By Marcus Bachhuber,
The harms from long-term use of opioid painkillers are clear. In 2014
alone, there were almost 19,000 overdose deaths involving these
medications. The New York Legislature, like legislatures around the
country, is struggling to find ways to help stem the opioid overdose
crisis. They don't have to look far.
In 2014, I authored a study in JAMA Internal Medicine that found the
average yearly rate of opioid painkiller overdose deaths in states with
medical marijuana laws was about 25 percent lower than the average rate
in states without these laws.
In other words, our findings suggested
that the availability of medical marijuana may have led to a decrease in
fatal opioid pain reliever overdoses. While no one would argue that
access to medical marijuana will completely fix the problem, it may
represent a small step in the right direction.
The good news is that, as of January this year, many patients in New
York have access to medical marijuana as a treatment option. The bad
news is that many people who could potentially benefit — including many
with severe, chronic pain—don't qualify under the current statute.
Recently, I saw a patient in my clinic who, because of a brain injury
as a child, walks with a pronounced limp, which puts severe stress on
her right hip, knee, and ankle. Despite intensive physical therapy, over
the years these joints have broken down, causing severe pain. Betty has
tried many medications and therapies, and opioid painkillers are one of
her last options.
Looking for relief, she recently tried marijuana offered to her by a
family member. Much to her surprise, it helped. She was able to get up
and go buy groceries "like a normal person."
But she doesn't qualify for medical marijuana in New York right now
because her pain isn't from "neuropathy" (nerve pain). While medical
marijuana has most commonly been studied in patients with neuropathy, it
has also been studied in other types of severe chronic pain, like what
my patient has.
These studies are small, but they have found that
medical marijuana can provide relief for some patients. But the current
program in New York cuts off access to medical marijuana for any patient
with chronic pain who doesn't specifically have neuropathy.
Medical marijuana is an alternative to opioid painkillers for many
patients like her. Research from other states has found that patients
taking medical marijuana often substitute it for other medications and
that they are interested in safer alternatives to opioids.
A study of
patients with chronic pain already taking opioid painkillers found that
adding medical marijuana improved pain relief, suggesting that medical
marijuana may allow patients to decrease their doses of opioid
painkillers. I've even heard from patients who traveled to Colorado to
buy legal marijuana to wean themselves off of their opioid medications.
While experts continue to debate marijuana's effectiveness in treating
pain, even the harshest critics will admit that it is safer than
long-term opioid painkiller use.
No one would argue that medical marijuana is the right choice for
everyone with severe chronic pain. But this decision should be left to
patients and their health care providers. Patients like the one I
described should have access to this treatment option, especially if it
means providing relief, avoiding the long-term use of opioid
painkillers, and potentially reducing overdose deaths from these
medications.
If the New York Legislature wants to help patients like her while
decreasing our reliance on opioid pain medications, it should pass the
bill (A9514A/S724A) adding severe chronic pain to New York's medical
marijuana program. It's the smart and humane thing to do.
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