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cdc-us-overdose-deaths-2014_jr-5In October, President Obama travelled to West Virginia to draw attention to what he calls an “epidemic” of prescription opioid painkiller and heroin overdoses. Obama told the crowd in Charlestown that, “since 1999, sales of powerful prescription pain medications have skyrocketed by 300 percent. In 2012, 259 million prescriptions were written for these drugs, which is more than enough to give every American adult their own bottle of pills.” As a result there has been a dramatic increase in prescription painkiller and heroin overdose deaths during his tenure. And while the Obama administration announced numerous steps to address the problem, they continue to stand in the way of what may be one of the more effective tools to help deal with the epidemic: the national adoption of medical marijuana.

A working paper from the RAND Corporation this year, Do Medical Marijuana Laws Reduce Addiction and Deaths Related to Pain Killers?, adds to the growing body of research which shows that states which adopted medical marijuana laws have significantly lower rates of opioid overdoses and abuse. According to the working paper:

Our results are intriguing in that we find fairly strong and consistent evidence using difference-in-differences, event study, and synthetic control group methods that states providing legal access to marijuana through dispensaries experience lower treatment admissions for addiction to pain medications. We provide complementary evidence that dispensary provisions also reduce deaths due to opioid overdoses. We estimate even larger effects in states that have both legally protected and active dispensaries.

This study not only looks at the impact of states technically adopting a medical marijuana law, but more importantly, what happens when states actually allow legal dispensaries, which make it possible for large numbers of patients to easily obtain it. They found that when looking at a variety of measures — overdose rates, legal opioid distribution, treatment rates, and self-reported non-medical consumption of painkillers — there was little or no positive impact in states merely adopting medical marijuana laws without real implementation. However, there was a clear positive impact in states that actually allowed medical marijuana dispensaries to operate. This strongly implies it is the ready availability of medical marijuana which actually causes the positive effect on opioid abuse and overdoses and not merely a correlation resulting from some third factor.

Medical marijuana is mainly used to treat pain

Looking at how patients use prescription opioids and medical marijuana, it is easy to understand why this pattern exists. Medical marijuana is mainly used as an alternative for pain management. In states that keep statistics on why patients receive medical marijuana, the treatment of severe pain is by far the most common use for it. For example, in Oregon 92.9 percent of patients registered severe pain as at least one of their qualifying conditions. In Colorado severe pain is a condition for 93.1 percent of medical marijuana patients. In Arizona 90 percent of patients list “severe and chronic pain” as one of their conditions, and for 71 percent of patients it is their only qualifying condition. In addition, studies indicate that for some patients with chronic pain, combining medical marijuana with prescription opioid painkillers may allow them to receive relief with a smaller dose of the painkiller.

Giving some patients the ability to choose medical marijuana for severe pain management instead of prescription opioids has the advantages of much lower toxicity, fewer negative side effects, and being less physically addictive. Consuming a lethal quantity of marijuana is exceptionally difficult, especially compared to overdosing on prescription opioids.

Data shows it is the use of prescription opioids which is helping to drive the recent dramatic increase in heroin overdoses. As President Obama pointed out, “four in five heroin users — new heroin users — started out by misusing prescription drugs; then they switched to heroin.  So this really is a gateway drug — that prescription drugs become a gateway to heroin.” Logically, individuals using medical marijuana for pain treatment instead of prescription opioids are going to be far less likely to get addicted to opioids or end up turning to heroin in search of a stronger, cheaper, or more readily available fix for their opioid addiction.

There is never a single silver-bullet solution to a problem as complex as the recent increase in opioid overdoses. But with a study last year finding that opioid overdoses are a remarkable 25 percent lower in medical marijuana states compared to states without medical marijuana laws, the nationwide implementation of medical marijuana potentially could have a significant positive impact. It is a policy change which has overwhelming public support that might be able to prevent hundreds of deaths.

Unfortunately, President Obama has not only yet to officially embrace this tool, but his administration still actively stands in the way of medical marijuana. Despite having the power to reschedule marijuana without needing to go to Congress, the Obama administration continues to legally classify marijuana as having no accepted medical value and has made no effort to change its official status.

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