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posted by fyngyrz on Tuesday April 03 2018, @08:24PM   Printer-friendly
from the let's-be-blunt-here dept.

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


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  • (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)

      by takyon (881) <{takyon} {at} {soylentnews.org}> on Tuesday April 03 2018, @10:43PM (#662223) Journal

      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.

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      • (Score: 5, Insightful) by NotSanguine on Tuesday April 03 2018, @10:55PM

        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.

        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

        by Anonymous Coward on Wednesday April 04 2018, @12:06AM (#662261)

        "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)

    by Anonymous Coward on Tuesday April 03 2018, @10:45PM (#662225)

    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)

      by takyon (881) <{takyon} {at} {soylentnews.org}> on Tuesday April 03 2018, @11:22PM (#662242) Journal

      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.

      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]

      None of this has anything to do with whether opioids are better or worse than marijuana at actually controlling the pain.

      You have stories like this:

      Opioids Don't Beat Other Medications For Chronic Pain [npr.org]

      "We found at the beginning of the study that patients who were enrolled really thought that opioids were far more effective than nonopioid medications," she says. But after about nine months, even with those expectations, the nonopioid group reported their pain was slightly less severe than the opioid group. At the end of the year, "there was really no difference between the groups in terms of pain interference with activities. And over time, the nonopioid group had less pain intensity and the opioid group had more side effects," such as constipation, fatigue and nausea, Krebs says.

      The study didn't explore why, but Krebs' theory is opioid tolerance. "Within a few weeks or months of taking an opioid on a daily basis, your body gets used to that level of opioid, and you need more and more to get the same level of effect," she says. Opioids also carry the risk of addiction and overdose. "This study adds the long-term evidence that shows that opioids really don't have any advantages in terms of pain relief that might outweigh the known harms that they cause," she adds.

      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

        by Anonymous Coward on Wednesday April 04 2018, @01:14AM (#662279)

        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)

    by fliptop (1666) on Tuesday April 03 2018, @11:15PM (#662239) Journal

    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)

      by Anonymous Coward on Tuesday April 03 2018, @11:26PM (#662244)

      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)

        by takyon (881) <{takyon} {at} {soylentnews.org}> on Tuesday April 03 2018, @11:44PM (#662254) Journal

        You seem to anecdotally be linking pot smoking with heroin relapse.

        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).

        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.

        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)

          by takyon (881) <{takyon} {at} {soylentnews.org}> on Tuesday April 03 2018, @11:46PM (#662255) Journal

          So rather than a gateway drug, the victim WAS just returning to using the drug they actually wanted. If you are using opioids TO kill pain, then cannabis could be an effective substitute, although it would BE better to avoid the opioids from the start.

          TooHIGH 2 post?

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          [SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
          • (Score: 0) by Anonymous Coward on Wednesday April 04 2018, @01:36AM

            by Anonymous Coward on Wednesday April 04 2018, @01:36AM (#662286)

            Umm, you tell us?

        • (Score: 2) by NewNic on Wednesday April 04 2018, @12:07AM (2 children)

          by NewNic (6420) on Wednesday April 04 2018, @12:07AM (#662263) Journal

          Despite it being on Schedule I of the Controlled Substances Act.

          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)

            by takyon (881) <{takyon} {at} {soylentnews.org}> on Wednesday April 04 2018, @12:52AM (#662271) Journal

            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.

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            • (Score: 3, Interesting) by NewNic on Wednesday April 04 2018, @04:38AM

              by NewNic (6420) on Wednesday April 04 2018, @04:38AM (#662343) Journal

              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)

          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.

          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

            by Anonymous Coward on Wednesday April 04 2018, @01:19AM (#662281)

            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

          by Anonymous Coward on Wednesday April 04 2018, @02:59AM (#662313)

          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)

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