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Debating the Impact of Medical Cannabis on the Opioid Crisis
Although still illegal on a federal level, in 2018 Pennsylvania joined 28 other states and the District of Columbia to allow access to medical cannabis. Data increasingly supports the use of cannabis for some serious medical conditions like chronic pain, although randomized trials have been impeded by drug control laws. Could access to medical cannabis impact the opioid epidemic? This was the topic of the most recent “Making the Connections” series presented by Mayes College in connection with the Substance Use Disorders Institute (SUDI).
Joe Schrank, Founder and Program Director, High Sobriety, and Devin Reaves, Executive Director of the Pennsylvania Harm Reduction Coalition, joined Gail Groves Scott, MPH, manager of SUDI, in a colorful conversation. An audience on campus and online got to hear some edgier comments on policy, as well as reasons why reducing harm can be a step towards healing.
The discussion followed an introduction to medical cannabis policy research, which highlighted some of the studies on population-level effects of marijuana laws in the United States. A recent study from researchers at the nonprofit RAND Corporation, found that reductions in opioid-related harms varied in states with regulated access to medical cannabis, with states that implemented broader access, seeing more benefits.
Making the analogy that today’s regulated use of cannabis is to the opioid crisis, as condoms were to the 1980’s HIV-AIDS epidemic, Schrank suggested medical cannabis as a harm reduction strategy for people with an addiction to opioids. After years of working in treatment programs, Shrank was fed up with the 80 percent relapse rates of traditional inpatient “rehab” programs, which require complete abstinence. He created a new model in High Sobriety, located in California, where people who were unsuccessful in traditional programs can recover from their addiction to opioids and other illicit drugs, but still be allowed to use legal cannabis.
Whether medical, or not, cannabis use is not for everyone, said Shrank, who doesn’t use it himself, but noted that it has fewer health risks than alcohol or tobacco. Schrank argued for the “individual’s right to self-determine” their use of substances, as well as their own path to recovery, and noted that the criminalization of marijuana was never a “war on drugs, but a war on people.”
The speakers acknowledged sharp divisions in the addiction recovery field over the legalization of cannabis, especially among traditional “12 step” mutual aid groups, which have historically disapproved of even FDA-approved medications, much less non-approved medical options like cannabis.
Reaves took aim at the disproportionate negative impact of federal drug policy on communities of color. He called for a public health approach to all substance use, even teaching “safer” use, which reduces overdose mortality and the spread of infectious diseases. He no longer views recovery as “binary,” where ”you are either ‘clean’ or ‘dirty’, abstinent or not.”
Differing views on cannabis won’t be resolved easily, whether it is viewed as medicine, a harm reduction tool, or simply a drug of abuse. More research is needed, as well as participation in policymaking by diverse voices. SUDI’s goal is educate both policymakers and healthcare professionals on the latest evidence, even on topics that can be controversial.
“Healthcare professionals want their education on cannabis to come from a credible source, leading USciences to gain approval as a “certification” training provider by the Pennsylvania Department of Health,” said Scott. “The four hour training qualifies physicians to certify patients for the state program and medical professionals to work in dispensaries, but the course is useful for all healthcare providers. In fact, medicinal cannabis was taught here in our pharmacy school for its first 100 years, so perhaps we’ve just come full circle.”
With the reemergence of a U.S. cannabis industry, and an increasing number of state dispensaries that employ licensed healthcare professionals, USciences will be offering more education on cannabis science, business and policy.
View the archived video of Making the Connections: Medical Cannabis and Its Impact on Opioid Use online here.
Selected Citations from the research review:
Hasin, D. S. (2018). US Epidemiology of Cannabis Use and Associated Problems. Neuropsychopharmacology, 43(1), 195–212.
Available free here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3859982/
Powell, D., Pacula, R., & Jacobson, M. (2018). Do medical marijuana laws reduce addictions and deaths related to pain killers? Journal of Health Economics, 58, 29–42. (The RAND 2017 study)
Article about the study: https://www.rand.org/news/press/2018/02/06.html
Bachhuber, M., Saloner, B., Cunningham, C., & Barry, C. (2014). Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010. JAMA Internal Medicine, 174(10), 1668.
Available free here: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1898878
Categories: News, Mayes College of Healthcare Business and Policy, Substance Use Disorders Institute, Event, Research, Faculty,