Opioid drugs are widely prescribed in the United States despite the large field of evidence which suggests they are highly addictive and damaging to the body. They are commonly prescribed to “treat” patients with chronic pain. That being said, there is little evidence of the effectiveness of opioids in managing chronic pain in the long term. There are however volumes of proof of the negative consequences of the widespread availability of these drugs, as the opioid epidemic continues to suffocate America(1).
Since 1996, over half of the United States have legalized the use of medical marijuana for qualifying patients, with the majority of programs identifying severe, chronic pain as a condition which benefits from medical marijuana use. As more and more individuals opt to utilize other methods of pain management, as awareness continues to spread of the risks associated with the use of opioids, conutless researchers and practitioners now endorse medical cannabis as an effective and safe way to manage pain. A new journal article, published by the American Pain Society acknowledges the link between opioids, cannabis, and chronic pain.
In February 2010, the University of California Center for Medicinal Cannabis Research released a report covering a decade-long research investigation. This double-blind, placebo-controlled clinical trial examines the effectiveness of inhaled marijuana. Marijuana is identified in the study as a “first line treatment” for patients with chronic and debilitating pain, who often do not respond to other available medications. Another study which investigated using marijuana as a treatment for patients suffering from multiple sclerosis determined that “smoked marijuana was superior to placebo in reducing spasticity and pain in patients with MS, and provided some benefit beyond currently prescribed treatments.” Marijuana has also been shown to be helpful in treating difficult to treat pain conditions such as HIV neuropathy. A plethora of research to support these findings exists.
Despite the growing evidence, many doctors are still wary to prescribe marijuana as an alternative to opiate treatment. Others are unable to. Doctors should be able to analyze the benefits and risks of medical marijuana therapy as is commonly done with other medications in order to provide patients with the best standard of care possible.
“We have an epidemic of undertreated pain. This suffering is cruel and unnecessary” – Medical Physician Assistant
“Cannabis has the safest therapeutic index of any scheduled drug. It is safer than acetaminophen and NSAIDs… As a physician who has seen the broad scourge of the opiate epidemic decimate towns all over the land, I find this therapeutic substitution not only timely but essential” – Doctor of Internal Medicine
Accidental overdose deaths the leading cause of accidental death in the United States, and many of these deaths are from opiates. In 2014, there were 14,000 overdose deaths due to opiates in the United States This statistic exceeds even that for motor vehicle accidents among people ages 25 to 64. Sales of opioids have quadrupled between 1999 and 2010 and between 2000 and 2014 the rates of death from prescription-opioid overdose nearly quadrupled. The United States holds about 25% of the world’s population but ingests 99% of the world’s hydrocodone((CDC)).
Opioid and cannabinoid receptors are both present in pain signaling regions of the brain and spinal cord and these signaling pathways interact with one another(2). Medical cannabis assists with the upregulation of opioid receptor proteins in the spinal cord. Because opioid and cannabinoid receptors are co-distributed in pain centers. Combination treatment with opiate and cannabis have been proven to be exponentially more effective than with opiates alone and also reduces an individual’s tolerance to opiates. Medical Cannabis has also enabled many opiate patients to effectively wean off of their medications permanently.
Not only can cannabis reduce or replace opioid use in chronic pain patients, but it also has therapeutic value in harm reduction practices and addiction-recovery. Cannabis also treats the symptoms of opioid withdrawal which include muscle spasms, anxiety, agitation, restlessness, and insomnia. Cannabis is safer than many current harm reduction options available to patients. Its utility in the medical system need to continually be addressed so justice is granted to those in need.