A better pain killer: How medical marijuana can fight opioid abuse

By the Editorial Board

 

As Pennsylvania officials continue building a regulated medical-marijuana system, they must consider not only the risks of marijuana abuse, but the risks of opioid abuse — from which, studies suggest, medical marijuana might save some patients.

A study published last summer said the average doctor prescribed an average of 1,826 fewer daily doses of painkillers per year that were filled through Medicare Part D when medical marijuana was available in his state as an alternative way of fighting pain. He prescribed fewer doses of drugs for some other conditions marijuana is sometimes used for, too. But he didn’t prescribe fewer doses of drugs for which marijuana is not a substitute. “This provides strong evidence that the observed shifts in prescribing patterns were in fact due to the passage of the medical marijuana laws,” said the study, conducted by researchers at University of Georgia and published in Health Affairs.

Presumably some of those painkillers that weren’t used would have been opioids.

According to an article in The Atlantic, at least one older study associates medical marijuana with a reduction in opioid-addiction deaths.

Medical marijuana carries risks. The 2016 study notes that prescription drugs require physician monitoring, and stepping away from that monitoring may mean getting less professional attention.

And Dr. Thomas Strouse, medical director of the Resnick Neuropsychiatric Hospital at the University of California, Los Angeles, said marijuana can contribute to psychiatric problems.

Perhaps more to the point, Dr. Strouse said there are no studies that looked at individual patients and showed that you can switch — let alone how. Moreover, pain that responds to one class of drug may not respond to another, so even if switching from opioids to marijuana works for some patients, it won’t work for all.

Under normal circumstances, it might seem wisest to wait for more studies. But Pennsylvania is not in normal circumstances. There is a crisis of opioid addiction. And that addiction often begins with a prescription.

The opioid crisis is killing people, ruining lives, destroying families, and leaving newborn babies in foster care suffering from withdrawal. If there is even a chance marijuana might help some patients avoid this hell, we cannot afford to neglect that prospect.

That doesn’t mean everyone who’s in pain should take marijuana. But if there’s a risk that making medical marijuana too expensive or too hard to get might result in some people becoming opioid addicts, then medical marijuana should be inexpensive and easily available.

In mid-February, Pennsylvania will begin accepting applications for medical marijuana growers and dispensaries, after legislation was passed last spring. Sales are likely to begin in mid-2018.

Regulation is strict; patients will receive cannabis in a pill, oil or vaporized form, not as the plant or in edibles. This is a reasonable restriction, preventing diversion for traditional recreational use, long considered by many a gateway to harder drugs.

It’s quite a turn of events to imagine that a marijuana derivative, prescribed medically, could be a gateway out of addiction for some people.