredibly easy for health workers to pocket and divert the drug to the illicit drug market and because it is so small and concentrated, it will likely kill people who overdose on it.
"This is a dangerous, reckless move," said Dr. Sidney Wolfe senior adviser of Public Citizen's Health Research Group. He questions whether there's need for yet another synthetic opioid when the U.S. is in the throes of an opioid overdose crisis.
Sufentanil is described as 5 to 10 times more potent than fentanyl and 500 times as potent as morphine. Carfentanil is 100 times more potent than fentanyl, but is only approved for the veterinary use of tranquilizing large animals. Sufentanil is the strongest opioid painkiller available for use in humans.
Cannabis and kratom? Exercise caution!
Also at STAT News, NPR, and The Hill.
See also: People on front lines of epidemic fear powerful new drug Dsuvia
Related:
Opioid Addiction is Big Business
Heroin, Fentanyl? Meh: Carfentanil is the Latest Killer Opioid
Study: Legal Weed Far Better Than Drug War at Stopping Opioid Overdose Epidemic
President Trump Declares the Opioid Crisis a National Emergency
Study Finds Stark Increase in Opioid-Related Admissions, Deaths in Nation's ICUs
FDA Blocks More Imports of Kratom, Warns Against Use as a Treatment for Opioid Withdrawal
Opioid Commission Drops the Ball, Demonizes Cannabis
U.S. Life Expectancy Continues to Decline Due to Opioid Crisis
FDA Labels Kratom an Opioid
Two More Studies Link Access to Cannabis to Lower Use of Opioids
"Synthetic Opioids" Now Kill More People than Prescription Opioids in the U.S.
U.S. Opioid Deaths May be Plateauing
Study finds CBD effective in treating heroin addiction
For their study, published Tuesday in the American Journal of Psychiatry, [Yasmin] Hurd and her colleagues looked at 42 adults who had a recent history of heroin use and were not using methadone or buprenorphine.
Recruited from social services groups, halfway houses and treatment centers, the participants had used heroin for an average of 13 years, and most had gone less than a month without using. They had to abstain from any heroin use for the entire trial period.
The participants were divided into three groups: one group given 800 milligrams of CBD, another 400 milligrams of CBD and another a placebo. All the participants were dosed once daily for three consecutive days and followed over the next two weeks.
During those two weeks, over the course of several sessions, the participants were shown images or videos of nature scenes as well as images of drug use and heroin-related paraphernalia, like syringes and packets of powder that resembled heroin. They were then asked to rate their craving for heroin and their levels of anxiety.
A week after the last administration of CBD, those who had been given CBD had a two- to three-fold reduction in cravings relative to the placebo group. Hurd said the difference between the two CBD groups was insignificant. The research team also measured heart rate and cortisol, the "stress hormone," and found that the levels in those who got CBD were significantly lower than those who hadn't received the drug
Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals With Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled Trial (DOI: 10.1176/appi.ajp.2019.18101191) (DX)
Related: Study Finds That Legalized Medical Cannabis Led to a Decline in Medicare Prescriptions
Study: Legal Weed Far Better Than Drug War at Stopping Opioid Overdose Epidemic
Opioid Commission Drops the Ball, Demonizes Cannabis
Two More Studies Link Access to Cannabis to Lower Use of Opioids
(Score: 5, Informative) by NotSanguine on Tuesday April 03 2018, @10:22PM (3 children)
Of what we already knew.
Nice to see it in the press though.
Oh, and fuck you, Jeff Session!
No, no, you're not thinking; you're just being logical. --Niels Bohr
(Score: 2) by takyon on Tuesday April 03 2018, @10:43PM (2 children)
It's mesmerizing to see the failed Drug War in action. There are a number of easy ways to help alleviate the opioid crisis, but they will always remain just out of reach.
[SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
(Score: 5, Insightful) by NotSanguine on Tuesday April 03 2018, @10:55PM
Yup. Like a car crash happening in slow motion. In this case a 45 year car crash.
I hope you're wrong about alleviating the situation, but I'm not holding my breath.
It's as if we examined the issue from every angle, Identified potential reactions, then picked the one that not only doesn't address the issue, but does the most harm while we're at it. Sigh.
No, no, you're not thinking; you're just being logical. --Niels Bohr
(Score: 3, Insightful) by Anonymous Coward on Wednesday April 04 2018, @12:06AM
"Failed"? For whom? Certainly not the policy makers and the people they serve... Simply ask *cui bono*. There is no mystery, it is strictly business, and advertising (propaganda) works. This "opioid crisis" sure is nasty.. All those white boys dyin'! Yeah, it's easy to alleviate, but where's the money in that? Besides, we need the distraction from our political corruption and fraud. Sorry, but that's how the psychopaths you put charge operate...
(Score: 1, Interesting) by Anonymous Coward on Tuesday April 03 2018, @10:45PM (2 children)
Over the time period covered in the studies, the medical profession in the U.S. increasingly made getting a 'daily opioid dose' via prescription an arduous process. As every doctor feared having their license to practice seized by the DEA, each patient had to do things like sign contracts limiting at which pharmacy they could get prescriptions filled, take drug tests every few months to prove they were taking their prescription and not taking street drugs (at the patients' expense), and sometimes just having their prescriptions dropped completely and not given new ones.
Of course people are increasingly going to stop jumping through those damn hoops, and go try weed! Especially where it's legal now. No insurance forms, no doctor visits past the first one to get the card/prescription, no one presuming you're a junkie. None of this has anything to do with whether opioids are better or worse than marijuana at actually controlling the pain.
Why not study how many people in the non-legal states are, when they can no longer get an opioid prescription, just blow their brains out: https://medium.com/@ThomasKlineMD/suicides-associated-with-non-consented-opioid-pain-medication-reductions-356b4ef7e02a [medium.com]
(Score: 5, Interesting) by takyon on Tuesday April 03 2018, @11:22PM (1 child)
A friend of mine got an opioid prescription a couple of weeks before surgery earlier this year. I think it was oxycodone/Percocet. I called a few pharmacies for him and they all gave pretty evasive answers until one pharm tech admitted that they tell people who call that the drugs are not in stock because they fear getting robbed. He couldn't get the prescription filled at CVS, Walgreen's, etc. even after driving to several locations. He ended up giving up on it AFAIK and sticking with aspirin or acetaminophen, but you could imagine the desperation one would have if they had more severe pain.
The CIA and U.S. military have sustained or tolerated [theguardian.com] Afghanistan's opium crop. And not all of it ends up in Europe. [latimes.com]
You have stories like this:
Opioids Don't Beat Other Medications For Chronic Pain [npr.org]
Maybe cannabis tolerance could also be an issue, but that should go away much more quickly if you stop, and you don't have a chance of overdosing either.
Meanwhile, if you want to stick with opioids, that may mean turning to heroin... fentanyl.... carfentanil [wikipedia.org]...
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(Score: 0) by Anonymous Coward on Wednesday April 04 2018, @01:14AM
cannabis tolerance takes a long time to build and it take a similar time to wear off
(Score: 2) by fliptop on Tuesday April 03 2018, @11:15PM (10 children)
Last November, the second time my friend's son got out of rehab, he swore up-and-down he was done w/ drugs. But he still smoked b/c, as he told me, "it's just pot."
In February she buried him after he overdosed again. He was twenty-three years old. Heroin addiction is a horrible, all-consuming beast.
Our Constitution was made only for a moral and religious people. It is wholly inadequate to the government of any other.
(Score: 1, Insightful) by Anonymous Coward on Tuesday April 03 2018, @11:26PM (9 children)
You seem to anecdotally be linking pot smoking with heroin relapse. From everything I've seen I would say smoking pot would actually lessen the chance of a relapse, similar to how smokers need chewing gum or SOMETHING to replace the habit.
I'm sorry your friend had to go through that, yet another sign of the times where people seek escapism because reality seems too bleak. Legalizing all the drugs would vastly reduce the chance of overdosing with reliable products and with less stigma people may be more willing to seek help.
(Score: 4, Interesting) by takyon on Tuesday April 03 2018, @11:44PM (8 children)
I also wondered about that, but I will give fliptop the benefit of the doubt. I think fliptop just meant to say that cannabis is considered such a "light" drug that people don't even think of it in the same way as heroin et al. Despite it being on Schedule I of the Controlled Substances Act. And then fliptop concluded the story.
If you are using opioids recreationally, then cannabis is probably not an effective substitute. So rather than a gateway drug, the victim just returning to using the drug they actually wanted. If you are using opioids for to kill pain, then cannabis could be an effective substitute, although it would better to avoid the opioids from the start. And if cannabis is legal in every state or federally, and people don't lose their jobs over it, then maybe we'll have a good way to stop or slow down the crisis, since many people are getting introduced to heroin through their legitimate opioid prescriptions (the real gateway).
Needle exchanges and supervised injection sites could be a huge help, but the latter is political suicide in the U.S.
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(Score: 2) by takyon on Tuesday April 03 2018, @11:46PM (1 child)
TooHIGH 2 post?
[SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
(Score: 0) by Anonymous Coward on Wednesday April 04 2018, @01:36AM
Umm, you tell us?
(Score: 2) by NewNic on Wednesday April 04 2018, @12:07AM (2 children)
Not sure what point you are trying to make there, but it sounds awfully like a circular argument that "Cannabis is illegal because it is on a list that makes it illegal", not because of any real harm.
Historically, Cannabis is illegal because of racism.
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: 2) by takyon on Wednesday April 04 2018, @12:52AM (1 child)
Point is that it is on Schedule I, deemed the worst of the worst by our government, but kids (and adults) barely even think of it as a drug. It's all a big joke.
[SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
(Score: 3, Interesting) by NewNic on Wednesday April 04 2018, @04:38AM
I don't agree that it is a joke.
What its Schedule 1 listing means is that this (and prior) governments have no regard for facts.
Facts show that it has valuable medical properties. Facts show that it is not addictive. Facts show that legalizing it would promote one of this administration's stated goals: reducing opioid-related deaths and other consequences of opioid abuse.
Facts show that it should be regulated more like alcohol.
But, legalizing cannabis would give a win to the very states that fund the nation, but are hated by Trump, so its not going to happen any time soon. Another failure by Obama!
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: 5, Informative) by NotSanguine on Wednesday April 04 2018, @12:20AM (1 child)
I had spine surgery not too long ago and made sure I had plenty of cannabis on hand, as I wanted to limit the amount of opiods I took for pain.
Most of my pain was related to the incision and tissue damage from rooting around in my spine. For the first couple of days after surgery, cannabis just didn't cut it for pain relief.
Cannabis took the edge off, but stronger (in this case oxycodone) drugs were needed to allow me to sleep. I took full doses of oxycodone every four hours for almost three days and it helped quite a bit, allowing me to sleep and let the incision begin to heal. I was also high off my ass that whole time.
I cut the dose in 1/2 after three days and started stretching out the time between doses. I didn't feel really high from the oxycodone then and started using cannabis as well, which didn't get rid of the pain, but made it so I didn't really care about it.
After five days or so, I tried stopping the opiods altogether, but the pain from my still-healing incision made it difficult to sleep. As such, I took a 1/2 dose before bed and another one when I woke up. That worked well to allow me to sleep and the cannabis allowed me to deal pretty easily with any pain I had when I was awake.
Once the oxycodone was gone (after nine days), I was no longer in much pain and had little desire for more oxycodone.
For the type of treatment (recovery from surgery), the oxycodone was absolutely necessary and cannabis was insufficient. That's anecdotal (obviously), but is, in my mind (even before this surgery), an appropriate use for opioids. Chronic pain on the other hand, was always a bad use case for them.
And as I understand it, the primary issue with dependence/addiction that stems from opioid use is when they are prescribed on an ongoing basis for chronic pain.
Depending on the level of pain, cannabis can absolutely help such folks. The idea that long-term use of opioids not causing dependence is ridiculous on its face, and it makes you wonder how big pharma convinced so many doctors that dependence/addiction shouldn't be the expected outcome.
Acetaminophen (Tylenol) is less than useless in my experience, although ibuprofen (Advil) has been very useful for me. Interestingly, naproxen sofium (Aleve) does absolutely nothing for me, even at prescription doses.
Everyone is different and will have different reactions to the use of various drugs, but thinking that long-term use of opioids, to treat chronic pain, won't cause dependence/addiction and its associated problems is, at best naive and, at worst, an attempt to create a permanent market for such pain medications.
None of that is new or even particularly profound. That so many who should have known better just went along has been disastrous. More's the pity.
No, no, you're not thinking; you're just being logical. --Niels Bohr
(Score: 0) by Anonymous Coward on Wednesday April 04 2018, @01:19AM
mix acetaminophen ibuprofen and caffeine that stack works better than the sum of it component
(Score: 0) by Anonymous Coward on Wednesday April 04 2018, @02:59AM
Naah, fliptop has a good point. We need to kill those motherfucking drug users before they kill themselves. Once a drug user, always a drug user. Kill them all!!!eleven!1!
(grin)