Another day, another round of studies suggesting that legalizing marijuana can help mitigate the harms of the opioid epidemic.
This time, one study published last week in the journal Drug and Alcohol Dependence looked at how adult-use legalization impacted opioid prescriptions. And a separate recently published research paper explored how medical cannabis dispensaries affect opioid overdoses.
Both studies bode well for reform advocates who’ve argued that legal marijuana can serve as a safer alternative to prescription painkillers. Here’s what you need to know about each new paper:
1. Adult-use legalization is associated with a decrease in the number of prescriptions, total doses and spending on opioids among Medicaid enrollees.
Researchers examined prescription data for Medicaid enrollees from 2010 to 2017. The team found “no evidence to support the concern that recreational marijuana legalization increased opioid prescriptions received by Medicaid enrollees.”
Rather, implementing a fully legal cannabis system in 2015 was linked to a 32 percent decrease in the total number of opioid prescriptions, a 30 percent decrease in the number of doses and a 31 percent decrease in spending on Schedule III opioids.
2. Deaths from opioid and heroin overdoses are lower in counties where medical cannabis dispensaries operate.
Looking at mortality data from 2009 to 2015, researchers found that counties with medical cannabis dispensaries experienced significantly lower rates of opioid and heroin overdoses, compared to counties without dispensaries.
Specifically, the average mortality rate for any opioid overdose increased by .37 per 100,000 people in counties without dispensaries from 2009 to 2015, while it increased by .07 per 100,000 people in counties with dispensaries during the same time period. Prescription opioid mortality rates “increased by 0.05 in dispensary-counties and rose by .2 in non-dispensary counties,” according to the study.
Mortality rates associated with heroin overdoses increased by .61 per 100,000 people in counties with marijuana dispensaries, while increasing by nearly 1 per 100,000 in non-dispensary counties.
Both new studies come on the heels of yet another round of research on cannabis and opioids issues that came out earlier this month.
See the original article published on Marijuana Moment below:
Legal Marijuana Helps Reduce Opioid Harms, Two More New Studies Reveal
Governor John Hickenlooper signed Senate Bill 74 last week, which will allocate $500,000 per year for the next two years towards combating opioid addiction.
The money will be given to the CU-Anschutz College of Nursing to fund a pilot program, which will focus its efforts on counties who’ve been particularly affected by the opioid epidemic. A specific statute within Colorado’s cannabis legislation allows cannabis tax revenue be used to “treat and provide related services to people with any type of substance use disorder, including those with co-occurring disorders, or to evaluate the effectiveness and sufficiency of substance use disorder services.”
The Southeastern Colorado region contains about 6 percent of the state’s population. However, it accounts for 18 percent of all hospital admissions for heroin abuse. Between 2014 and 2016, drug overdoses in Routt county increased by almost 600 percent. Text within the bill mentions that fatal overdoses have doubled between 2000 and 2015. But between Pueblo and Routt counties, there are a total of four physicians trained in prescribing medication for opioid treatment. The allocated tax dollars would help train more medical professionals in administering treatments.
“…we all know that the opioid problem is impacting every single one of our districts across the state, so I think we are all just trying to help find solutions that will work,” said Representative Daneya Esgar (D-Pueblo) in February after the legislation was approved unanimously in committee. “This isn’t a Pueblo issue. This isn’t a Republican issue. This isn’t a Democrat issue. This is an issue impacting every single of one our districts.”
The program would focus on awarding grants to initiatives that focus on treatment, mental health services, and medical care given to patients suffering from addiction. A grant-style approval process for would be used to request funds, which would include an advisory board made up of local and state health officials, and requirements for reporting the results of the grant programs. The data gathered by the grant programs would be presented to the state legislature and the governor’s office.
It is not clear if state health officials are considering cannabis as a possible treatment for opioid addiction or opioid withdrawal. Last year, a study showed a decrease in opioid prescriptions in states who had legalized medical marijuana, and an increase in patients using medical marijuana to treat pain conditions instead of opioid painkillers. While public health experts are looking to curb addiction and fatal overdoses, cannabis could be a non-fatal and less addictive alternative. The CDC estimates that the nation spends $72 billion on opioid abuse annually, and deaths from opioids had quadrupled since 1999.
Colorado’s new program is set to launch on or before January 2018. Any unused funds at the end of the fiscal year would rollover to the following year, and the CU-Anschutz College of Nursing advisory board will have the latitude to accept additional funds in the forms of donations and gifts that would directly benefit the program. Thanks to the Comprehensive Addiction and Recovery Act of 2016, created during the Obama Administration, the state legislature was able to help initialize the program.
By now the perceptions that cannabis is a gateway to harder drug use and a depressed life have been quashed. Public opinion supports cannabis legalization while the federal government is still trying to make the case that cocaine, methamphetamine, and about 50 opiates and opioids are less dangerous and more medically beneficial than cannabis. Arguments based on fear, ignorance, money, racism and dogma justify abominable views but do little to save lives.
Fighting the War on Drugs with harm reduction as a goal opposed to incarceration and shaming is generally accepted as a more humane and respectful way to deal with the opiate addiction crisis in the United States but is eschewed in favor of mandatory minimum sentences and civil forfeiture. It’s already been proven that cannabis can help folks get off crack cocaine; the notion that less harmful substances can be replaced with safer alternatives is not new.
In America, children are being called on to save their overdosing parents and send them to jail. Across the Atlantic harm reduction is a way of life and not the theory or experiment that Americans believe it to be. According to Harm Reduction International’s website,
“Harm reduction forms an integral component of HIV and drug policy and programmes within most Western European countries. Almost every country with reported injecting drug use has key harm reduction interventions in place. Several countries also include drug consumption rooms, syringe vending machines and the prescription of injectable OST and pharmaceutical heroin among their harm reduction interventions.“
On this side of the pond any progress we had been making stalled with the ascension of Supreme Leader Trump and his merry band of billionaires. They are poised to strip away addiction services and fill private prisons with the low-hanging fruit of drug offenders (minorities). That’s American Economics for you.
Led by Prince’s untimely passing, a surge of overdose deaths attributed to the very powerful and very FDA-approved opioid Fentanyl, which is regarded as less dangerous than cannabis by the Controlled Substances Act has not done anything to curb the enthusiasm of drug manufactures. Now would seem like a primo time to consider whether a substance 50-100 times more powerful than morphine is overkill. Instead one maker of the drug donated $500,000 to defeat cannabis legalization in Arizona last November showing just how brash, ignorant and insensitive Big Pharma can be.
Prescription drug prices continue to rise and pound prices for cannabis are steadily falling. It’s just a big money hustle for the approved drug dealers of the world. A new study presented by Ashley C. Bradford and W. David Bradford states,
“In the past twenty years, twenty-eight states and the District of Columbia have passed some form of medical marijuana law. Using quarterly data on all fee-for-service Medicaid prescriptions in the period 2007–14, we tested the association between those laws and the average number of prescriptions filled by Medicaid beneficiaries. We found that the use of prescription drugs in fee-for-service Medicaid was lower in states with medical marijuana laws than in states without such laws in five of the nine broad clinical areas we studied. If all states had had a medical marijuana law in 2014, we estimated that total savings for fee-for-service Medicaid could have been $1.01 billion. These results are similar to those in a previous study we conducted, regarding the effects of medical marijuana laws on the number of prescriptions within the Medicare population. Together, the studies suggest that in states with such laws, Medicaid and Medicare beneficiaries will fill fewer prescriptions”
Cannabis consumption reduces dependency on opiates. Whether attempting to get clean through rehabilitation, 12-step programs or sheer white-knuckling self-control the use of cannabis during such an undertaking is thought to be counter-intuitive or blasphemous among the majority. Wayward positions such as those will continue to proliferate until addiction is no longer treated as a crime and the status quo is challenged.
Researchers and political leaders have praised the potential of cannabis as a viable alternative to prescription medicine for years. Even the federal government now believes that the plant could curtail current opioid epidemic trends sweeping the country.
People looking for hard proof surrounding this movement can refer to a recent study published in the Journal of Pain Research. Analysts and researchers from the Bastyr University Research Institute, Department of Medical Research, Center for the Study of Cannabis and Social Policy and Center for Medical Cannabis Education joined forces to survey cannabis consumers based in various locations around the US.
The sample consisted of 2,774 individuals, sourced from social media and medical dispensaries in Washington (state). In order to qualify, participants must have consumed cannabis in the past 90 days. Most participants were 22-35 years old, held full-time jobs and resided in the US. Over 59 percent identified themselves as a medical cannabis user.
Results and Substitutions
Over 46 percent (1,248) of surveyed individuals admitted to consuming cannabis with the intention to replace (temporarily or permanently) prescription medicine. Researchers collected 2,473 substitutions, which equates to roughly two entries per respondent in the positive group. This finding emphasizes the plant’s ability to curb multiple conditions at once, due to its diverse molecular profile consisting of robust cannabinoids and terpenes.
The top three ailments that were most frequently addressed using the plant includes chronic pain, anxiety and depression. Prescription opioids topped the list at 35.8 percent, while anxiolytics/benzodiazepines and antidepressants accounted for 13.6 percent and 12.7 percent, respectively. Other substitutions that were made by positive respondents include muscle relaxants, anticonvulsants, sedatives and non-opioid based analgesics (NSAIDs).
Although not statistically significant, the majority of affirmative respondents live in states where medical cannabis is legal (47 percent, compared to 44 percent). Based on this comparison, it would be possible to conclude that the need for alternatives to prescription medication in states where the plant is widely prohibited is critical.
Focusing on gender-based characteristics, women were more likely to report such activities; despite more males participating in the study. The results get really interesting when the positive batch is divided into their respective age groups. Survey participants between 22-35 and 36-50 accounted for the majority of affirmative answers.
According to the National Survey on Drug Use and Health (NSDUH), the opioid epidemic is making its way to younger age groups, as around 2.3 million Americans 12 years of age or older reported a substance disorder related to prescription pain medication in 2015.
“These data contribute to a growing body of literature suggesting cannabis, legal or otherwise, is being used as a substitute for prescription drugs, particularly prescription pain relievers,” concluded the authors.
In a separate study published in the journal Drug and Alcohol Review, researchers from the Centre for Addictions Research of British Columbia were able to arrive at similar conclusions. Around 80.3 percent of participants reported substituting pharmaceutical medication for cannabis. In the arena of prescription medication, popular substitutions include Vicodin, Xanax, Ambien and Zoloft.
The opioid epidemic could be described through the life and tragic death of Sarah Fuller.
As a survivor of two car accidents who suffered from fibromyalgia, Fuller experienced debilitating pain that led to an opioid addiction. The drugs eventually caused kidney damage, but she managed to fight her dependency on opioids.
Fuller was clean when she entered the office of Dr. Vivienne Matalon in January 2015. She was still suffering from chronic pain and needed help managing her symptoms. Despite her history of opioid abuse, Dr. Malaton urged Fuller to “let the sales rep start talking about helping her with the pain,” according to Fuller’s father who witnessed the appointment.
The sales rep was from Insys Therapeutics, and the drug for sale was Subsys, a fentanyl equivalent dispensed as an oral spray and typically reserved for the terminally ill. The prescription drug is legal, and was delivered to Fuller’s door.
Fifteen months later, Fuller was dead. She was 32 years old. Her cause of death was recorded as “adverse effect of drugs.” Fuller’s bloodwork showed she had a lethal amount of the prescription drug in her system.
“As far as I’m concerned they killed her,”
said Fuller’s mother, who blames both Dr. Matalon and Insys Therapeutics. Matalon’s license has since been suspended.
The doctor, Insys Therapeutics and their sales reps, the legislation that allows a drug like this to be prescribed, and the politicians who help maintain the status quo can all share the blame for Fuller’s death, as well as their part in the opioid epidemic. Subsys is a Schedule II narcotic, which means the DEA believes it has some therapeutic benefits and is less dangerous than a plant – cannabis. Recently, the FDA awarded Insys with a Schedule II listing for their new pain medication Syndros, a synthetic form of THC, even though marijuana itself is still a Schedule I substance.
Meanwhile, Insys has been actively lobbying to stop marijuana legalization efforts, and is listed among the most dangerous companies fighting legalization to maintain revenue.
Why do pharmaceutical companies care if cannabis is legal?
The reality is pharmaceutical companies see the benefits of cannabis as a non-addictive painkiller that’s inherently safer than opioids. By spending millions of dollars on lobbying to keep marijuana illegal, they can market their own cannabis medication and sell it legally.
The process is made easier by having former DEA officials take jobs at pharmaceutical companies. An investigation by The Washington Post showed that 42 former DEA employees have taken jobs at pharmaceutical companies since 2005, 31 of which have a background in regulation.
“There’s this misconception that illicit markets are run by dangerous criminals, while prescription markets are run by responsible business people, when the truth is that these are not mutually exclusive classifications,”
said Amanda Reiman, former manager of marijuana law and policy at the Drug Policy Alliance.
“Insys has made their money off peddling an extremely dangerous drug, so the idea that they somehow now have this benevolent motivation to provide cannabinoid medication to the public is just a horse and pony show meant to usher in the pharmaceuticalization of cannabis.”
Dr. Lester Grinspoon’s warning
Dr. Lester Grinspoon, a longtime medical marijuana advocate, anticipated the pharmaceutical industry’s attempt to take ownership of cannabis-based medicines.
“The ‘pharmaceuticalization’ of marijuana will only succeed if pharmaceutical products displace marijuana as a medicine,” Grinspoon wrote in 2001. While he seemed to think this was improbable, “due to the plant’s limited toxicity, easy availability, low cost relative to pharmaceuticals, ease with which it can be self-titrated, and remarkable medical versatility,” Syndros is an example of Grinspoon’s “pharmaceuticalization” coming to fruition.
While the Fuller family seeks justice for their daughter, the opioid epidemic continues with some help from the Trump Administration. Tom Marino is suspected to be Trump’s choice for the Drug Czar position. He was a proponent of the Ensuring Patient Access and Effective Drug Enforcement Act, a bill that opponents said would make it more difficult for the DEA to prosecute pharmaceutical companies. He will also have an ally in Attorney General Jeff Sessions, who has vocally opposed medical marijuana as a legitimate medicine. Trump also wants Dr. Scott Gottlieb to run the FDA, who has been paid by opioid manufacturers to speak at events.