Trump’s opioid agency fails to cite marijuana’s benefits, despite mounting evidence

By Paul Armentano

 

Despite the growing body of scientific evidence showing that cannabis access is associated with reductions in opioid abuse and mortality, President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis remains mum on the subject. Their silence is unacceptable. It is time for the administration to stop placing political ideology above the health and safety of the American public.

Just last week, data published online in The American Journal of Public Health reported a 6.5 percent decrease in monthly opioid deaths in Colorado following the enactment of retail cannabis sales. “This reduction represents a reversal of the upward trend in opioid-related deaths in Colorado,” authors concluded.

Their conclusion was hardly unique. Data published in 2014 in JAMA Internal Medicine reports that medical cannabis regulation is associated with year-over-year declines in overall opioid-related mortality, including heroin overdose deaths. Specifically, medicalization states experienced a 20 percent decrease in opioid deaths as compared to non-medicalized states within one year.

This decrease climbed to 33 percent by year six. A 2015 study published by the National Bureau of Economic Research linked the establishment of state-licensed  dispensaries to reductions in opioid deaths. Traffic fatalities involving opioid-positive drivers have also fallen in states that have implemented medical marijuana laws.

Cannabis medicalization is associated with a reduction in opioid-related hospitalizations. According to a 2017 study published in the journal Drug and Alcohol Dependence, legal medical cannabis states experienced a 23 percent drop in hospitalizations related to opioid dependence and a 13 percent decline in hospitalizations due to overdose.

Patients in states where marijuana is legal use far fewer prescription drugs than do those in jurisdictions where it is prohibited. According to a pair of recent studies published in the journal Health Affairs, the passage of medical cannabis regulations results in a significant drop in Medicare and Medicaid-related prescription drug spending. 

Separate studies find that many registered medical cannabis patients diminish their use of pharmaceuticals. For instance, a 2017 University of New Mexico study reported that state registrants often reduced or even eliminated their prescription drug intake over time, while non-registrants with similar medical conditions did not. A study assessing state-qualified patients in Illinois concluded that many subjects consumed cannabis “intentionally to taper off prescription medications.”

A 2017 analysis of Canadian-registered cannabis patients reported that a majority of subjects self-reported substituting marijuana for prescription drugs, particularly opioids, benzodiazepines, and anti-depressants. A separate review of over 1,500 state-qualified patients in New England similarly determined that patients typically used medical cannabis as a replacement for opioids, anti-anxiety drugs, and sleep aids. 

Another recent study finds that the opening of medical marijuana dispensaries is associated with a “20 percentage point relative decrease in painkiller treatment admissions over the first two years of dispensary operations.”

To date, over 10,000 communications have been sent to Trump’s Opioid Commission asking its members to consider this growing and compelling body of scientific literature. Yet, to date, the Commission’s sole response to these requests has been to suggest that marijuana “is associated with higher rates of opioid-abuse disorder and prescription drug misuse” — an allegation that was recently rejected by the National Academy of Sciences, which, in a January 2017 review of some 10,000 peer-reviewed studies, failed to identify even one “good or fair-quality systematic review that reported on the association between cannabis use and the initiation of use of opioids.”

No one is opining that cannabis is the sole cure-all for America’s ongoing opioid crisis. Nonetheless, the available data indicates that it may play a potentially valuable role in mitigating this public health emergency. It is time for the administration must set aside its canna-bigotry and to stop placing politics ahead of American lives.