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Can Marijuana Help Addicts Kick Opioids?

Late last month Donald Trump’s administration declared the rising death rate from opioid overdoses a national public health emergency. Thirty-three thousand lives were lost to this scourge in 2015, and early reports from the Centers for Disease Control and Prevention paint an even bleaker picture [1] for 2016.

Policymakers working for the president are doubling down on a policy aimed at restricting opioids. But this policy isn’t working. In fact, it might even be contributing to abusers’ switch [2] to more potent drugs such as heroin in recent years. Yet there is an approach that can truly curb the rising rate of overdose deaths that is staring them right in the face: legalizing marijuana.  

According to research [3] published earlier this month in the American Journal of Public Health, Colorado’s legalization of recreational marijuana in 2014 coincided with a 6.5 percent reduction in opioid overdose deaths. The researchers studied the opioid overdose rate in the state from 2000 to 2015, and found that after 14 years of a steady rise in opioid overdose deaths, the rate decreased by an average of 0.7 deaths per month.

This is not the first study to find that marijuana is associated with a drop in the use and abuse of opioids and other dangerous drugs. A 2014 study [4] examined states where marijuana was available for medical use between 1999 and 2010 and found, on average, a 25 percent reduction in annual opioid overdose mortality compared to states in which marijuana was illegal. Researchers at the RAND Corporation found similar results [5] in 2015. And in June of this year, a study of chronic pain patients [6] by the University of California at Berkeley found that 97 percent of patients decreased opioid consumption as a result of using medical marijuana, and 81 percent found marijuana alone was more effective than using both marijuana and opioids.

Clearly some patients require fewer opioids to treat their pain when they have access to marijuana. But Colorado’s encouraging data reflects the impact of recreational marijuana access—not medicinal. These new findings suggest the possibility that people seeking to get “high” on mind-altering drugs, when given the opportunity, tend to choose the safer option—when it’s legal and available from sources other than black market drug dealers. There might even be a pharmacological basis to these findings. Research [7] published in 2013 in the journal Addiction Biology suggests cannabis “interferes with brain reward mechanisms responsible for the expression of the acute rewarding properties of opioids…”  

And a 2017 article [8] by researchers at Mt. Sinai School of Medicine points to animal models that suggest cannabidiol, found in cannabis, might reduce withdrawal symptoms as well as opioid-seeking behavior. This is an area that needs further investigation, but one thing is clear: marijuana availability is associated with a decrease in opioid use, abuse, and overdose.

Opponents of marijuana legalization have claimed for years that marijuana is a dangerous “gateway drug [9]” that leads users to more treacherous and addictive drugs, like heroin. These claims are premised on the fact that most users of heroin, cocaine, and other dangerous drugs also report that they use marijuana. But they also report the use of tobacco and alcohol. Critics of the gateway theory are quick to point out that correlation is not the same as causation. Now there’s evidence of a negative correlation between marijuana and harder drugs. More marijuana correlates with less opioids.

Even proponents of opioid restriction agree that Medication-Assisted Treatment is a useful tool for dealing with opioid addiction. This employs medications such as methadone, suboxone, and naltrexone to wean addicts away from opioids. Marijuana’s potential for medicinal use has been recognized by healthcare professionals—and realized by patients—for many years. Now, it offers the potential for averting and treating opioid abuse.

Rather than a gateway, marijuana may be an off-ramp to opioid abuse. Opponents of marijuana legalization should keep that in mind before they try to close this ramp off.

Dr. Singer practices general surgery in Phoenix, AZ and is a Senior Fellow at the Cato Institute

19 Comments (Open | Close)

19 Comments To "Can Marijuana Help Addicts Kick Opioids?"

#1 Comment By Whine Merchant On November 14, 2017 @ 12:55 am

Sorry – Trumpet’s ‘base’ won’t allow this, and Sessions has already made it clear that science, facts, and logic have no place in the GOP’s vision of Law & Order.

#2 Comment By mrscracker On November 14, 2017 @ 6:35 am

Maybe so but there’s also increasing data suggesting a link between cannabis use and schizophrenia.
Marijuana’s not the worst thing out there but it’s not without risk.

#3 Comment By JeffK On November 14, 2017 @ 7:47 am

My CPA’s son was a heroin addict. He went through ‘rehab’ 2 or 3 times, without success. One of the last times I talked to the father he said his son had been clean for over a year. I asked him how it happened, since the previous rehabs didn’t work. His answer: ‘I kept him stoned every waking moment for 2 months. I put a joint in his mouth when he woke up and kept one there till when he went to bed’.

So…. $50,000 spent on rehab without success. Probably less than $750 spent on pot with success.

I have always said the last thing Big Pharma wants is legal pot. Say goodbye to all of their sleep aids, nausea drugs, anti-anxiety medications and mood enhancers.

Just fire one up and enjoy the day (but don’t operate heavy equipment!).

#4 Comment By Ben James On November 14, 2017 @ 11:27 am

The most dangerous thing about cannabis is running into lazy cops looking for soft targets instead of fighting real crime. Data from the Center for Disease Control makes it absolutely clear that cannabis is far safer to consume than booze or tobacco.

It is about time for our government to get over “Reefer Madness” and remove cannabis from the DEA drug schedule.

“Medical“ Cannabis has been legal throughout the state of California since 1996. Cannabis is now COMPLETELY LEGAL in California, Massachusetts, Maine, Nevada, Colorado, Washington, Oregon, Alaska and Washington DC!

29 US states have legalized cannabis for “medical use”. Uruguay, Peru and Jamaica are now completely legal, Canada will go fully legal in 2018 and Mexico is moving toward full legalization.

Cannabis prohibition criminalizes people for selecting a product that is much safer than alcoholic beverages or tobacco products. Cannabis prohibition is a ridiculous waste of police, court resources and taxpayer funds!!

According to FBI statistics:

100 BILLION a year is currently being spent on “black market” recreational cannabis in the USA and all that money goes to “criminals”.

30 BILLION is lost annually in potential tax revenue.

15 BILLION a year is spent enforcing draconian cannabis laws that make no sense and destroy people’s lives daily.

Data from the Center for Disease Control shows that cannabis is much safer than booze or tobacco!!

Legalize, regulate and TAX!

#5 Comment By Gerry Shuller On November 14, 2017 @ 12:12 pm

Stoners are what stoners do.

#6 Comment By EarlyBird On November 14, 2017 @ 12:51 pm

Mrs. Cracker wrote: “Maybe so but there’s also increasing data suggesting a link between cannabis use and schizophrenia. Marijuana’s not the worst thing out there but it’s not without risk.”

Critical clarification: there is no “link” between marijuana and becoming schizophrenic. It’s that those who are at risk for schizophrenia or other psychosis (typically young adults) are more likely to develop it if they smoke pot or do other drugs.

But it does not in any way CAUSE schizophrenia. Yes, there are risks and downsides, but let’s focus on reality.

#7 Comment By Nikephoros On November 14, 2017 @ 1:24 pm

Sessions is changing his position, if gradually, on this as well. See Today’s Forbes Article, “Sessions: Obama Marijuana Policy Remains In Effect.”

#8 Comment By Andy On November 14, 2017 @ 1:50 pm

“mrscracker says:
November 14, 2017 at 6:35 am
Maybe so but there’s also increasing data suggesting a link between cannabis use and schizophrenia.
Marijuana’s not the worst thing out there but it’s not without risk.”

If that’s true, then why are the percentage of people diagnosed and living in the US with schizophrenia, remained constant between 21 and 26% of the population from when they started tracking it in 1962. Marijuana use in 1968 was 4%, now 52% have at least used it once. Then why would the percentage now be lower than it was in 1962 (26%) and now 21%? The trend actually shows the opposite of what you are claiming. Did it ever occur to you, that maybe they are seeking self medication for their undiagnosed schizophrenia?

#9 Comment By Steve Rafalsky On November 14, 2017 @ 2:27 pm

Hello Dr. Singer,

Here’s a responsible opposing view. Perhaps this will be most pertinent to those among TAC’s readership who hold the Bible as authoritative, being the word of God.

Those of us still alive from the 1960s Woodstock generation, or even from the later 70s and 80s, are aware of an unusual property the psychedelic drugs—grass, hashish, LSD, mescaline, peyote, psilocybin mushrooms, etc—had, which is the ability to send the users of them into the realm of spirits. This ability in marijuana and hashish (a derivative of grass) is well-known to other cultures who use such agents for that very purpose, such as the Hindus in India, Nepal, Sikkim, and Tibet. In Benaras, the main city of Shiva worship, cannabis is such an important part of the religion it is sold in government-run shops. It also has a long history of use in ancient China, Japan, Iran, ancient Europe, and in Africa—all for shamanistic purposes—that is, for facilitating communion with spirits and sundry “deities”.

In ancient times, among the Hebrews, the use of psychedelic agents was called sorcery (Hebrew, kāšaph) and was forbidden as a capital crime against God and the community of worshippers. In the Septuagint (the Greek Old Testament) kāšaph was translated pharmakeia—the use of magic potions. It was forbidden because it brought demonic influence and presence into the tight-knit holy community.

In New Testament times it is the same, at least for the Christian, though many are ignorant of these things, being separated from such practices. In the 60s counterculture generation our teachers (Tim Leary, Richard Alpert, various singers, writers, etc) taught us these were sacraments of the new consciousness that would illumine and liberate humankind, and we fell for it. But our “seers” were deceived, and what we really did was open our collective consciousness (for many did it, including intellectuals, therapists, politicians, the CIA, etc) to an influx of satanic influence and activity. We then exported this into all the world, a true Trojan Horse from Hell.

In the New Testament pharmakeia (translated “sorcery”) is considered equivalent to murder and adultery (Galatians 5:20), and unrepentant practitioners of this activity are forbidden entrance into the Paradise of God prepared for the godly in the eternal age to come (Revelation 21:8; 22:15). Judgment comes upon the end-time political entity symbolically called Babylon in part for exporting it into all the world (Revelation 18:23).

It is true that marijuana, far more potent than it used to be, does have “medicinal” properties. It can psychically detach one from the sensation of pain; it can restore appetite, and enable sleep, to list but a few. It may seem a humane blessing to the terminally ill, tormented, or pain-racked soul. But spiritually speaking—which Christians are attuned to—were I (now 75 years of age) terminally ill with end-stage cancer offered marijuana medicinally to ease my condition, I would refuse it. For what would it profit me to open my mind and heart to the demonic realm when at the very door of death? Not to mention polluting with unclean spiritual presence those visiting at my bedside, through the “contact high”! No, sorcery is to be avoided at all cost. I am no longer deceived as to the nature of the “high” of marijuana or the other psychedelics. (Note: there is legitimate medicinal use of marijuana’s non-psychoactive ingredient CBD, with the THC—its psychoactive ingredient—removed, and which does not get people “high”, so the recent literature has shown.)

It remains that substituting marijuana for opioids will have folks going from the frying pan into the fire, though there may be some short-term benefit. User beware! I say these things for TAC’s Christian readership, as others may not appreciate our understanding.

#10 Comment By Zech Judy On November 14, 2017 @ 3:24 pm

Legalizing marijuana is only the first step. Employers need a “high at work” test. Existing tests only show if someone has been high on marijuana sometime in the last month. Anyone caught with a positive test is fired. This is absurd, as no one cares if you get drunk silly over the weekend.

Bear in mind, “Rat Park” showed unemployment is the kind of thing that leads people to get addicted to opiates in the first place.

#11 Comment By Dan P On November 14, 2017 @ 3:49 pm

Steve Rafalsky,

The idea that the prohibited “sorcery” in scripture refers to drug usage doesn’t stand up to fact, because we actually see “sorcery” when Saul goes to see the Witch of Endor. There is no drug usage described in this passage, but something more similar to what we would call being a medium. So the evidence for this quite frankly bizarre translation just really doesn’t exist.

Of course, using obscure scripture that isn’t often brought up in Church on Sundays is an old tactic when it comes to justifying policy. After all, people tried to pretend that black people had the mark of Cain (a mark described as being on the forehead), that blacks should be slaves because they are descended from Ham (the curse was on Canaan, and was fulfilled during the Israelite conquest of Canaan), and other ridiculous things using obscure scriptures.

#12 Comment By mrscracker On November 14, 2017 @ 4:44 pm

Thanks for the comments regarding marijuana and schizophrenia.
We don’t have a test to identify who is at risk of developing schizophrenia. I wish that were so.
I’d really recommend reading the studies and literature about the link between cannabis use among the young and the onset of psychosis.
Marijuana has changed in potency since the 1960s and 70s. It’s not the milder drug it used to be.

#13 Comment By Dale McNamee On November 14, 2017 @ 5:33 pm

Combatting drug abuse by using another addicting drug is what’s currently wrong with this approach…

All that happens, is that one addiction is replaced with another and while marijuana may not be physically addicting ( I have my doubts ), it’s certainly psychologically addicting…

I’ve been around enough users who can’t function without a joint or a bowl first thing in the morning… And they equally non-functional after doing so…

I wonder if trying to figure out why someone wants or needs to get high ever enters the conversation ?

As for me, I’m working with my doctor on non-opioid alternatives should I need an opioid level painkiller…

As a diabetic, I suffer from intense neuropathy which is crippling… I could have taken Lyrica, but I didn’t want the possible side effects…

I asked my doctor for an alternative to Lyrica.
He came up with Gabapentin, an anti-epileptic medicine that also reduces the pain of neuropathy…

I started with the minimal dose and within 24 hours, my neuropathy pain was cut by 90%.

So why take opioids ?

#14 Comment By JeffK On November 14, 2017 @ 8:15 pm

Steve Rafalsky. This is truly mind boggling: “Were I (now 75 years of age) terminally ill with end-stage cancer offered marijuana medicinally to ease my condition, I would refuse it. For what would it profit me to open my mind and heart to the demonic realm when at the very door of death?”

Demonic realm? Using the bible to justify onerous drug laws that go against scientific and empirical evidence is abhorrent. The most harmful thing about smoking pot is the potential of getting caught. Talk about the Christian Taliban.

I am 61 years old. I am very gainfully employed, work somewhat steadily in the IT industry, and getting ready to retire. I pay taxes (approximately $30K annually) and am generally law abiding. I have children and grand children. I exercise regularly, and can ride dirt bikes with youngsters in their 20’s. I take no prescription drugs at all, and only maybe 4 or 5 times a year take an ibuprofen for a headache. And I partake in marijuana on a regular basis, since I was 15 years old. I believe that sitting at home and lighting one up after a challenging day is my right as an American citizen. Talk about a victimless crime.

20 years from now our children and grandchildren will shake their heads at this insanity. In the meantime tens of thousands of people every year will become entangled with the criminal justice system for a ‘crime’ that harms no one.

Is this insane or what? Legalize it. Tax it. Regulate it. Just like alcohol.

FWIW a friend of mine that lives in the country and doesn’t even smoke grows a few plants every year and gives the harvest to people with cancer or PTSD. Why? Because IT WORKS.

Also, employers complain about not being able to hire qualified people because not enough can pass the drug test. Sure, test for opioids, meth, lsd, etc to disqualify hard drug users. But pot? If java programmers couldn’t find work due to smoking pot then many of the web pages developed in the US wouldn’t exist.

#15 Comment By Youknowho On November 14, 2017 @ 9:17 pm

@Dale, so there are users who can’t function without a joint or bowl first thing in the morning?

Yeah, that is me with coffee.

(Coffee was the reason I voted against Mitt Romney. Did not want the risk of his following Mormon doctrine and banning coffee in the US)

As for Marijuana being a gateway drug, it probably comes from it being sold by the same dealer who sells other drugs, and wants his customers to buy the more expensive stuff..

#16 Comment By mrscracker On November 15, 2017 @ 10:22 am

Youknowho says:

@Dale, so there are users who can’t function without a joint or bowl first thing in the morning?

Yeah, that is me with coffee.”
**********
Me, too.
🙂

#17 Comment By JonF On November 15, 2017 @ 11:58 am

Re: Also, employers complain about not being able to hire qualified people because not enough can pass the drug test.

The employers are perfectly free not to consider positive results for marijuana as a factor in their decision.

#18 Comment By EarlyBird On November 15, 2017 @ 12:07 pm

Steve Rafalsky,

My prayers and good wishes are with you as you move on your path back towards God.

However, there were, indeed, some very sincere God-seekers in’60s counterculture who used drugs as a sacrament. And like so much of that counterculture, and so much of well…anything, most of those who bought into it missed the point entirely and were not looking for God, but seeking external, physical pleasures, and the drugs were an end in and of themselves.

But while they are by no means to be taken lightly, there is nothing about these substances which are in and of themselves “demonic.” It’s all about how and why they are used, and the setting in which they are used. Currently, some licensed professional therapists are administering low doses of MDMA (“Ecstasy”) to end stage cancer patients who are terrified of death, individuals who have not bothered to developed a relationship with their Creator or any spiritual basis for living. Rather than bringing in evil forces, at the end of their lives they are finally able to see beyond this physical realm to a deeper, spiritual truth, let go of their fear and anger, and welcome God for the first time.

There is also other very important work with these drugs for soldiers coming back from the wars crippled from PTSD.

#19 Comment By Dr. Diprospan On November 17, 2017 @ 1:23 pm

Can Marijuana Help Addicts Kick Opioids?
Indeed, many complex systems in the human body work as a combination of gas and brake in the car. You can press on the gas and you can kick the brake. However, the key word in this matter is addiction. This happens when, for some reason, a person does not use the brake and only presses on the gas.
Man is endowed with passions and pain in equal measure. Passion is his driving force, while pain is a protective function.
People who are deprived of pain are simply doomed to perish. Violation of the well-coordinated work of gas and brakes, the violation of a complex balance between pain mediators (histamine, prostaglandins ..) and anti-pain mediators (endorphins,
enkephalins ..) leads to addictions. Dependencies can be treated, but can not be cured. They are treated by substitution. So nicotine dependence is well replaced by food addiction. This is clearly seen against the background of the success of the fight against tobacco smoking… Achieving high productivity has a high price too.
“Unnecessary” people appear, unable to participate in high-tech production.
They receive unemployment benefits from the state and turn into alcoholics. Labor and workaholism are in antagonism with alcohol.
So, why would not poppy give way to hemp in the fields? A good question, but too prosaic for the American conservative.
Trump ace for all kinds of addictions is the Super Idea that gives meaning to the very existence of a person. It seems to me that people communicating on the pages of the AC are busy synthesizing it. We need an answer to the questions: Why do people exist? Do we need each person or not? Is man needed only to obtain pleasure, extract profit from him or he is needed for something else?
Christianity as a civilization is based on pain and sadness. Pain gives meaning and reward for patience. So people belonging to this civilization believe…