USA TODAY
The
head of the National Institute on Drug Abuse said there’s no evidence
that marijuana weans people from opioid addiction – and promoting such
treatment might deny people a chance at recovery.
The nation's research agency on drug use wants to assess
cannabis ingredients as possible treatments for more than 2 million
Americans with opioid-use disorder, NIDA Director Nora Volkow said this
week. But there's not any evidence that marijuana works for opioid
addiction, she said.
New York, New Jersey, Pennsylvania and Illinois allow
marijuana as a treatment for addiction to opioids such as heroin,
fentanyl and OxyContin. The Maryland General Assembly is considering a
bill that would add opioid-use disorder to the state's list of
qualifying medical conditions for marijuana.
Volkow said she worries people who substitute marijuana
for the Food and Drug Administration-approved medications
buprenorphine, methadone and naltrexone might be more likely to relapse.
"If you don’t treat it properly, your risk of dying is
quite high," Volkow told the USA TODAY Editorial Board in a wide-ranging
interview. "My main concern is by basically misinforming potential
patients about the supposedly beneficial effects of cannabis, they may
forgo a treatment that is lifesaving."
NIDA has two or three studies planned or underway to
evaluate cannabis ingredients for opioid addiction. Still, Volkow
said, scientific evidence does not support claims that marijuana helps
people kick opioids.
"I’m not saying it’s not possible," Volkow said. "Like
anything else, we do science in order to determine and provide the
evidence of whether it’s effective or not."
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"We're losing the battle" on opioids, said Maryland
Delegate Cheryl Glenn, who sponsored a bill that would allow patients to
take marijuana for opioid-use disorder.
Glenn's bill passed Maryland's Senate. A Maryland House
hearing to amend the bill is scheduled for March 27. The legislation
would require patients to first try other opioid treatments before using
marijuana, a change Glenn opposes.
"My mother died from kidney cancer, and no one told the
doctor he had to try this medication first, second or third,"
Glenn said. "I think the same respect ought to be given when you look at
opioid disorders."
About 47,000 Americans died in 2017 from overdoses of
heroin, fentanyl and other opioids – a "public health crisis of almost
unprecedented scale," said Alan Leshner, chair of a study issued
Wednesday on medication to treat opioid addiction.
The lengthy report from the National Academies of
Science, Engineering and Medicine concludes that many Americans that
could benefit are not getting buprenorphine, methadone and
extended-release naltrexone.
The report cites treatment barriers such as
misunderstanding and stigma toward addiction, lack of education, a
fragmented system of care, regulatory limits and patients' lack of
money.
Adolescents and young adults, rural residents and racial and
ethnic minorities don't have equal access to treatment, according to the
report, sponsored by NIDA and the Substance Abuse and Mental Health
Services Administration.
Regulatory barriers prevent people from getting access to
treatment, the report says. Methadone can be administered only at
opioid treatment program clinics that are accredited and certified
by SAMHSA, but the report says evidence shows delivering methadone
through a medical practice is effective.
Few people who need medicine in prison, jail or under the
supervision of drug court get the treatment they need. But the
treatment can be effective, the report says, citing a 50 percent
reduction in deaths among people on methadone or buprenorphine.
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